The effect of expressive writing on fear of childbirth among nulliparous pregnant women: A randomized controlled trial

Background: Fear of childbirth (FOC) is a common and complicated problem among nulliparous pregnant women. Objectives: The aim of this study was to compare the effects of expressive writing and neutral writing on FOC in nulliparous pregnant women. Methods: A randomized controlled trial was conducted on 90 nulliparous pregnant women referred to selected comprehensive health centers in Isfahan for prenatal care from May 1 to September 30, 2021. The participants were recruited consecutively and randomly allocated to two groups to perform either expressive writing or neutral writing at home for 20 min daily for 7 days. Before and after the intervention, FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire. Paired t-test, independent t-test, and Chi-square were used for statistical analysis. Results: The mean age of pregnant women was 29.93 ± 5.20 and 29.18 ± 5.65 years in the usual and expressive writing groups, respectively. The mean FOC scores of the women in the neutral writing and expressive writing groups were 36.31 ± 7.35 and 35.96 ± 6.80, respectively, at baseline (P = 0.81) and changed to 34.98 ± 8.18 and 31.58 ± 7.99, respectively, at the end of the study (P < 0.04). The paired t-test showed that the mean FOC score of the expressive writing group decreased significantly at the end of the study (P < 0.001), whereas it did not change significantly in the neutral writing group (P = 0.11). Conclusion: Expressive writing can reduce FOC in nulliparous pregnant women and can be used as an effective, low-cost, simple, and accessible method.