Tocophobia or severe fear of childbirth is rising in
frequency. More than 6% of women, and
some men, experience tocophobia during pregnancy. This leads to an increase in obstetric
interventions including preterm birth, emergency cesarean section, or cesarean section
at maternal request. Severe postpartum
fear of childbirth and trauma anxiety has also been reported.
Studies, primarily in Europe, over the past decade
demonstrate an increase in evidence that Haptotherapy might be effective in
reducing fear of childbirth in pregnancy women.
What is Haptotherapy and is there a way childbirth educators can
incorporate aspects into their classes?
Haptonomy is a typical Dutch form of therapeutic assistance therapy
discovered by Dutch physiotherapist Frans Veldman, and first used in oncology. Haptotherapy is the field of application of Haptonomy. Haptonomy is being in connection with someone
in a non-judgmental way. Practitioners
work to establish an environment of acceptance and calm, peace and tranquility
so that the client can let go and begin trusting their own inner wisdom. It involves listening, accepting,
sharing. In some instances, touch
relaxation or simply holding hands leads to the calming of the client and
activating their inner resources. The goal is for the client to develop inner
security, self-awareness and self-confidence.
The most recent Dutch study is examining a standard haptotherapeutical treatment
for pregnant women (and their partners) with severe fear of childbirth, implies
teaching a combination of skills in eight one hour sessions. The internet group
follows an eight-week internet course containing information about pregnancy
and childbirth comparable to childbirth classes. The control group has care as
usual according to the standards of the Royal Dutch Organisation of Midwives
and the Dutch Organization of Obstetrics and Gynaecology.
Click here to read the full study.
Included are
singleton pregnant women with severe fear of childbirth, age >= 18 year,
randomised into three arms: (1) treatment with haptotherapy, (2) internet
psycho-education or (3) care as usual. The main study outcome is fear of
childbirth. Measurements are taken at baseline in gestation week 20-24,
directly after the intervention is completed in gestation week 36, six weeks
postpartum and six months postpartum. Secondary study outcomes are distress,
general anxiety, depression, somatization, social support, mother-child
bonding, pregnancy and delivery complications, traumatic anxiety symptoms,
duration of delivery, birth weight, and care satisfaction.
Sessions include
a getting to know each other opportunity, awareness and presence in pregnancy,
identification of cause of fear of childbirth,
desensitization of body anatomy as well as hospital procedures through education,
practicing correct pushing techniques, working with contractions and dealing
with labor pain, labor rehearsals, and finally introduction to birth of the
placenta and first days postpartum.
Haptotherapy has
dynamic similarities to childbirth education classes. One might even call them “old school”
childbirth education where educators had
the time to take the time to listen to the clients and their partners and
confront fears one by one.
They say you
cannot go home again, but it looks like we are….with a different name.
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