Effectiveness of Childbirth Self-efficacy Promotion Among Pregnant Women: A Systematic Review


  • Pennapa Dumminsek Instructor, Boromarajonani College of Nursing Buddhachinaraj
  • Kannika Kantaruksa Associate Professor, Faculty of Nursing, Chiang Mai University
  • Nonglak Chaloumsuk Lecturer, Faculty of Nursing, Chiang Mai University


Effectiveness, Childbirth Self-efficacy Promotion, Pregnant Women, Systematic Review


Childbirth can be a crisis situation with unpredictable outcomes for a woman in labor and her fetus. This causes fear and anxiety for the situation of childbirth. Self-efficacy is a factor affecting women’s self confidence. Therefore, the promotion of childbirth self-efficacy affects a woman’s ability to successfully overcome a crisis situation at childbirth. The purpose of this systematic review was to investigate the effectiveness of childbirth self-efficacy promotion among pregnant women. This was done by searching for randomized controlled trials and quasi-experimental studies regarding the childbirth self-efficacy promotion among pregnant women based on the Bandura and/or Lowe framework which were discussed in both published and unpublished studies in English and Thai languages from 1997 to 2017 and using a systematic guideline developed by the Joanna Briggs Institute (JBI, 2016). Quality assessment and data extraction were undertaken using a critical appraisal form and a data extract form developed by the Joanna Briggs Institute. This systematic search identified a total of seven studies, which met the inclusion criteria. Data were analyzed using meta-analysis of two studies and narrative synthesis of five studies with different types of intervention and different time periods of outcome evaluation.

The findings from a meta-analysis indicated that:

  1. The primary outcome was found, that childbirth self-efficacy promotion significantly enhanced the outcome expectancy (95% CI 11.86, 22.68, p <.001) and the self-efficacy expectancy (95% CI 15.76, 27.75, p <.001). The quality of this evidence was identified at a moderate level.
  2. Secondary outcomes were found, that childbirth self-efficacy promotion significantly affected pain control during labor (95% CI 1.02, 2.15, p<.001) and significantly reduced anxiety among pregnant women (95% CI 0.84, 2.31, p <.001).

The findings from this narrative synthesis found that the promotion of childbirth self-efficacy during pregnancy as well as continuing promotion through pregnancy and labor periods had a positive outcome on childbirth self-efficacy. Evaluating the outcome during pregnancy was more appropriate than during the postpartum period.

            The findings of this systematic review recommend that health personnel should be aware about childbirth self-efficacy promotion in order to enhance childbirth self-efficacy for pregnant women. However, additional primary studies on the effectiveness of childbirth self-efficacy among pregnancy women are required in order to obtain sufficient studies for a meta-analysis which can confirm the effectiveness of childbirth self-efficacy promotion among pregnant women.


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