Feasibility and evaluation of a Patient Pathway Video showing healthcare facilities in women undergoing elective caesarean section – a pseudorandomised trial (Preprint)

BACKGROUND Caesarean section (CS) is a common way of giving birth in Sweden and indications also include primary or secondary fear of childbirth. Preoperative anxiety is common in women undergoing CS, often exacerbated by a sense of loss of control. An informational video can assist in mental preparation, possibly mitigate anxiety and increase postoperative satisfaction. At our hospital, no such video has previously been used. OBJECTIVE We aimed to evaluate the feasibility of a Patient Pathway Video (PPV) showing healthcare facilities, and to investigate anxiety in women undergoing CS for the first time. METHODS This feasibility trial was a prospective, pseudorandomised, parallel group, controlled trial with a 1:1 randomisation ratio conducted at the Central Hospital of Karlstad, Sweden. Eligible women were to undergo elective CS for the first time, without pre-existing significant comorbidity. All participants followed the standard operating procedure. Women randomised to the video watched the informational video after their midwife consultation at the specialised prenatal care unit. Participants were included by convenience during the active, 14-month study period. Primary outcomes were feasibility, patient anxiety, and overall impression of the video. Secondary outcomes were exploratory and included information on complications and obstetric recovery. RESULTS From September 2023 to October 2024 a total of 31 women were included, 17 were randomised to watch the video and 14 were controls. At the 3-month follow-up, 16 women in the PPV group provided feedback on the movie, 13 (81%) of which had a positive experience of the movie. Their qualitative feedback on how the video was helpful was themed: visualisation of the healthcare facilities; complementary information; and assistance in mental preparation. The anxiety levels on enrolment, preoperatively and at postnatal ward discharge was similar, and within normal ranges in both groups. All women had a good obstetric recovery. CONCLUSIONS It is feasible to use an informational video showing the healthcare facilities in a Caesarean section care pathway. The video was deemed helpful by the midwifes, and the women included in our trial. Although, this was not reflected by a mitigation of preoperative anxiety in the PPV group. CLINICALTRIAL The trial was registered in the regional research registry “ResearchWeb.org” no. 283206; https://www.researchweb.org/fouliv/project/283206. The registration includes a project outline.