Psychoeducation for psychological issues and birth preparedness in LMICs: A systematic review

Background: Psychological issues usually accompany the pregnancy of first-time mothers and psychoeducational interventions might be effective in addressing these concerns and preparing first-time mothers for childbirth and the postnatal period. This study aimed to identify, analyse and synthesise the components as well as determine the effectiveness of psychoeducational interventions that are used for managing psychological issues and enhancing birth preparedness among primigravid women or couples in LMICs. Method: A systematic search of 12 databases (APA PsycINFO, Emcare, Embase, MEDLINE(R), Ovid Nursing, British Nursing Index, Health and Medical Collection, ProQuest, CINAHL, Cochrane, Hinari and PubMed) was conducted to identify relevant studies published between 1946 and October 2021. Quality of the included studies was appraised by the JBI critical appraisal tool and a narrative synthesis was conducted to analyse data extracted from included articles. The systematic review protocol is registered with PROSPERO (CRD42021237896). Findings: The initial search yielded 8,658 articles. Sixteen articles including seven randomised controlled trials and nine non-randomised trials met the inclusion criteria and were selected and reviewed for quality. Thirty-nine outcomes were measured in the studies including psychological outcomes, birth preparedness outcomes and other outcomes. The design of the interventions included antenatal education that was delivered through lectures, role plays, trainings, and antenatal counselling. All the psychoeducational interventions had a significant effect (p <. 05; Cohen’s d or Hedge’ g = 0.2 to 1.9) on certain psychological outcomes including childbirth attitude, fear of childbirth, depression, fear, and anxiety and birth preparedness outcomes. Interpretation: Although first-time mothers experience a range of psychological issues during pregnancy, psychoeducational interventions were beneficial in addressing their psychological concerns. It would appear that these interventions are less expensive and could be easily implemented in LMICs. However, rigorous research like RCTs are hereby warranted to standardise the interventions and outcome assessment tools