Internet-based CBT programme can help women suffering from severe FOC

Women expecting their first child but who are experiencing severe fear of childbirth (FOC) stand to dramatically benefit in reducing their anxieties with cognitive behavioural therapy (CBT) delivered via the internet, according to the results of new research.

FOC can have a devastating impact on a nulliparous woman's life, disrupting her work and home routines and even extending to social situations and relationships with people as she is overly consumed by a fear of delivering her first child. Some women suffering from the condition seek out Caesarean sections as an answer to their fears, and up to 25% of pregnant woman have FOC, according to a number of studies. In some cases, the fear is so overpowering it can be defined as an all-out phobia of delivering the baby.

For the new study, researchers took 28 Swedish-speaking women who were expecting their first baby and suffering from severe FOC. The women then actively took part in an internet-based CBT programme that lasted for eight weeks and included elements of psycho-education, breathing retraining, imaginary exposure and cognitive restructuring.

The participants were given homework that had to be submitted weekly and also gave a measurement of their level of fear about delivering their first child - using the Wijma Delivery Expectancy/Experience Questionnaire, at enrolment, during the therapy and after giving birth. A therapist then gave each woman feedback via a secure online system.

The outcome of the feasibility study, which appears in the Journal of Psychosomatic Obstetrics & Gynaecology, showed a statistically significant decrease in the anxieties of the nulliparous women following the online therapy. However, the authors caution that before CBT can be determined as the definitive solution to severe FOC, the results must first be confirmed in randomised controlled studies.

Katri Nieminen, co-author of an article on the study that was published in the journal, said the findings showed that women can gain significant relief from FOC by using CBT and that it could become an effective treatment in dealing with the problem and allowing women to give birth naturally without being consumed by what are mostly irrational fears.

"This study indicates new treatment possibilities for pregnant women suffering from severe fear of childbirth," she said.