The Effect of Midwifery-led Counseling on Expectant Fathers’ Fear of Childbirth: A Smartphone- Based Randomized Controlled Trial

Background: Fear of childbirth has been reported in 11-37% of expectant fathers. It has adverse consequences on both the father and his family. The aim of this study was to investigate the effect of midwifery-led counseling on the fear of childbirth among expectant fathers. Methods: : A two-armed parallel design randomized controlled trial was conducted from July to August 2020. Fifty expectant fathers with severe fear of childbirth at the 24th-27th weeks of gestation, who were covered by health centers affiliated to Mazandaran University of Medical Sciences, Iran, were assigned to intervention and control groups (allocation ratio1:1) using permuted block randomization. Participants assigned to the intervention group were engaged in six 60-90-minute sessions (twice a week) in the Skyroom platform. Measures were administered at recruitment, post-intervention, and one-month follow-up. The primary outcome was the change in fear of childbirth score between groups over time. Secondary outcomes were changes in the General Self-Efficacy score as well as changes in the frequency of the preferred type of delivery between groups over time. Results: : Fifty expectant fathers with a mean (SD) age of 31.64 (3.33) years were randomized and 47 finished the trial. In the intention-to-treat analysis, the fear of childbirth score in the intervention group significantly decreased (β= - 11.84; 95% Confidence Interval: -21.90 to -1.78; P=0.021) compared to that of the control group. In terms of secondary outcomes, the intervention group showed a significant increase in General Self-Efficacy compared to the intervention group at one-month follow-up measurement (β= 1.43; 95% Confidence Interval: 0.28 to 2.58; P=0.014). However, the frequency of preferred delivery type was not significantly different between the intervention and control groups (P=0.139). Conclusions: : Midwifery-led counseling can be an effective approach in reducing expectant fathers’ childbirth fear with potential clinical significance. Although the inconclusive results imply more research on this issue. Registration number: IRCT20150608022609N6. Registered 12/04/2019.