{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:49:40Z","timestamp":1782730180406,"version":"3.54.5"},"reference-count":26,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: The aim of this study was to examine the effects of midwife-led continuity education on fear of childbirth, mode of delivery, and postpartum trauma among primiparous women.  METHODS: A single-blind randomized controlled trial was conducted at Adana City Hospital, Turkey, between December 2023 and November 2024. Ninety-two primiparous pregnant women were enrolled and randomized to an intervention group (n=46) or a control group (n=46). Inclusion criteria were age 18\u201335 years, singleton low-risk pregnancy, Turkish literacy, and no medical or obstetric contraindications to vaginal birth. Women with high-risk pregnancies, psychiatric disorders, systemic diseases, or prior structured childbirth education were excluded. The intervention group received a four-module education program based on the Midwife-Led Continuity of Care Model, while the control group received routine antenatal care.  RESULTS: Baseline childbirth fear scores were comparable between groups. Following the intervention, mean childbirth fear scores were lower in the intervention group than in the control group. One month postpartum, mean City Birth Trauma Scale scores were 5.43\u00b15.69 in the intervention group and 22.93\u00b19.92 in the control group. Vaginal birth occurred in 69.6% of women in the intervention group compared with 24.4% in the control group. Among women who had vaginal births, postpartum fear scores remained lower in the intervention group.  CONCLUSION: Midwife-led continuity education is associated with reduced fear of childbirth, lower postpartum trauma symptoms, and higher vaginal birth rates among primiparous women. These findings support the integration of continuity-based midwifery education into routine maternity care.<\/jats:p>","DOI":"10.1590\/1806-9282.20252084","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:42:38Z","timestamp":1782729758000},"source":"Crossref","is-referenced-by-count":0,"title":["Midwife-led continuity education on fear and birth outcomes in primiparas"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6751-1206","authenticated-orcid":false,"given":"\u00d6zlem","family":"Ko\u00e7","sequence":"first","affiliation":[{"name":"Tarsus University,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0088-4219","authenticated-orcid":false,"given":"\u015eule G\u00f6ky\u0131ld\u0131z","family":"S\u00fcr\u00fcc\u00fc","sequence":"additional","affiliation":[{"name":"\u00c7ukurova University,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","series-title":"WHO recommendations: \u0131ntrapartum care for a positive childbirth experience","year":"2018"},{"key":"ref2","series-title":"WHO recommendations on maternal and newborn care for a positive postnatal experience","year":"2023"},{"key":"ref3","series-title":"Statistics yearbook 2019","year":"2019"},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1080\/02646838.2022.2057938","article-title":"The prevalence and associated factors of fear of childbirth among Turkish pregnant women","volume":"42","author":"G\u00f6k\u00e7e \u0130sbir G","year":"2024","journal-title":"J Reprod Infant Psychol"},{"key":"ref5","first-page":"604","article-title":"Effects of traumatic birth experience and transmission intergenerational","volume":"15","author":"Aydin N","year":"2018","journal-title":"J Hum Sci"},{"key":"ref6","article-title":"Antenatal care management guideline","year":"2018","journal-title":"Ankara: Ministry of Health"},{"issue":"3","key":"ref7","first-page":"2863","article-title":"Comparing the implications of midwifery-led care and standard model on maternal and neonatal outcomes during pregnancy, childbirth, and postpartum","volume":"9","author":"Bagheri M","year":"2021","journal-title":"J Midwifery Reprod Health"},{"issue":"1","key":"ref8","first-page":"1","article-title":"The knowledge and opinions among pregnant women about home birth by midwife-led continuity model of care","volume":"29","author":"Yurtsal ZB","year":"2020","journal-title":"STED"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"104273","DOI":"10.1016\/j.midw.2024.104273","article-title":"Continuity of care as central theme in perinatal care: a systematic review","volume":"141","author":"Baart A","year":"2025","journal-title":"Midwifery"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"105300","DOI":"10.1016\/j.ijnurstu.2025.105300","article-title":"Midwife continuity of care: a systematic review and meta-analysis of case-control and cohort studies","volume":"174","author":"Kuipers Y","year":"2026","journal-title":"Int J Nurs Stud"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"102986","DOI":"10.1016\/j.midw.2021.102986","article-title":"Leadership and management in midwifery-led continuity of care models: a thematic and lexical analysis of a scoping review","volume":"98","author":"Hewitt L","year":"2021","journal-title":"Midwifery"},{"issue":"4","key":"ref12","doi-asserted-by":"crossref","first-page":"e421","DOI":"10.1016\/j.wombi.2023.01.006","article-title":"Exploring women's experiences in a midwifery continuity of care model following a traumatic birth","volume":"36","author":"Tafe A","year":"2023","journal-title":"Women Birth"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz KF","year":"2010","journal-title":"BMJ"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.apnr.2016.07.013","article-title":"The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study","volume":"32","author":"G\u00f6k\u00e7e \u0130sbir G","year":"2016","journal-title":"Appl Nurs Res"},{"issue":"2","key":"ref15","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3109\/01674829809048501","article-title":"Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth","volume":"19","author":"Wijma K","year":"1998","journal-title":"J Psychosom Obstet Gynaecol"},{"issue":"3","key":"ref16","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/j.1365-2850.2011.01694.x","article-title":"The reliability and validity of the Turkish version of the Wijma Delivery Expectancy\/Experience Questionnaire (W-DEQ) with pregnant women","volume":"19","author":"Korukcu O","year":"2012","journal-title":"J Psychiatr Ment Health Nurs"},{"issue":"2","key":"ref17","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3109\/01674820209042791","article-title":"Development of the delivery fear scale","volume":"23","author":"Wijma K","year":"2002","journal-title":"J Psychosom Obstet Gynaecol"},{"key":"ref18","series-title":"Validity and reliability study of the Wijma Delivery Expectancy\/Experience Questionnaire Version B [master's thesis]","author":"Ucar E","year":"2013"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3389\/fpsyt.2018.00409","article-title":"Development of a measure of postpartum PTSD: the city birth trauma scale","volume":"9","author":"Ayers S","year":"2018","journal-title":"Front Psychiatry"},{"issue":"7","key":"ref20","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1080\/01443615.2020.1821354","article-title":"Validity and reliability of the Turkish version of the City Birth Trauma Scale (CityBiTS)","volume":"41","author":"Bayr\u0131 Bing\u00f6l F","year":"2021","journal-title":"J Obstet Gynaecol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.midw.2015.11.016","article-title":"Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment","volume":"34","author":"Ser\u00e7eku\u015f P","year":"2016","journal-title":"Midwifery"},{"issue":"3","key":"ref22","first-page":"115","article-title":"Effect of childbirth preparation training on fear of normal vaginal delivery and delivery type preference: a randomized controlled trial","volume":"10","author":"Masoumi SZ","year":"2016","journal-title":"J Fam Reprod Health"},{"issue":"6","key":"ref23","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1177\/1054773820916984","article-title":"Effects of antenatal education on fear of birth, depression, anxiety, childbirth self-efficacy, and mode of delivery in primiparous pregnant women: a prospective randomized controlled study","volume":"30","author":"\u00c7ankaya S","year":"2021","journal-title":"Clin Nurs Res"},{"issue":"1","key":"ref24","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1186\/s12884-024-06922-0","article-title":"Effect of antenatal education on pregnant women's knowledge, attitude and preferences of delivery mode","volume":"24","author":"El-Shrqawy EH","year":"2024","journal-title":"BMC Pregnancy Childbirth"},{"issue":"6","key":"ref25","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/aogs.13291","article-title":"Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review","volume":"97","author":"Graaff LF","year":"2018","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"1","key":"ref26","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s12884-020-2826-1","article-title":"Effectiveness of midwife-led brief counseling intervention on post-traumatic stress disorder, depression, and anxiety symptoms of women experiencing a traumatic childbirth: a randomized controlled trial","volume":"20","author":"Asadzadeh L","year":"2020","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302026000402217&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T10:42:41Z","timestamp":1782729761000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302026000402217&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0104-42302026000402217"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20252084","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20252084"}}