Transforming fear of childbirth through narrative: Feasibility and efficacy of a community-based online-offline intervention

Xinchen Chen; Cuiqin Zheng; Mian Pan; Shengbin Guo; Lu Jing; Huijing Liu; Sisi Huang; Chenyin Liu; Pingping Qiu

doi:10.1016/j.midw.2025.104492

Transforming fear of childbirth through narrative: Feasibility and efficacy of a community-based online-offline intervention

Midwifery. 2025 Jun 16:148:104492. doi: 10.1016/j.midw.2025.104492. Online ahead of print.

Authors

Xinchen Chen¹, Cuiqin Zheng¹, Mian Pan², Shengbin Guo², Lu Jing¹, Huijing Liu¹, Sisi Huang¹, Chenyin Liu³, Pingping Qiu⁴

Affiliations

¹ School of Nursing, Fujian Medical University, Fuzhou, China.
² Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
³ Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China. Electronic address: 965912481@qq.com.
⁴ School of Nursing, Fujian Medical University, Fuzhou, China. Electronic address: qiupingping1@fjmu.edu.cn.

PMID: 40532339
DOI: 10.1016/j.midw.2025.104492

Abstract

Background: Fear of childbirth (FoC) is a prevalent negative emotional experience that affects the psychological health of primiparous women. Psychoeducation offers a promising solution, but high-quality evidence underscores the need to evaluate programme feasibility, appropriateness, and acceptability. Developed based on Story Theory and Narrative Transportation Theory, and adhering to the Medical Research Council guidelines, the Stories-Empowered Education for New Parents (SEEN) program seeks to address these concerns by combining community-based online and offline interventions.

Methods: A single-group pre-post study involving 15 primiparous women utilized mixed methods for assessment. Feasibility metrics, including rates of consent, programme completion, and inter-session tasks completion were analysed quantitatively. The perceived appropriateness and acceptability of SEEN were assessed using a visual analogue scale, while the effectiveness of the program was measured through the Fear of Birth Scale (FOBS) and physiological stress indicators. Qualitative data from focus group interviews provided further interpretation of the quantitative findings.

Findings: SEEN achieved a 91 % consent rate and a 94 % program-completion rate, with all participants completing inter-session tasks without reminders. Significant satisfaction and improvements in FOBS scores and physiological stress indicators were reported (p < 0.05). Qualitatively, SEEN was found to be understandable, practical, and effective in utilizing community medical resources, overcoming common barriers such as time and transportation.

Conclusion: SEEN is a feasible, acceptable, and suitable approach for reducing FoC in primiparous women, combining education with empathy-driven narratives to make a significant impact on maternal well-being.

Keywords: Community-Based Psychoeducation; Fear of childbirth; Health education; Maternal health; Narration; Primiparity.