The certainty of evidence is downgraded by high or unclear risk of bias (allocation concealment and blinding).
A Cochrane review [Abstract] 1 included 7 studies with a total of 1357 subjects. Non-pharmacological interventions (psychoeducation, cognitive behavioural therapy, group discussion, peer education, art therapy) reduced caesarean sections (RR 0.70, 95% CI 0.55 to 0.89; 5 studies, n=557; moderate-certainty evidence; psychoeducation in 4 and art therapy in 1 trial). The interventions reduced levels of fear of childbirth, as measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ, scored from 0 to 165; higher score = greater fear), but the reduction may not be clinically meaningful (mean difference -7.08, 95% CI -12.19 to -1.97; 7 studies, n=828; low-certainty evidence).
Date of latest search: 2021-10-11
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