The effect of midwife-led solution-focused approach training on traumatic birth perception, vaginal birth self-efficacy, and mode of birth in nulliparous women: a randomized controlled trial

This study examined the effect of midwife-led solution-focused approach (SFA) training provided to nulliparous pregnant women on their perception of childbirth as traumatic, self-efficacy regarding vaginal birth, and mode of birth. This randomized controlled trial was conducted with 80 pregnant women (experimental 40; control 40) who presented to a state hospital in Türkiye and were between 28 and 32 weeks of gestation. The experimental group received SFA training delivered by a midwife once a week for 4 weeks. Data were collected using the Descriptive Information Form, Traumatic Childbirth Perception, and Vaginal birth Self-efficacy Scales. Traumatic childbirth perception were significantly lower in the experimental group than control group (P < .001), representing a large effect size (η2 = 0.64). Vaginal birth self-efficacy were significantly higher in the experimental group (P < .001), indicating a medium effect size (η2 = 0.08). Although the vaginal birth rate was higher in the experimental group (32.5%) than control group (17.5%), the difference wasn't significant (P > .05); however, it reflected small effect size (Phi = 0.17). Midwife-led SFA training is effective in reducing traumatic childbirth perception and enhancing self-efficacy for vaginal birth, with tendency towards increased preference for vaginal birth. It is recommended that SFA training be more widely incorporated into obstetric care.