Erika Turkstra1, Gabor Mihala2, Paul A Scuffham2, Debra K Creedy3, Jenny Gamble3, Jocelyn Toohill3, Jennifer Fenwick4. 1. Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Australia. Electronic address: e.turkstra@griffith.edu.au. 2. Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Australia. 3. Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia. 4. Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Australia; Gold Coast Hospital, Australia.
Abstract
OBJECTIVE: The rate of caesarean section continues to increase, and there is evidence that childbirth fear is a contributing factor. Insufficient evidence is available on the impact of reducing childbirth fear on health-related quality of life and health service use. We undertook an economic evaluation of a psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia. METHODS:Pregnant women (n = 339) with high childbirth fear were randomised to a midwife-led psycho-education intervention for childbirth fear or to usual care. This paper presents the economic evaluation of the intervention based on health-related quality of life and health service use from recruitment to six weeks postpartum (n = 184). RESULTS: The changes in health-related quality of life after birth (EQ-5D-3L: 0.016 vs. 0.010, p = 0.833, for usual care and intervention) and total health care use cost (AUS$10,110 vs. AUS$9980, p = 0.819) were similar between groups. The intervention did not increase costs; however, in a post hoc analysis, the interventions might be cost-effective for those women with very high childbirth fear. CONCLUSION: This brief psycho-education intervention by midwives did not improve the health-related quality of life of women, and had no impact on overall cost.
RCT Entities:
OBJECTIVE: The rate of caesarean section continues to increase, and there is evidence that childbirth fear is a contributing factor. Insufficient evidence is available on the impact of reducing childbirth fear on health-related quality of life and health service use. We undertook an economic evaluation of a psycho-education counselling intervention offered by midwives to address women's fear of childbirth in Australia. METHODS: Pregnant women (n = 339) with high childbirth fear were randomised to a midwife-led psycho-education intervention for childbirth fear or to usual care. This paper presents the economic evaluation of the intervention based on health-related quality of life and health service use from recruitment to six weeks postpartum (n = 184). RESULTS: The changes in health-related quality of life after birth (EQ-5D-3L: 0.016 vs. 0.010, p = 0.833, for usual care and intervention) and total health care use cost (AUS$10,110 vs. AUS$9980, p = 0.819) were similar between groups. The intervention did not increase costs; however, in a post hoc analysis, the interventions might be cost-effective for those women with very high childbirth fear. CONCLUSION: This brief psycho-education intervention by midwives did not improve the health-related quality of life of women, and had no impact on overall cost.