Evidence mapPaperPMID 40033245Full record

Trial reportBMC pregnancy and childbirth2025

Digital intervention for tokophobia: a randomized controlled trial of internet-based cognitive behavioral therapy on fear of childbirth and self-efficacy among Egyptian pregnant women.

Enas Mahrous Abdelaziz, Afrah Madyan Alshammari, Nadia Bassuoni Elsharkawy, Fatma Ali Oraby, Osama Mohamed Elsayed Ramadan

2 registry-linked trialsAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06640608 nacompletednot on this map

Efficacy of Internet- Based Cognitive Behavioral Therapy Among Women With Fear of Childbirth: A Randomized Controlled Trial

TypeinterventionalSponsorJouf UniversityRan2023 to 2024Enrolled96ConditionsPregnant Women, Fear of Childbirth, Self Efficacy, Cognitive Behavioral TherapyArmsICBT - Internet Based Cognitive Behavioral Therapy
NCT07549204 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

The Effect of a Health Belief Model-Based Solution-Focused Childbirth Preparation Program on Fear of Childbirth, Belief in Normal Birth, Pregnancy Stress, and Mode of Delivery in Primigravid Women

TypeinterventionalSponsorOrdu UniversityRan2026 to 2026Enrolled72ConditionsFear, Stress (Psychology), PregnancyArmsHealth Belief Model-Based Solution-Focused Childbirth Preparation Education, Standard Antenatal Education (Pregnancy School)
3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Enas Mahrous AbdelazizDepartment of Psychiatric Mental Health Nursing, College of Nursing, Jouf University, Sakaka, Jouf, 72388, Saudi Arabia.ORCID http://orcid.org/0000-0002-5748-6887
Afrah Madyan AlshammariDepartment of Maternal and Child Health Nursing, College of Nursing, Jouf University, Sakaka, Al-Jouf, 72388, Saudi Arabia. amshammari@ju.edu.sa.ORCID http://orcid.org/0009-0008-1481-014X
Nadia Bassuoni ElsharkawyDepartment of Maternal and Child Health Nursing, College of Nursing, Jouf University, Sakaka, Al-Jouf, 72388, Saudi Arabia.ORCID http://orcid.org/0000-0002-3316-7312
Fatma Ali OrabyDepartment of Obstetrics and Gynecological Health Nursing, Faculty of Nursing, Innovation University, 10th of Ramadan, 44629, Egypt.
Osama Mohamed Elsayed RamadanDepartment of Maternal and Child Health Nursing, College of Nursing, Jouf University, Sakaka, Al-Jouf, 72388, Saudi Arabia. omramadan@ju.edu.sa.ORCID http://orcid.org/0000-0002-9616-8590

Funding

This research is funded by the Deanship of Graduate Studies and Scientific Research at Jouf Uni-versity through the Fast-Track Research Funding Program
6 · The paper itself

Abstract

backgroundTokophobia affects up to 14% of pregnant women globally and is linked to high cesarean rates, particularly in Egypt. This study evaluated the efficacy of a culturally adapted Internet-based Cognitive Behavioral Therapy program on fear of childbirth and maternal self-efficacy among Egyptian pregnant women.

methodsA randomized controlled trial was conducted in Damanhur City, Egypt, involving 96 pregnant women with moderate to severe tokophobia. Participants were randomly assigned to an intervention group (n = 48) receiving a six-week program via WhatsApp or a control group (n = 48) receiving routine antenatal care. The intervention included cognitive restructuring, exposure therapy, relaxation techniques, and psychoeducation grounded in Bandura's Self-Efficacy Theory. Outcomes were assessed using the Childbirth Attitude Questionnaire and Childbirth Self-Efficacy Inventory at baseline and post-intervention.

resultsPost-intervention, the intervention group demonstrated a significant reduction in fear of childbirth scores (mean decrease: 14.32 ± 5.55; p < 0.001) and an increase in maternal self-efficacy (mean increase: 38.3 ± 35.7; p < 0.001). Large effect sizes were observed for both fear reduction (η²=0.876) and self-efficacy enhancement (η²=0.600). The control group showed no significant changes.

conclusionThe culturally adapted Internet-based Cognitive Behavioral Therapy program significantly reduced tokophobia and enhanced maternal self-efficacy, supporting its integration into perinatal care. These findings align with Bandura's Self-Efficacy Theory and suggest the potential of digital interventions in improving psychological outcomes, especially in resource-limited settings. IMPLICATIONS FOR PRACTICE: Integrating the program into routine antenatal care could provide accessible, cost-effective support for women experiencing tokophobia, potentially reducing unnecessary cesarean sections and informing health policy regarding the effectiveness of the ICBT program. Future research should assess long-term outcomes and generalizability in diverse populations.

trial registrationThe study was registered on ClinicalTrials.gov under the identifier (NCT06640608) on October 15, 2024.

Indexed as

Cognitive Behavioral TherapyFearInternet-Based InterventionParturitionPhobic DisordersPregnant PeopleSelf EfficacyAdultEgyptFemaleHumansPregnancyPrenatal CareYoung AdultEgyptian pregnant womenFear of childbirthInternet-based cognitive behavioral therapyRandomized controlled trialSelf-efficacyTokophobia

Identifiers

PMID40033245
PMCPMC11877725

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.