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Research Paper
- Effects of a one-to-one midwife counseling intervention on fear of childbirth, childbirth readiness, and maternal birth outcomes: a nonrandomized study
- Uri Bang, Hyun Kyoung Kim
- Received February 12, 2026 Accepted October 21, 2026 Published online November 13, 2026
- DOI: https://doi.org/10.4040/jkan.26022 [Epub ahead of print]
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Abstract
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ePub - Purpose
This study examined the effects of one-to-one midwife-led counseling on fear of childbirth, childbirth readiness, and maternal birth outcomes.
Methods
A quasi-experimental, nonequivalent control-group pretest–posttest design was used to evaluate the intervention. A total of 54 pregnant women were allocated to the two groups, and 52 were included in the final analysis. Between August 2024 and August 2025, 52 pregnant women were recruited from a birth center and a public health center in South Korea. The experimental group (n=25) received four individualized midwife-led counseling sessions, and the control group (n=27) attended routine childbirth education. Outcomes were compared between groups using analysis of covariance (ANCOVA) and the chi-square test.
Results
After adjustment for baseline childbirth readiness, ANCOVA showed a significant group effect on fear of childbirth (F=18.14, p<.001, partial η2=.29). The adjusted posttest mean score on the Wijma Delivery Expectancy/Experience Questionnaire, version A, was significantly lower in the experimental group than in the control group. Childbirth readiness did not differ significantly between groups (F=1.04, p=.314). The experimental group had a significantly lower cesarean section rate (4.0% vs. 48.2%) and less frequent use of epidural analgesia, together with higher rates of rooming-in and breastfeeding (all p<.05).
Conclusion
One-to-one midwife-led counseling is associated with lower fear of childbirth and with selected maternal birth outcomes. These findings suggest that individualized midwife counseling may be considered as part of antenatal care to support positive birth experiences. The study was registered with the Clinical Research Information Service, Republic of Korea (registration number: KCT0007006).
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