Relationship between Primigravid women’s awareness, attitude, fear of childbirth, and mode of delivery preference

Preferences for childbirth delivery and pain relief methods among pregnant women in Vietnam

Background

Understanding childbirth delivery and pain relief method preferences is important as a part of the shared decision-making process between pregnant women and health professionals. This study aimed to examine the preferences for childbirth delivery modes and pain relief methods and factors related to these preferences among pregnant women in Vietnam.

Methods

A cross-sectional survey on pregnant women was conducted in two obstetrics hospitals in Vietnam. Face-to-face interviews using a structured questionnaire were performed to collect information about sociodemographic characteristics, pregnancy characteristics, preferences for different childbirth delivery modes, and pain relief methods. Multivariate logistic regression was employed for determining associated factors with the preferences.

Results

Of 576 pregnant women, 34% of participants preferred cesarean section. Most of the sample did not have any preferences for specific pharmacological pain relief methods (70.1%), while support from partner/relatives was the most preferable non-pharmacological method (61.3%), following by water birth (11.1%) and acupuncture (9.9%). Desire to have another baby, relatives' experience, selection date of birth, and instrumental social support were major drivers of the cesarean section selection. This preference was an important factor in the preference for pharmacological pain relief. Meanwhile, high levels of informational and emotional support were associated with non-pharmacological method preference.

Conclusion

This study highlighted a high preference rate for cesarean section in urban pregnant women in Vietnam. Holistic approaches from family, health facility, and policy should be performed to diminish the cesarean rate preference and promote the use of non-pharmacological pain relief methods during birth.

Mode of delivery preferences: the role of childbirth fear among nulliparous women

Introduction

The increasing Cesarean Section (CS) rates may be attributed to women's increasing requests for elective CS. High Fear of Childbirth (FOC), especially among nulliparous women, may be significantly associated with CS preference without medical indications. The current study aims to investigate the impact of childbirth fear on the mode of delivery preference among nulliparous women.

Methods

A cross-sectional correlational study was performed in the Maternal and Children Hospital (MCH) from the beginning of October 2022 to the end of February 2023 and incorporated a convenience sample of 342 nulliparous women. The data was collected using a self-reported questionnaire comprising participants' demographic and obstetrics characteristics and the FOC questionnaire. A logistic regression model examined the relationship between CS preference and the other independent variables.

Results

The results indicated that 74.3% of the nulliparous women preferred vaginal delivery, while 25.7% preferred Cesarean Section. Concerning childbirth-related fear, the highest mean scores were related to fear of clinical procedures, fear of harming or distressing the infant, and fear of pain 5.19 ± 1.13, 5.12 ± 1.27, and 5.09 ± 1.22, respectively. High FOC was present among 74.6%, moderate in 17.3%, and severe in 6.7% of the participants. Logistic regression analysis showed maternal age and monthly income were the significant sociodemographic determinants of choosing CS as the preferred delivery mode (p < 0.05). Moreover, the participants who had increased fear of harming or distressing the infant, fear from pain, fear from the body's ability to give birth, fear from not being involved in decision-making, and overall FOC had a higher probability of choosing CS as the preferred delivery mode compared to the participants who had lower fear (p < 0.05).

Discussion

Having high FOC increases the CS preference among nulliparous women. Increased fear of harming or distressing the infant, fear from pain, fear from the body's ability to give birth, and fear from not being involved in decision- making seem to be significant dimensions of childbirth fear associated with CS preference among nulliparous women.

Exploring the Relationship Between Childbirth Expectations and Fear Among Primigravida Women in Saudi Arabia

Background Childbirth is a significant life event that is accompanied by fear, particularly among primigravida mothers. However, little is known about the expectations and fears of childbirth of primigravida women in Saudi Arabia. Aim This study aimed to explore expectations and fears of childbirth among primigravidas. Methods An exploratory, descriptive, cross-sectional study involving 369 primigravidas was conducted at antenatal outpatient clinics at the Maternity and Children's Hospital in Tabuk, Saudi Arabia. Results In the current study, most participants were aged 25-34 years 204 (55.3%), married 355 (96.2%), and had secondary or higher education 279 (75.6%). A majority of participants 265 (71.8%) reported financial difficulties and 244 unplanned pregnancies (66.1%), while most were pregnant beyond 30 weeks 254 (66.4%). The results showed that the mean total score on the Wijma Delivery Expectancy Questionnaire (W-DEQ) fear of childbirth scale was 57.56, indicating moderate levels of fear on average among primigravida women, with the highest subscale score for the moment of birth. The mean total score on the Childbirth Expectations Questionnaire (CEQ) childbirth expectations scale was 108.15, also indicating moderate expectations on average, with other significant expectations having the highest subscale score. A significant negative correlation was found between the fear and expectations scales (r=-0.775, p<0.001). Sociodemographic factors such as older age, higher education, income, employment, and planned pregnancy were associated with higher expectations and lower fear, whereas younger age, lower education, income, employment, unplanned pregnancy, and medical issues were associated with higher fear. Conclusions The findings of this study provide valuable insights into the expectations and fears of childbirth of primigravida women in Saudi Arabia. The results could inform healthcare providers and policymakers about the predictors of fear and effective interventions to reduce fear and improve birth experience in primiparous women.