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Xu R, Wang J, Li Y, Chen Y, Zhang W, Pan X, Zou Z, Chen X, Huang S. Pre- and postpartum fear of childbirth and its predictors among rural women in China. BMC Pregnancy Childbirth 2024; 24:394. [PMID: 38816809 PMCID: PMC11138059 DOI: 10.1186/s12884-024-06585-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/15/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Fear of childbirth (FOC) can influence both maternal and child health. Research on FOC in China is scarce, especially on rural women. This study aimed to assess pre- and postpartum FOC and its predictors among Chinese rural women. METHODS This was a prospective correlation study. A total of 569 women completed the prenatal questionnaire in the third trimester, and 477 of them completed the postpartum questionnaire within three days after childbirth. Maternal socio-demographic information, clinical information, childbirth self-efficacy and prenatal and postpartum FOC were investigated. FOC was evaluated using the Wijma Childbirth Expectancy/ Experience Questionnaire (WDEQ). Descriptive, bivariate, multivariate linear regression analysis, univariate and multivariate logistic regression analyses were performed. RESULTS The mean pre- and postpartum FOC scores were 64.5 (standard deviation: 25.1) and 64.3 (standard deviation: 23.9), respectively, with 20.8% of women reporting severe fear before childbirth and 18.2% after childbirth. Multivariate linear regression analysis revealed predictors for higher levels of prenatal FOC including higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy (p < 0.05) and the predictors for higher levels of postpartum FOC included unemployed status, lower childbirth self-efficacy, and higher prenatal FOC (p < 0.05). Multivariate logistic regression showed that higher childbirth self-efficacy reduced the likelihood of severe prenatal FOC (OR: 0.99, p < 0.001), while severe prenatal FOC increased the likelihood of severe postpartum FOC (OR: 3.57, p < 0.001). CONCLUSION The rural women have high levels of FOC before and after childbirth, with approximately 20% experiencing severe FOC during both periods. Higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy are predictors of heightened prenatal FOC. Unemployed status, lower childbirth self-efficacy, and higher prenatal FOC are predictors of heightened postpartum FOC. Notably, enhancing childbirth self-efficacy emerges as crucial in mitigating severe prenatal FOC, while severe prenatal FOC significantly increases the likelihood of severe postpartum FOC. The development of targeted intervention strategies for the above factors can help reduce women's FOC level and improve their overall pregnancy and childbirth experience.
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Affiliation(s)
- Rong Xu
- School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China
- Guoyang County People's Hospital, Anhui, China
| | - Jiarun Wang
- School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Yuejie Li
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yujia Chen
- School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Wei Zhang
- School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Xinlong Pan
- School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China
| | - Zhijie Zou
- School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China.
| | - Xiaoli Chen
- School of Nursing, Wuhan University, No. 115 Donghu Road, Wuhan, 430071, Hubei Province, China.
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China.
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Atan SU, Daşıkan Z, Ibis BK, Köprülü C, Donmez EM, Kırcan ND, Ocalan D, Erdogan M. The effect of interventions in vaginal birth on fear of childbirth: A multicentre study. Int J Nurs Pract 2024:e13260. [PMID: 38600750 DOI: 10.1111/ijn.13260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024]
Abstract
AIM This cross-sectional multicentre study aimed to determine the effect of interventions during vaginal birth for fear of childbirth. METHODS In this cross-sectional and analytical study, 852 women who had a vaginal birth between 2019 and 2020 were enrolled. Data were collected using the Descriptive Questionnaire and Wijma Birth Expectation/Experience Scale Version B. RESULTS The mean total Wijma Birth Expectation/Experience Scale Version B score of the women was 97.00 ± 24.24, indicating severe and clinical levels of fear of childbirth. Moreover, 69.4% of the women had clinical, 18.6% had severe and 12% had moderate levels of fear of childbirth. During birth, women who had close supporters, who were allowed to move and who did not undergo amniotomy, enema, perineal shaving and electronic foetal monitoring had a low level of fear of childbirth. As the number of pregnant women in the labour room, frequency of vaginal examinations, duration of delivery/hour, severity of labour pain and negative perception of the approach of health professionals increased, the women's fear of childbirth increased. Fear of childbirth decreased as the frequency of antenatal follow-ups, number of births and satisfaction levels of the women increased (p < 0.05). Low income perception, irregular prenatal follow-up, severe labour pain and a long duration of labour were strong predictors of increased fear of childbirth. Increasing number of births, high birth satisfaction level and positive perception of the approach of health professionals were strong predictors of reduced fear of childbirth. CONCLUSIONS The reduction of interventions in vaginal delivery and support from health care providers during delivery can be effective in reducing fear of childbirth.
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Affiliation(s)
- Senay Unsal Atan
- Faculty of Nursing, Department of Women's Health and Diseases Nursing, Ege University, İzmir, Turkey
| | - Zeynep Daşıkan
- Faculty of Nursing, Department of Women's Health and Diseases Nursing, Ege University, İzmir, Turkey
| | - Berna Kaya Ibis
- Institute of Health Sciences, Department of Women's Health and Diseases Nursing, Ege University, İzmir, Turkey
| | - Cigdem Köprülü
- Institute of Health Sciences, Department of Women's Health and Diseases Nursing, Ege University, İzmir, Turkey
| | - Elmas Mutlugunes Donmez
- Institute of Health Sciences, Department of Women's Health and Diseases Nursing, Ege University, İzmir, Turkey
| | - Nurten Denizhan Kırcan
- Fethiye Faculty of Health Sciences, Department of Women's Health and Diseases Nursing, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Dilek Ocalan
- Faculty of Health Sciences, Midwifery Department, Tokat Gaziosmanpaşa University, Tokat, Turkey
| | - Meryem Erdogan
- Faculty of Health Sciences, Midwifery Department, Sinop University of Health Sciences Faculty of Health Sciences, Sinop, Turkey
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Yin A, Shi Y, Heinonen S, Räisänen S, Fang W, Jiang H, Chen A. The impact of fear of childbirth on mode of delivery, postpartum mental health and breastfeeding: A prospective cohort study in Shanghai, China. J Affect Disord 2024; 347:183-191. [PMID: 38007102 DOI: 10.1016/j.jad.2023.11.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/11/2023] [Accepted: 11/17/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND The prevalence and impact of fear of childbirth (FOC) has not been sufficiently understood. We aimed to investigate the prevalence of FOC among Chinese population and its impact on mode of delivery, postpartum mental health and breastfeeding. METHODS We conducted a prospective cohort study, wherein pregnant women in their third trimester who underwent antenatal assessments at Shanghai Changning Maternity and Infant Health Hospital between September 2020 and March 2021 were recruited. Sociodemographic data of the participants were gathered by self-administered questionnaire, and their FOC was assessed using the Wijma Delivery Expectancy Questionnaire. Participants were followed up to 42 days postpartum. Information regarding their modes of delivery was retrieved from medical records, and data regarding postpartum mental health symptoms and one-month postpartum breastfeeding were obtained through self-administered questionnaires. RESULTS Among 1287 participants, 461 (35.8 %) had high-level FOC (W-DEQ ≥ 66). Logistic regressions showed that women with high-level of FOC had higher rates of caesarean delivery on maternal request (CDMR) (aOR = 1.55, 95 % CI: 1.00-2.41, p = 0.049), a higher incidence of postpartum mental health symptoms (aOR = 1.68, 95 % CI: 1.09-2.59, p = 0.018), lower rates of one-month postpartum exclusive breastfeeding (aOR = 0.33, 95 % CI: 0.16-0.69, p = 0.003) and mixed feeding (aOR = 0.44, 95 % CI: 0.21-0.91, p = 0.028). LIMITATIONS The long-term implications of FOC beyond the immediate postpartum period were not explored in the study. CONCLUSIONS High-level FOC during the third trimester was associated with increased CDMR and postpartum mental health symptoms and reduced breastfeeding establishment. These results underscore the significance of FOC screening and tailored interventions for affected women.
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Affiliation(s)
- Anxin Yin
- School of Public Health, Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Yunmei Shi
- Shanghai Changning Maternity and Infant Health Hospital, Shanghai, China
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sari Räisänen
- School of Health, Tampere University of Applied Sciences, Tampere, Finland
| | - Wenli Fang
- Shanghai Changning Maternity and Infant Health Hospital, Shanghai, China
| | - Hong Jiang
- School of Public Health, Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai, China.
| | - An Chen
- School of Public Health, Zhejiang Chinese Medical University, Zhejiang, China; Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
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Zhong X, Hu R, Afulani PA, Li X, Guo X, He T, Li D, Li Z. Cross-cultural adaptation and psychometric properties of the Chinese version of the Person-Centered Maternity Care Scale. BMC Pregnancy Childbirth 2023; 23:652. [PMID: 37689683 PMCID: PMC10492356 DOI: 10.1186/s12884-023-05959-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND Increasing evidence show that women across the world face unacceptable mistreatment during childbirth. Person-centered maternity care is fundamental and essential to quality of healthcare services. The aim of this study was to translate and determine the psychometric properties of the Person-Centered Maternity Care (PCMC) Scale among Chinese postpartum women. METHODS A cross-sectional study was conducted among 1235 post-partum women in China. The cross-cultural adaptation process followed the Beaton intercultural debugging guidelines. A total of 1235 women were included to establish the psychometric properties of the PCMC. A demographic characteristics form and the PCMC were used for data collection. The psychometric properties of the PCMC were evaluated by examining item analysis, exploratory factor analysis, known-groups discriminant validity, and internal consistency. RESULTS The number of extracted common factors was limited to three (dignity & respect, communication & autonomy, supportive care), explaining a total variance of 40.8%. Regarding internal consistency, the Cronbach's alpha coefficient and split-half reliability of the full PCMC score were 0.989 and 0.852, respectively. CONCLUSIONS The Chinese version of the PCMC is a reliable and valid tool to assess person-centered care during childbirth in China.
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Affiliation(s)
- Xiaoying Zhong
- Department of Nursing, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, China
| | - Rong Hu
- Department of Nursing, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, China
| | - Patience A Afulani
- Department of Epidemiology and Biostatistics, University of California, San San Francisco, California, USA
| | - Xixi Li
- Department of Nursing, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, China Philippines Women's University, Manila, Philippines.
| | - Xiujing Guo
- Department of Nursing, West China Second University Hospital, Sichuan University / Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
| | - Tingting He
- Nephrology department, The Third Hospital of Mianyang, Sichuan Mental Health Center/ The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, China
| | - Dehua Li
- Department of Nursing, West China Second University Hospital, Sichuan University / Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Zuowei Li
- Department of Nursing, The Third Hospital of Mianyang, Sichuan Mental Health Center/ The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, China
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Han L, Wu J, Wu H, Liu J, Liu Y, Zou Z, Liu J, Bai J. Validating the use of the Wijma Delivery Expectancy/Experience Questionnaire in Mainland China: a descriptive, cross-sectional study. BMC Pregnancy Childbirth 2022; 22:931. [PMID: 36510165 PMCID: PMC9743539 DOI: 10.1186/s12884-022-05283-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Fear of childbirth (FOC) is a common psychological problem in Chinese pregnant women. FOC can influence both maternal health and infants' wellness. Special assessment tools for FOC in Mandarin Chinese are currently lacking. The aim of this study was to evaluate the psychometric properties of the Mandarin Chinese of the Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A). METHODS We recruited 364 Chinese pregnant women from April 2021 to July 2021. Translation and cultural adaptation, as well as reliability and validity testing were conducted. Analyses included the content validity, structural validity, criterion-related validity, convergent validity and reliability. The content validity indices were used to assess the content validity of the tool. The structural validity was tested through exploratory factor analysis and confirmatory factor analysis. The Cronbach's alpha coefficient was used to evaluate the reliability of the W-DEQ-A Chinese version. RESULTS The Chinese translation showed excellent similarities and equivalence to the original version, with the satisfactory content validity. Factor analysis indicated 5 factors, accounting for 57% of the total variance. Both criterion-related validity and convergent validity proved to be acceptable. The reliability was tested with a Cronbach's alpha coefficient of 0.911 for the total scale. CONCLUSION The W-DEQ-A Chinese version is a reliable and valid tool to identify FOC in Mandarin Chinese-speaking populations.
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Affiliation(s)
- Lu Han
- grid.49470.3e0000 0001 2331 6153School of Nursing, Wuhan University, Hubei, China
| | - Jiaxin Wu
- grid.49470.3e0000 0001 2331 6153School of Nursing, Wuhan University, Hubei, China
| | - Hengchang Wu
- grid.49470.3e0000 0001 2331 6153School of Public Health, Wuhan University, Hubei, China
| | - Jun Liu
- grid.49470.3e0000 0001 2331 6153School of Nursing, Wuhan University, Hubei, China
| | - Yanqun Liu
- grid.49470.3e0000 0001 2331 6153School of Nursing, Wuhan University, Hubei, China
| | - Zhijie Zou
- grid.49470.3e0000 0001 2331 6153School of Nursing, Wuhan University, Hubei, China
| | - Juan Liu
- grid.49470.3e0000 0001 2331 6153Department of Obstetrics and Gynecology, Zhongnan Hospital affiliated with Wuhan University, Hubei, China
| | - Jinbing Bai
- grid.189967.80000 0001 0941 6502Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA USA
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Lai THT, Kwok ST, Wang W, Seto MTY, Cheung KW. Fear of childbirth: Validation study of the Chinese version of Wijma Delivery Expectancy / Experience Questionnaire Version B. Midwifery 2022; 108:103296. [DOI: 10.1016/j.midw.2022.103296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/24/2022] [Accepted: 02/27/2022] [Indexed: 10/19/2022]
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