The Effect of a Birth Plan on Anxiety Levels in Chinese Pregnant Women: a Randomised Controlled Trial

Abstract

Objective: To investigate the effect of a birth plan on the anxiety levels of low-risk pregnant women.
Methods: This was a prospective, randomised controlled trial, which targeted at low-risk Chinese pregnant women. Using a standardised randomisation table, subjects were allocated to active intervention and control groups. Active intervention entailed formulation of a birth plan with the assistance of staff. The anxiety levels were measured by the validated self-administered Chinese version of the Spielberger State–Trait Anxiety Inventory and the Edinburgh Postnatal Depression Scale (EPDS) to observe any relationship between anxiety and the postnatal depression. Participants who attended the antenatal health talks held in Tsan Yuk Hospital at or beyond the 20th week of their pregnancy were invited to join the study.
Results: Of the 86 women recruited into the study, 45 (52%) and 41 (48%) were randomised to the active intervention and control groups, respectively. There were no significant differences between the groups for personality trait and anxiety-state scores determined on five occasions, namely: during recruitment, on admission, at delivery, as well as 5 days and 6 weeks later. There was also no significant difference in the EPDS score between the subjects in the two groups, determined on three occasions, namely on day 3, day 5, and week 6 after delivery.

Conclusion: Our findings suggested that the birth plan had no influence on maternal anxiety levels. However, this may be due to our small sample size, which was a limitation of this study. The role and merits of birth plans deserve to be explored further.