The Effects of Positive Birth Experience Sharing and Guided Imagery on Childbirth Self-Efficacy and Fear of Childbirth

Fear of childbirth may negatively affect women's emotional well-being, perceptions of childbirth, and confidence in their ability to cope with labor. Non-pharmacological approaches that promote positive perceptions of childbirth and support women's coping resources may therefore be beneficial during pregnancy. Positive birth experience sharing may provide pregnant women with positive representations of childbirth, while guided imagery may help them mentally rehearse and approach the childbirth experience in a more positive and manageable way.

This study evaluates a combined intervention consisting of positive birth experience sharing and guided imagery in primiparous pregnant women. The intervention is initiated at 26-28 weeks of gestation and is delivered individually and online. During an individual online session, a researcher shares her own positive birth experience and provides participants with an opportunity to ask questions and discuss issues they are curious or concerned about regarding childbirth.

The guided imagery component is based on childbirth-focused guided imagery techniques. The original English-language guided imagery instructions were translated into Turkish and reviewed by the research team for clarity, comprehensibility, and suitability for pregnant women. The finalized Turkish script was subsequently recorded as a standardized audio recording. Participants use this recording independently at home throughout the 10-week intervention period. Daily reminders and a structured follow-up chart are used to support and monitor regular practice.

Assessments are conducted before randomization, after completion of the 10-week intervention, and during the early postpartum period. The study primarily examines changes in fear of childbirth and childbirth self-efficacy during pregnancy and additionally evaluates fear associated with the actual childbirth experience after birth.

Inclusion criteria

Aged 18 years or older Primiparous At 26-28 weeks of gestation at enrollment No maternal or fetal complications during the current pregnancy (e.g., gestational diabetes, hypertension, preeclampsia, intrauterine growth restriction, or congenital anomalies) No mental, hearing, visual, language, or other communication problems that could interfere with participation Able to use WhatsApp® and access the online study procedures Willing to participate in the study and provide informed consent

Exclusion criteria

Development of a maternal or fetal complication during the study Birth before 37 weeks of gestation Withdrawal from the study at the participant's request Failure to complete the post-intervention assessment Failure to perform the guided imagery exercise for three consecutive days (intervention group only)