The effect of high-fidelity simulation based education on self-efficacy and childbirth fear in pregnant women

BACKGROUND: Approximately 14% of women experience severe childbirth fear (tocophobia), influencing delivery choices. High childbirth self-efficacy, or confidence in managing labour, can reduce fear and improve outcomes. High-fidelity simulation-based education may enhance self-efficacy and decrease labour anxiety. This study evaluated its effects on childbirth self-efficacy and fear. METHOD: A parallel-group randomized controlled trial was conducted with sixty primiparous women randomly assigned to simulation-based education or standard prenatal education. Birth expectations and self-efficacy were measured pre- and post-intervention using the Self-Efficacy in Labor Scale (SELS) and Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-A). Data were analyzed using independent and paired t-tests and MANOVA. RESULTS: At baseline, no significant differences were observed between the groups in terms of birth expectations or self-efficacy. However, after the intervention, the intervention group showed a significant reduction in birth fear and a significant improvement in self-efficacy compared to the control group. CONCLUSION: High-fidelity simulation-based birth education significantly improved childbirth self-efficacy and reduced fear of labour. These results suggest that simulation-based education can be a valuable tool in prenatal care, helping expectant mothers feel more confident and prepared for childbirth.