QR-Based Virtual Tour and Childbirth Outcomes

Childbirth is a unique experience that affects maternal health physiologically, emotionally, and socially, serving as a significant step in the transition to motherhood. Primiparous women, in particular, often experience fear during pregnancy due to both their anticipation of holding their baby and concerns about the challenges and difficulties they may face during labor. Studies show that fear of childbirth is higher in primiparous women compared to multiparous women and can cause emotional and psychological distress in daily life.

The main causes of fear of childbirth include lack of knowledge about the labor process, inability to tolerate pain, panic, lack of trust in healthcare providers, doubt in vaginal delivery, fear of interventions such as episiotomy or laceration, and concerns about the health of the baby or mother. Additionally, negative birth stories shared in social environments can increase anxiety.

Research indicates that preparation for childbirth can reduce fear and increase active participation in the labor process. When women feel psychologically and physiologically prepared, they are more likely to have a positive birth experience. Furthermore, childbirth self-efficacy-confidence in the ability to cope with labor pain and achieve vaginal birth-is directly associated with birth outcomes. Higher self-efficacy increases perceived control, reduces the need for surgical interventions, and improves postpartum satisfaction.

This study aims to evaluate the effect of a QR code-based virtual tour of the delivery room on childbirth fear, birth readiness, vaginal birth rates, and postpartum breastfeeding self-efficacy in primiparous women. Participants between 28 and 40 weeks of gestation will be provided with a three-step virtual tour: (1) Admission and Interventions in the Delivery Room, (2) Virtual Visit of the Labor and TDL Rooms, and (3) Postpartum Care and Breastfeeding Education. Access to the videos will be provided through separate QR codes for each session.

The study will employ a randomized controlled design. The intervention group will watch the QR code-based videos, and pre-test and post-test measurements will be conducted. The control group will not receive any intervention, and parallel measurements will be taken. Measurement tools include the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Version A, Prenatal Self-Assessment Scale - Birth Readiness Subscale, Self-Efficacy for Normal Birth Scale, Birth Beliefs Scale (BBS), Breastfeeding Self-Efficacy Scale (BSES), and Revised Birth Satisfaction Scale (BSS-R).

It is expected that the intervention will reduce fear of childbirth, improve birth readiness and self-efficacy, increase vaginal birth rates, and enhance postpartum breastfeeding satisfaction among primiparous women. Additionally, the study aims to provide an innovative and sustainable model that can contribute to the effectiveness of national initiatives such as Normal Birth Action Plans, Midwifery Clinics, and Antenatal Classes.

The study population consists of primigravida women aged 18-45 attending the Midwifery Clinic at Erzurum City Hospital. The sample size was determined as 100 participants using a priori power analysis and randomly assigned to the intervention and control groups.

• Vaginal Birth Rate [Time frame: Within the first 10 days after delivery.]
• Breastfeeding Self-Efficacy Scale (BSES)-Short Form [Time frame: On the first 10 days postpartum]
• Birth Satisfaction Scale Revised (BSS-R) Form [Time frame: On the first 10 days postpartum]