Psychoeducational Intervention for Reducing Childbirth Anxiety among Pregnant Women in Two Hospitals in Owerri: A Cluster Randomised Trial

Childbirth anxiety negatively impacts maternal well-being and the birth experience. Structured psychoeducation may enhance emotional preparedness and coping among first-time mothers. This study evaluated the effectiveness of a psychoeducational intervention in reducing childbirth anxiety among first-time pregnant women attending antenatal clinics in Imo State, Nigeria. A Cluster Randomised Controlled Trial design was used, recruiting 254 participants (127 per group) from Federal Medical Centre Owerri (control) and Imo State Specialist Hospital, Umuguma (intervention) through cluster sampling. At baseline (16–20 weeks of gestation), there were no significant demographic differences between groups. The intervention comprised three structured psychoeducational sessions addressing childbirth processes, coping strategies, and emotional regulation, while the control group received routine antenatal care. Data were collected using a demographic survey and the Beck Anxiety Inventory (BAI), with a content validity index of 0.815 and a reliability coefficient of 0.870. Only 122 intervention and 118 control participants completed the study. At baseline, all participants exhibited morbid levels of childbirth anxiety. At post-intervention, the intervention group was twice as likely to experience reduced anxiety levels compared with controls (RR = 2.08, 95% CI: 1.81–2.38, p = 0.001). Anxiety reduction was significant across women aged 25–31 years (p = 0.004) and among those with secondary and tertiary education (p = 0.005 and p = 0.028, respectively). In conclusion, the psychoeducational intervention effectively reduced childbirth anxiety, particularly among specific age and education subgroups. Integrating structured psychoeducation into routine antenatal care is recommended to enhance maternal psychological well-being and support positive childbirth outcomes.