Effect of Midwifery Students' Continuity of Care on Childbirth Fear and Postpartum Depression: An Individually Randomized Two-Arm Superiority Trial.
6 affiliations
- 1Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
- 2Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- 3Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
- 4Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- 5Centre for Nursing and Midwifery Research, School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
- 6Department of Health Policy and Management, Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Abstract
Introduction
Midwifery continuity of care may improve maternal mental health. Integrating this model into midwifery education may facilitate broader adoption; however, no trials examined its effects on maternal health. We aimed to assess the effect of a midwifery student's continuity of care program on fear of childbirth and postpartum depression (primary outcomes).Methods
In this trial, low-risk women at 26-29 weeks of gestation were recruited from Tabriz health centers from November 2022 to February 2023 and assigned to intervention or control groups using stratified block randomization. Twenty-five final-year midwifery students provided continuity of care (each for one to two women) from pregnancy through postpartum for the intervention group; both groups received usual care. Childbirth fear and depression were assessed using the Wijma Delivery Expectancy/Experience Questionnaire and Edinburgh Postnatal Depression Scale at baseline, and 40-50 days postpartum. Analysis of covariance, adjusted for baseline values, parity, and intended hospital type, was used to compare the groups.Results
All 93 recruited women were analyzed; 50% were primiparous. In the intervention group (n=45), 76% attended≥6 antenatal sessions, and 64% participated in≥3 postpartum sessions provided by the students. The intervention group showed lower mean total fear of childbirth (35.8 vs. 75.8, adjusted mean difference (AMD) -43.2; 95% CI: -52.7 to -33.7) and depression scores (5.3 vs. 11.2, AMD -5.9; 95% CI: -8.1 to -3.7) than controls.Conclusion
The findings support further evaluation and implementation research. However, these findings should be interpreted cautiously considering the single-city design, lack of blinding, and reliance on self-reported outcomes.Trial registration
Iranian Registry of Clinical Trials, IRCT20100414003706N41, registered prospectively on 30 April 2022, https://www.irct.ir/search/result?query = IRCT20100414003706N41.
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BibTeX
@article{jafari2026effect,
title = {{Effect of Midwifery Students' Continuity of Care on Childbirth Fear and Postpartum Depression: An Individually Randomized Two-Arm Superiority Trial.}},
author = {Elham Jafari and Mojgan Mirghafourvand and Shamsi Abbasalizadeh and Shahla Meedya and Leila Doshmangir and Sakineh Mohammad-Alizadeh-Charandabi},
journal = {Health promotion perspectives},
year = {2026},
month = aug,
doi = {10.34172/hpp.45154},
url = {https://europepmc.org/article/MED/42968761},
note = {CC BY},
}
RIS
TY - JOUR
TI - Effect of Midwifery Students' Continuity of Care on Childbirth Fear and Postpartum Depression: An Individually Randomized Two-Arm Superiority Trial.
AU - Elham Jafari
AU - Mojgan Mirghafourvand
AU - Shamsi Abbasalizadeh
AU - Shahla Meedya
AU - Leila Doshmangir
AU - Sakineh Mohammad-Alizadeh-Charandabi
PY - 2026
DA - 2026/08/21
JO - Health promotion perspectives
DO - 10.34172/hpp.45154
UR - https://europepmc.org/article/MED/42968761
AB - Introduction Midwifery continuity of care may improve maternal mental health. Integrating this model into midwifery education may facilitate broader adoption; however, no trials examined its effects on maternal health. We aimed to assess the effect of a midwifery student's continuity of care program on fear of childbirth and postpartum depression (primary outcomes).Methods In this trial, low-risk women at 26-29 weeks of gestation were recruited from Tabriz health centers from November 2022 to February 2023 and assigned to intervention or control groups using stratified block randomization. Twenty-five final-year midwifery students provided continuity of care (each for one to two women) from pregnancy through postpartum for the intervention group; both groups received usual care. Childbirth fear and depression were assessed using the Wijma Delivery Expectancy/Experience Questionnaire and Edinburgh Postnatal Depression Scale at baseline, and 40-50 days postpartum. Analysis of covariance, adjusted for baseline values, parity, and intended hospital type, was used to compare the groups.Results All 93 recruited women were analyzed; 50% were primiparous. In the intervention group (n=45), 76% attended≥6 antenatal sessions, and 64% participated in≥3 postpartum sessions provided by the students. The intervention group showed lower mean total fear of childbirth (35.8 vs. 75.8, adjusted mean difference (AMD) -43.2; 95% CI: -52.7 to -33.7) and depression scores (5.3 vs. 11.2, AMD -5.9; 95% CI: -8.1 to -3.7) than controls.Conclusion The findings support further evaluation and implementation research. However, these findings should be interpreted cautiously considering the single-city design, lack of blinding, and reliance on self-reported outcomes.Trial registration Iranian Registry of Clinical Trials, IRCT20100414003706N41, registered prospectively on 30 April 2022, https://www.irct.ir/search/result?query = IRCT20100414003706N41.
SN - 2228-6497
ER -