Support for pregnant women identified with fear of childbirth (FOC)/tokophobia – A systematic review of approaches and interventions
Abstract
Background providing appropriate care for pregnant women with high or severe fear of childbirth (FOC) is a challenge in midwifery care today. FOC is associated with predisposing anamnestic factors, various sociodemographic and psychosocial characteristics, and may result in serious healthrelated consequences. It is therefore important to establish which interventions may increase a woman's faith in her own ability to cope with labour and birth. Aim to systematically identify and review studies examining interventions for relief of severe fear of childbirth in pregnancy and their underlying conceptual foundation. Methods a systematic literature search was performed following Cochrane Collaboration and PRISMA Statement recommendations. Inclusion criteria were: studies including pregnant women diagnosed with high or severe FOC or who requested a caesarean section due to severe FOC, studies (regardless of design) observing the effect of an intervention addressing FOC, and studies published in English. Publications addressing anxiety or stress were excluded. 377 references were screened by title and abstract. The risk of bias was assessed. Findings 19 articles referring to 15 research projects were included in the analysis. The studies show heterogeneity regarding assessment methods, type, conceptualisation and application of interventions. There is evidence that both cognitive therapy sessions and a theory-based group psychoeducation with relaxation are effective interventions. K…
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There is a need for briefer, cheaper interventions within the healthcare system.
“This is important considering the need for briefer, cheaper interventions within the healthcare system (Striebich et al., Citation2018).”
From The feasibility and acceptability of a single-session Acceptance and Commitment Therapy (ACT) intervention to support women self-reporting fear of childbirth in a first pregnancy. (2023) · cites this paper as Striebich et al., 2018
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Howard, S., Houghton, C. M. G., White, R., Fallon, V., & Slade, P. (2023) · Psychology & Health · doi:10.1080/08870446.2021.2024190 · Cited by 12 · see citing works
“A review by Striebich et al. (2018) highlights relatively limited evidence for psychological interventions and calls for the evaluation of theory-based interventions based on cognitive factors for overcoming fear.”
Background
- Authors
- Striebich, S., Mattern, E., & Ayerle, G. M.
- Affiliations
- Martin Luther University Halle-Wittenberg (DE)
- Hochschule für Gesundheit - University of Applied Sciences (DE)
- Corresponding author
- Striebich, Sabine
- Venue
- Midwifery
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 61
- Pages
- 97-115
- ISSN
- 0266-6138 (ISSN-L)
- OpenAlex
- W2788962344
- Cited by
- 162
- References
- 25
- Citations by year
- 2026: 8 · 2025: 19 · 2024: 30 · 2023: 20 · 2022: 25 · 2021: 26 · 2020: 19 · 2019: 11 · 2018: 4
- FWCI
- 2.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Midwifery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- fear of childbirth, prenatal care, midwifery intervention, cognitive therapy, group psychoeducation, relaxation, cesarean section, self-efficacy, nulliparous women, prenatal anxiety
- MeSH terms
- Adult, Anxiety, Fear, Female, Humans, Pregnancy, Social Support, Delivery, Obstetric, Pregnant People
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