Effectiveness of Midwifery Counseling on Adaptation to Pregnancy, Maternal-Fetal Attachment, and Quality of Life in Unplanned Pregnant Women: A Randomized Controlled Trial

Authors

1 Ferdows paramedical school, Birjand University of Medical Sciences, Birjand, Iran.

2 PhD in Reproductive Health. Department of Midwifery, School of Nursing and Midwifery. Zanjan University of Medical Sciences, Zanjan, Iran.

3 Department of Clinical Psychology, Beheshti Hospital and Zanjan University of Medical Sciences, Zanjan, Iran.

4 Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

5 Department of Midwifery, School of Nursing and Midwifery. Zanjan University of Medical Sciences, Zanjan, Iran.

Abstract

Background: Women with unplanned pregnancy experienced a number of psychological problems. Thus, the present study aimed to examine the effectiveness of midwifery counseling based on cognitive approach in improvement of adaptation to pregnancy, mother-fetal attachment and quality of life among unplanned pregnant women.
Materials and Methods: This pre-test posttest control group single blind study was done on pregnant women who were chosen from the healthcare centers of Zanjan city, Iran.Of 187 women screened for eligibility to participate in the study, 54 unplanned pregnant women met inclusion criteria and were randomly assigned into intervention group or control group. The intervention group received eight weekly group cognitive therapy sessions. The control group received prenatal routine care. The participants answered WHO Quality of Life Questionnaire, Maternal–Fetal Attachment Scale, and Lederman Prenatal Self-evaluation Questionnaire at pretest, posttest, and one-month follow- up periods. 
Results: The two groups were not different in terms of age (p = 0.89), educational status (p = 0.56), and job status (p = 0.31). In addition, they were not different regarding pre-test scores of Lederman Prenatal Self-evaluation Questionnaire (p = 0.27), Maternal–Fetal Attachment Scale (p = 0.22), and WHO Quality of Life Questionnaire (p = 0.37). At posttest and one-month follow- up, the intervention group showed significant improvement in adaptation to pregnancy (p < 0.0001), Maternal-fetal attachment (p < 0.0001), and quality of life (p < 0.0001) than the control group.
Conclusion
Midwifery counseling based on cognitive approach could be an effective approach to improve adaption to pregnancy, maternal-fetal attachment, and quality of life among women who became pregnant unintentionally.

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