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Alizadeh-Dibazari Z, Abbasalizadeh F, Mohammad-Alizadeh-Charandabi S, Jahanfar S, Mirghafourvand M. Childbirth preparation and its facilitating and inhibiting factors from the perspectives of pregnant and postpartum women in Tabriz-Iran: a qualitative study. Reprod Health 2024; 21:106. [PMID: 38997718 PMCID: PMC11241919 DOI: 10.1186/s12978-024-01844-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The World Health Organization recognizes childbirth preparation as an essential component of antenatal care, as it plays a crucial role in reducing maternal mortality and improving women's childbirth experience. Countries worldwide have implemented various interventions to assist women in preparing for childbirth, based on their own resources. This study was conducted with the aim of exploring the perspectives of pregnant and postpartum women on childbirth preparation and the facilitating and inhibiting factors, in Tabriz, Iran. METHODS This qualitative study was conducted with 25 participants, selected purposively among pregnant women in weeks 37 to 40 of gestation and postpartum women within 10 days to 6 weeks after childbirth. Data collection was done through semi-structured, in-depth individual interviews using an interview guide. The data was analyzed using content analysis method with conventional approach. RESULTS The perspectives of pregnant and postpartum women regarding childbirth preparation revealed that factors such as maternal health during pregnancy, having an antenatal care plan, improving health literacy, and developing a birth plan were identified as crucial elements for effective childbirth preparation. Additionally, mental and emotional preparation, support, financial planning, participation in preparation classes, and awareness of childbirth methods were recognized as facilitators. On the other hand, insufficient mental and emotional preparedness, inadequate support, weak antenatal care, information deficiencies, insufficient physical activity, and a lack of a birth plan were identified as barriers. CONCLUSION The findings highlight the multifaceted nature of childbirth preparedness, necessitating the involvement of families, the healthcare system, and the entire community. Utilizing the study results in strategic planning for pre-pregnancy, during pregnancy, and inter-pregnancy care can enhance childbirth preparedness and contribute to achieving Iran's population rejuvenation policy goals.
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Affiliation(s)
- Zohreh Alizadeh-Dibazari
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Abbasalizadeh
- Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Nordin-Remberger C, Wells MB, Woodford J, Lindelöf KS, Johansson M. Preferences of support and barriers and facilitators to help-seeking in pregnant women with severe fear of childbirth in Sweden: a mixed-method study. BMC Pregnancy Childbirth 2024; 24:388. [PMID: 38796427 PMCID: PMC11127315 DOI: 10.1186/s12884-024-06580-2] [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: 07/15/2023] [Accepted: 05/13/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND There are few support interventions for women with fear of childbirth tailored towards type of fears and parity. To inform the future development of an acceptable and relevant intervention for women with severe fear of childbirth, primary objectives were to examine: (1) pregnant women's experiences of and preferences for support and (2) barriers and facilitators to help-seeking. Secondary objectives were to examine if there are any differences based on pregnant women's parity. METHODS Pregnant women with a severe fear of childbirth in Sweden completed an online cross-sectional survey between February and September 2022. Severe fear of childbirth was measured using the fear of childbirth scale. Quantitative data were analysed using descriptive and inferential statistics and free answers were analysed using manifest content analysis. A contiguous approach to integration was adopted with qualitative and quantitative findings reported separately. RESULTS In total, 609 participants, 364 nulliparous and 245 parous women, had severe fear of childbirth. The main category "A twisting road to walk towards receiving support for fear of childbirth" was explored and described by the generic categories: Longing for support, Struggling to ask for support, and Facilitating aspects of seeking support. Over half (63.5%), of pregnant women without planned or ongoing treatment, wanted support for fear of childbirth. Most (60.2%) pregnant women with ongoing or completed fear of childbirth treatment regarded the treatment as less helpful or not at all helpful. If fear of childbirth treatment was not planned, 35.8% of women would have liked to have received treatment. Barriers to help seeking included stigma surrounding fear of childbirth, previous negative experiences with healthcare contacts, fear of not being believed, fear of not being listened to, and discomfort of having to face their fears. Facilitators to help seeking included receiving respectful professional support that was easily available, flexible, and close to home. CONCLUSIONS Most pregnant women with severe fear of childbirth felt unsupported during pregnancy. Findings emphasise the need to develop individual and easily accessible psychological support for women with severe fear of childbirth, delivered by trained professionals with an empathetic and respectful attitude.
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Affiliation(s)
- Carita Nordin-Remberger
- Obstetric and Reproductive Health Research, Department of Women´s and Children´s Health, Uppsala University, Uppsala, 752 37, Sweden.
- Women's Mental Health during the Reproductive Lifespan - WOMHER, Uppsala University, Uppsala, Sweden.
| | - Michael B Wells
- Women's and Children's Health, Karolinska Institute, Solna, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
| | | | - Margareta Johansson
- Obstetric and Reproductive Health Research, Department of Women´s and Children´s Health, Uppsala University, Uppsala, 752 37, Sweden
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Dai J, Shi Y, Guo L, Wang Y, Kong X. Discrepancy in parental fear of childbirth: A scoping review. Midwifery 2023; 126:103830. [PMID: 37769587 DOI: 10.1016/j.midw.2023.103830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Fear of childbirth is a prevalent clinical psychological issue for both mother and father; however, there is a lack of research comparing and summarizing discrepancies in parental fear of childbirth. AIM This study aimed to explore differences in parental fear of childbirth, identify gaps in related research area, and provide directions for future studies. METHODS Original references were searched from six databases by using subject terms associated with fear of childbirth. The guideline of the scoping review framework proposed by Arksey and O' Malley were applied. RESULTS The review covered 203 publications in all. Of them, 181 were maternal studies and 22 were paternal studies. 105 articles examined prevalence and influencing factors ranging from 0.7 % to 89.3 % in mothers and 5 % to 54.3 % in fathers. The current study included 84 influencing factors, 9 of which were common to parents and 75 of which were different, containing fathers' specific influences on fear of childbirth are perceived pregnancy difficulties, perceived birth difficulties, feelings about the upcoming birth, more frequent thoughts of birth in the middle of pregnancy and not attending parent education classes. 12 articles dealt with the experience of fear of childbirth, and the parents' fear of childbirth had 5 common themes, including fear of the birthing process, fear related to the baby, fear of lack of support, fear of postnatal health and life, and adverse psychological problems. But they have different sub-themes. 61 articles on fear of childbirth interventions, including 8 mother-specific approaches and 4 identical approaches for parents, and all of these methods were effective in reducing the prevalence of parental fear of childbirth. CONCLUSION Factors such as marital status, personality, etc., that are specific to mothers can also be applied to paternal fear of childbirth. Cognitive-behavioral therapy and group discussion, which are unique to maternal fear of childbirth, may be attempted for paternal fear of childbirth. In addition, future research should be devoted to developing a specific measurement tool for fathers, studying paternal fear of childbirth in depth from various aspects.
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Affiliation(s)
- Jiayang Dai
- School of Nursing and School of Public Health, Yangzhou University, China
| | - Ya Shi
- School of Nursing and School of Public Health, Yangzhou University, China; School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, England
| | - Lu Guo
- School of Nursing and School of Public Health, Yangzhou University, China
| | - Yuanyuan Wang
- School of Nursing and School of Public Health, Yangzhou University, China
| | - Xiang Kong
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Experimental & Translational Non-coding RNA Research, Yangzhou, Jiangsu Province, China; Department of Obstetrics and Gynecology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.
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Sandström L, Kaunonen M, Klemetti R, Raussi-Lehto E, Aho AL. Factors helping pregnant multiparas cope with fear of birth: A qualitative study. Midwifery 2023; 125:103803. [PMID: 37659151 DOI: 10.1016/j.midw.2023.103803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/17/2023] [Accepted: 08/25/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE This study describes factors helping pregnant multiparas cope with their fear of birth and aims to contribute insight into measures that could be taken to support and develop care for multiparas with fear of birth. METHODS Purposive sampling was used for collecting data from closed discussion forums. An electronic questionnaire included structured background questions and qualitative open-ended questions related to the factors multiparas had found helped them cope with their fear of birth. After excluding respondents in early pregnancy (n = 20), the data consisted of answers from 78 pregnant multiparas from Finland. The data were analysed using inductive content analysis. RESULTS The factors helping pregnant multiparas to cope with their fear of birth included obtaining information, planning ahead, receiving empathic support, dealing with emotions in different ways, and focusing on the positive. CONCLUSIONS The support multiparas receive for their fear of birth from healthcare providers is insufficient and the quality and content of care varies widely. As a result, multiparas have been left to personally take responsibility for coping with their fear. IMPLICATIONS FOR PRACTICE The care for treating fear of birth in multiparas needs to be improved. This requires a critical evaluation of the maternity system, policies, and competence of healthcare professionals who work with pregnant people.
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Affiliation(s)
- Laura Sandström
- Faculty of Social Sciences, Health Sciences, Nursing Science, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland.
| | - Marja Kaunonen
- Faculty of Social Sciences, Health Sciences, Nursing Science, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland; Pirkanmaa Hospital District, PO BOX 2000 FI-33521 Tampere, Finland
| | - Reija Klemetti
- Department of Knowledge Management and Co-Creation, Finnish Institute for Health and Welfare, Po Box 30, FI-00271 Helsinki, Finland
| | - Eija Raussi-Lehto
- Customer oriented Wellbeing and Health Hub, Metropolia University of Applied Sciences, PO BOX 4000, FI-00079 Metropolia, Helsinki, Finland
| | - Anna Liisa Aho
- Faculty of Social Sciences, Health Sciences, Nursing Science, Tampere University, Arvo Ylpön katu 34, 33520, Tampere, Finland
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Pidd D, Newton M, Wilson I, East C. Optimising maternity care for a subsequent pregnancy after a psychologically traumatic birth: A scoping review. Women Birth 2023; 36:e471-e480. [PMID: 37024378 DOI: 10.1016/j.wombi.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/05/2023] [Accepted: 03/22/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Psychological birth trauma is recognised as a significant and ubiquitous sequelae from childbirth, with the incidence reported as up to 44%. In a subsequent pregnancy, women have reported a range of psychological distress symptoms from anxiety, panic attacks, depression, sleep difficulties and suicidal thoughts. AIM To summarise evidence on optimising a positive pregnancy and birth experience for a subsequent pregnancy following a psychologically traumatic pregnancy and identify research gaps. METHODS This review followed the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR check list. Six databases were searched using key words relating to psychological birth trauma and subsequent pregnancy. Utilising agreed criteria, relevant papers were identified, and data were extracted and synthesised. RESULTS A total of 22 papers met the inclusion criteria for this review. All papers addressed different aspects of what was important to women in this cohort, summarised as women wanting to be at the centre of their care. Pathways of care were diverse ranging from free birth to elective caesarean. There was no systematic process for identifying a previously traumatic birth experience and no education to enable clinicians to understand the importance of this. CONCLUSION For women who have experienced a previous psychologically traumatic birth, being at the centre of their care, in their subsequent pregnancy, is a priority. Embedding woman-centred pathways of care for women with this experience, as well as multidisciplinary education on the recognition and prevention of birth trauma, should be a research priority.
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Affiliation(s)
- Deborah Pidd
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; Mercy Hospital for Women, Heidelberg, VIC 3084, Australia.
| | - Michelle Newton
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia
| | - Ingrid Wilson
- Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; Singapore Institute of Technology, Singapore
| | - Christine East
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia; Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia; Mercy Hospital for Women, Heidelberg, VIC 3084, Australia
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Larsson B, Rubertsson C, Hildingsson I. Previous negative experiences of healthcare reported by Swedish pregnant women with fear of birth - A mixed method study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 36:100859. [PMID: 37210773 DOI: 10.1016/j.srhc.2023.100859] [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: 11/04/2022] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Negative encounters in healthcare might affect women's health. During their reproductive life span, women are exposed to various health examinations, and have reported disrespectful care and obstetric violence. Such experiences might be a basis for fear of birth. AIM to explore and describe the prevalence, associated factors and experiences of previous negative healthcare encounters in women with fear of birth. METHODS A cross-sectional mixed-method study of 335 pregnant women with fear of birth. Data were collected by a questionnaire in mid-pregnancy, which included socio-demographic and obstetric background data as well as a question about the occurrence of previous negative experiences in healthcare. RESULT A previous negative experience of healthcare was found in 189 women (56.6%). The analysis of the women's comments regarding what caused their negative experiences generated three themes: disrespectful treatment and no one listened; painful, inadequate, or improper care; and impact of other people's stories. CONCLUSION This study showed that previous negative experiences in healthcare were common in women with fear of birth and the content of the encounters could be summarised as disrespectful care and obstetric violence. Women's previous encounters in healthcare might be an underlying reason for fear of birth and should be investigated. It is, therefore, of utmost importance to listen to women and their narratives in order to establish a trustful relationship and promote evidence-based, women-centred, respectful care, which is urgently needed.
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Affiliation(s)
- Birgitta Larsson
- Department of Health Promoting Science, Sophiahemmet University College, Stockholm, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christine Rubertsson
- Department of Health Science, Medical Faculty, Lund University, Lund, Sweden; Department of Obstetrics and Gynecology, Skane University Hospital, Sweden
| | - Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
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Zeng T, Li B, Zhang K, Chen Y, Yuan M, Wu M, Zhao H, Zhu Z, Ju D. The association between childbirth-related fear, childbirth readiness, and fertility intentions, and childbirth readiness as the mediator. Reprod Health 2023; 20:62. [PMID: 37085786 PMCID: PMC10122374 DOI: 10.1186/s12978-023-01607-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 04/02/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Fertility intentions have been proved to be a reliable predictor of actual fertility behaviour. Also, childbirth-related fear (CBRF) has been proven to be negatively associated with childbirth readiness and fertility intentions among women, while childbirth readiness was positively related to fertility intentions. However, the associations and potential mechanisms between CBRF, childbirth readiness, and fertility intentions remain unknown. This study aimed to investigate the unique association between CBRF, childbirth readiness, and fertility intentions and whether childbirth readiness would mediate the relationship between CBRF and fertility intentions. METHOD A cross-sectional study of women (N = 1119, aged 16-53 years) who gave birth within 72 h was conducted. Using a convenience sampling, women were recruited from obstetric wards-10 comprehensive hospitals and 3 specialized hospitals in 7 provinces in mainland China. Pearson correlation was used to examine the relationship between CBRF, childbirth readiness, fertility intentions, and social support. Multivariate linear regression was further used to analyze the association between demographic and personal characteristics, CBRF, childbirth readiness, and fertility intentions. Mediation analysis was used to examine whether childbirth readiness mediates the relationship between CBRF and fertility intentions. RESULTS Women with high childbirth readiness (β = 0.09, P = 0.002) had higher fertility intentions. However, women with high CBRF (β = - 0.17, P < 0.001) were more likely to have lower fertility intentions. CBRF had both direct and indirect effects on the level of fertility intentions. As predicted, childbirth readiness mediated the relationship between CBRF and the level of fertility intentions (estimate = - 0.012, 95% bootstrap CI: - 0.021 to - 0.005). Higher CBRF was associated with lower scores of childbirth readiness, which was associated with lower levels of fertility intentions. CONCLUSIONS This study established the evidence that CBRF had both direct and indirect effects on the level of fertility intentions and childbirth readiness mediated the relationship between CBRF and the level of fertility intentions. Specifically, higher CBRF was associated with lower scores of childbirth readiness, which was associated with lower levels of fertility intentions. This finding suggested that it is important for health policymakers and health providers to pay more attention to improving women's childbirth readiness, which might reduce the negative influence of CBRF on fertility intentions, thus strengthening their fertility intentions.
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Affiliation(s)
- Tieying Zeng
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
| | - Bingbing Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Ke Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Ye Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Mengmei Yuan
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Meiliyang Wu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Huimin Zhao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Zining Zhu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Dandan Ju
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
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Inoue N, Nakao Y, Yoshidome A. Development and Validity of an Intrapartum Self-Assessment Scale Aimed at Instilling Midwife-Led Care Competencies Used at Freestanding Midwifery Units. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1859. [PMID: 36767225 PMCID: PMC9914374 DOI: 10.3390/ijerph20031859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Building experience in midwife-led care at freestanding midwifery units is needed to enhance assessment, technical, and care competencies specific to midwives. This study aimed to develop a self-assessment scale for midwifery practice competency based on the characteristics of midwife-led care practices in freestanding midwifery units. This study was conducted at 65 childbirth facilities in Japan between September 2017 and March 2018. The items on the scale were developed based on a literature review, discussion at a professional meeting, and a preliminary survey conducted at two timepoints. The validity and reproducibility of the scale were evaluated based on item analysis, compositional concept validity, internal consistency, stability, and criterion-related validity using data from 401 midwives. The final version of the scale consisted of 40 items. Cronbach's α for the overall scale was 0.982. The results for compositional concept validity, internal validity, and criterion-related validity demonstrated that this scale is capable of evaluating a midwife's practice competencies in intrapartum care. Repeated self-assessment using this scale could improve the competencies of midwives from an early stage, maximize the roles of physicians and midwives, and create an environment that provides high-quality assistance to women.
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Boz İ, Akgün M, Duman F. Women's experiences about the psychoeducational group programme with caring-healing modalities and peer support on fear of childbirth: A phenomenological study. Perspect Psychiatr Care 2022; 58:1512-1520. [PMID: 34611915 DOI: 10.1111/ppc.12958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/27/2022] Open
Abstract
AIM To explore women's experiences on the psychoeducation programme based on Human Caring Theory in decreasing fear of childbirth. DESIGN AND METHODS This Husserlian phenomenological qualitative study was conducted with 11 women. RESULTS Four themes were identified; "self-motivators for participate in psychoeducation programme", "psychoeducation: a bridge to deal with fears", "ability to manage the fear of childbirth," and "change in birth type preference", with 10 subthemes. PRACTICE IMPLICATIONS Clarifying the experiences of women on educational interventions gives an idea about the applicability, sustainability and developability of these interventions.
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Affiliation(s)
- İlkay Boz
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
| | - Mehtap Akgün
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
| | - Ferdane Duman
- Antalya Education and Research Hospital, Health Sciences University, Antalya, Turkey
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Hildingsson I, Rubertsson C. The role of women's emotional profiles in birth outcome and birth experience. J Psychosom Obstet Gynaecol 2022; 43:298-306. [PMID: 33586598 DOI: 10.1080/0167482x.2021.1885026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The aim was to investigate birth outcome and birth experience in relation to women's emotional health. An additional aim was to explore the relationship between emotional health, continuity with a known midwife, and the birth experience. METHODS A prospective longitudinal cohort study of 243 women enrolled in a continuity of care project in a rural area in Sweden. Profiles were constructed from instruments measuring depressive symptoms, worries, fear of birth, and sense of coherence. Antenatal and birth records and questionnaires were used to collect data. RESULT Women were categorized into two cluster profiles: "emotionally healthy" vs. "emotionally unhealthy". Women in the "emotionally unhealthy" cluster had a less positive birth experience (p = 0.006). The total score of the Childbirth Experience Questionnaire was highest in women who had had a known midwife assisting at birth. Babies born to women in the "emotionally unhealthy" cluster were more likely to have a severe neonatal diagnosis. CONCLUSION There were few differences in birth outcome between the clusters, while there were explicit differences in the childbirth experience. Having a known midwife is important to warrant women a more positive childbirth experience. Screening with validated instruments during antenatal care could be a first step to further investigate women's emotional well-being and provide targeted psychosocial support.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden
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A longitudinal case-control analysis of pain symptoms, fear of childbirth, and psychological well-being during pregnancy and postpartum among individuals with vulvodynia. Midwifery 2022; 114:103467. [DOI: 10.1016/j.midw.2022.103467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022]
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Turan Z, Suveren Y, Vural G. A qualitative study on the expectations and experiences of mothers during the childbirth process in Western Anatolia, Turkey. Women Health 2022; 62:444-453. [DOI: 10.1080/03630242.2022.2084211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Zekiye Turan
- Department of Nursing, Faculty of Health Sciences, Sakarya University, Sakarya, Turkey
| | - Yaşar Suveren
- Department of Sociology, Faculty of Science and Literature, Sakarya University, Sakarya, Turkey
| | - Gülşen Vural
- Department of Obstetrics and Genecology Nursing, Faculty of Nursing, Near East University, Lefkosa, Cyprus
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Peters LL, van der Pijl MSG, Vedam S, Barkema WS, van Lohuizen MT, Jansen DEMC, Feijen-de Jong EI. Assessing Dutch women's experiences of labour and birth: adaptations and psychometric evaluations of the measures Mothers on Autonomy in Decision Making Scale, Mothers on Respect Index, and Childbirth Experience Questionnaire 2.0. BMC Pregnancy Childbirth 2022; 22:134. [PMID: 35180852 PMCID: PMC8857821 DOI: 10.1186/s12884-022-04445-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background The Mothers Autonomy in Decision Making Scale (MADM) assesses women’s autonomy and role in decision making. The Mothers on Respect Index (MORi) asseses women’s experiences of respect when interacting with their healthcare providers. The Childbirth Experience Questionnaire 2.0 assesses the overall experience of childbirth (CEQ2.0). There are no validated Dutch measures of the quality of women’s experiences in the intrapartum period. Therefore, the aim of this study was to evaluate the psychometric properties of these measures in their Dutch translations. Methods The available Dutch versions of the MADM and MORi were adapted to assess experiences in the intrapartum period. The CEQ2.0 was translated by using forward-backward procedures. The three measures were included in an online survey including items on individual characteristics (i.e. maternal, birth, birth interventions). Reliability was assessed by calculating Cronbach’s alphas. Mann-Whitney, Kruskal Wallis or Student T-tests were applied where appropriate, to assess discrimination between women who differed on individual characteristics (known group validity). We hypothesized that women who experienced pregnancy complications and birth interventions would have statistically lower scores on the MADM, MORi and CEQ2.0, compared with women who had healthy pregnancies and physiological births. Convergent validity was assessed using Spearman Rank correlations between the MADM, MORi and/or CEQ2.0. We hypothesized moderate to strong correlations between these measures. Women’s uptake of and feedback on the measures were tracked to assess acceptability and clarity. Results In total 621 women were included in the cross sectional study. The calculated Cronbach’s alphas for the MADM, MORi and CEQ, were ≥ 0.77. Knowngroup validity was confirmed through significant differences on all relevant individual characteristics, except for vaginal laceration repair. Spearman Rank correlations ranged from 0.46-0.80. In total 98% of the included women out of the eligible population completed the MADM and MORi for each healthcare professional they encountered during childbirth. The proportions of MADM and MORi-items which were difficult to complete ranged from 0.0-10.8%, 0.6-2.7%, respectively. Conclusions The results of our study showed that the Dutch version of the MADM, MORi and CEQ2.0 in Dutch are valid instruments that can be used to assess women’s experiences in the intrapartum period. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04445-0.
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Affiliation(s)
- L L Peters
- Department of General Practice & Elderly Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science AVAG, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,AVAG (Midwifery Academy Amsterdam Groningen), Groningen, The Netherlands.
| | - M S G van der Pijl
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science AVAG, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S Vedam
- Birth Place Laboratory, Division of Midwifery, University of British Columbia, Vancouver, BC, Canada
| | - W S Barkema
- Department of General Practice & Elderly Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science AVAG, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,AVAG (Midwifery Academy Amsterdam Groningen), Groningen, The Netherlands
| | - M T van Lohuizen
- AVAG (Midwifery Academy Amsterdam Groningen), Groningen, The Netherlands
| | - D E M C Jansen
- Department of General Practice & Elderly Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science AVAG, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - E I Feijen-de Jong
- Department of General Practice & Elderly Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Midwifery Science AVAG, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,AVAG (Midwifery Academy Amsterdam Groningen), Groningen, The Netherlands
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14
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Onchonga D, Alfatafta H, Ngetich E, Makunda W. Health-seeking behaviour among pregnant women during the COVID-19 pandemic: A qualitative study. Heliyon 2021; 7:e07972. [PMID: 34541362 PMCID: PMC8432977 DOI: 10.1016/j.heliyon.2021.e07972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 08/12/2021] [Accepted: 09/08/2021] [Indexed: 12/23/2022] Open
Abstract
Background The novel coronavirus pandemic has killed millions of people globally while significantly destroying the social, economic, and political wellbeing of people. The global pandemic has negatively impacted pregnant women's access to prenatal care. The current study sought to understand the health-seeking behaviour of women who were pregnant during the onset of the COVID-19 pandemic in Kenya. Methods The “Three Delay” model theoretical framework was applied to piece together the pregnant women's health-seeking behaviour during the early stages of the pandemic through focus group discussions. The collected qualitative data was analysed using thematic analysis. Results The delays in deciding to seek care, delays in reaching healthcare facilities and delays in receiving quality healthcare services at the healthcare facility were a result of the fear of contracting the virus. These delays were occasioned by participants’ personal experiences and uncertainties about COVID-19 pandemic, compulsory quarantines, national cessation of movements, compulsory lockdowns, loss of income to many households and the influence of traditional birth attendants (TBAs). Conclusion The current study found that fear of COVID-19 was a major factor that hindered access to maternal healthcare services. In this regard, there is a need to upscale awareness creation on the significance of seeking maternal health services during the pandemic to reduce the possibility of obliterating the gains made in reducing poor health-seeking behaviours among pregnant women.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
| | - Huda Alfatafta
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
| | - Enoch Ngetich
- School of Public Health, Mount Kenya University-Nairobi, Kenya
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15
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O'Connell MA, Khashan AS, Leahy-Warren P, Stewart F, O'Neill SM. Interventions for fear of childbirth including tocophobia. Cochrane Database Syst Rev 2021; 7:CD013321. [PMID: 34231203 PMCID: PMC8261458 DOI: 10.1002/14651858.cd013321.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Many women experience fear of childbirth (FOC). While fears about childbirth may be normal during pregnancy, some women experience high to severe FOC. At the extreme end of the fear spectrum is tocophobia, which is considered a specific condition that may cause distress, affect well-being during pregnancy and impede the transition to parenthood. Various interventions have been trialled, which support women to reduce and manage high to severe FOC, including tocophobia. OBJECTIVES To investigate the effectiveness of non-pharmacological interventions for reducing fear of childbirth (FOC) compared with standard maternity care in pregnant women with high to severe FOC, including tocophobia. SEARCH METHODS In July 2020, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and reference lists of retrieved studies. We contacted researchers of trials which were registered and appeared to be ongoing. SELECTION CRITERIA We included randomised clinical trials which recruited pregnant women with high or severe FOC (as defined by the individual trial), for treatment intended to reduce FOC. Two review authors independently screened and selected titles and abstracts for inclusion. We excluded quasi-randomised and cross-over trials. DATA COLLECTION AND ANALYSIS We used standard methodological approaches as recommended by Cochrane. Two review authors independently extracted data and assessed the studies for risk of bias. A third review author checked the data analysis for accuracy. We used GRADE to assess the certainty of the evidence. The primary outcome was a reduction in FOC. Secondary outcomes were caesarean section, depression, birth preference for caesarean section or spontaneous vaginal delivery, and epidural use. MAIN RESULTS We included seven trials with a total of 1357 participants. The interventions included psychoeducation, cognitive behavioural therapy, group discussion, peer education and art therapy. We judged four studies as high or unclear risk of bias in terms of allocation concealment; we judged three studies as high risk in terms of incomplete outcome data; and in all studies, there was a high risk of bias due to lack of blinding. We downgraded the certainty of the evidence due to concerns about risk of bias, imprecision and inconsistency. None of the studies reported data about women's anxiety. Participating in non-pharmacological interventions may reduce levels of fear of childbirth, as measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ), but the reduction may not be clinically meaningful (mean difference (MD) -7.08, 95% confidence interval (CI) -12.19 to -1.97; 7 studies, 828 women; low-certainty evidence). The W-DEQ tool is scored from 0 to 165 (higher score = greater fear). Non-pharmacological interventions probably reduce the number of women having a caesarean section (RR 0.70, 95% CI 0.55 to 0.89; 5 studies, 557 women; moderate-certainty evidence). There may be little to no difference between non-pharmacological interventions and usual care in depression scores measured with the Edinburgh Postnatal Depression Scale (EPDS) (MD 0.09, 95% CI -1.23 to 1.40; 2 studies, 399 women; low-certainty evidence). The EPDS tool is scored from 0 to 30 (higher score = greater depression). Non-pharmacological interventions probably lead to fewer women preferring a caesarean section (RR 0.37, 95% CI 0.15 to 0.89; 3 studies, 276 women; moderate-certainty evidence). Non-pharmacological interventions may increase epidural use compared with usual care, but the 95% CI includes the possibility of a slight reduction in epidural use (RR 1.21, 95% CI 0.98 to 1.48; 2 studies, 380 women; low-certainty evidence). AUTHORS' CONCLUSIONS The effect of non-pharmacological interventions for women with high to severe fear of childbirth in terms of reducing fear is uncertain. Fear of childbirth, as measured by W-DEQ, may be reduced but it is not certain if this represents a meaningful clinical reduction of fear. There may be little or no difference in depression, but there may be a reduction in caesarean section delivery. Future trials should recruit adequate numbers of women and measure birth satisfaction and anxiety.
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Affiliation(s)
- Maeve Anne O'Connell
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Fiona Stewart
- Cochrane Children and Families Network, c/o Cochrane Pregnancy and Childbirth, Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK
| | - Sinéad M O'Neill
- School of Epidemiology and Public Health Alumna, University College Cork, Cork, Ireland
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Abstract
Background Between 5% and 14% of women suffer from fear of childbirth (FOC) which is associated with difficulties during birth and in postnatal psychological adjustment. Therefore, effective interventions are needed to improve outcomes for women. A systematic review and meta-analysis was used to identify effective interventions for treating women with FOC. Methods Literature searches were undertaken on online databases. Hand searches of reference lists were also carried out. Studies were included in the review if they recruited women with FOC and aimed to reduce FOC and/or improve birth outcomes. Data were synthesised qualitatively and quantitatively using meta-analysis. The literature searches provided a total of 4474 citations. Results After removing duplicates and screening through abstracts, titles and full texts, 66 papers from 48 studies were identified for inclusion in the review. Methodological quality was mixed with 30 out of 48 studies having a medium risk of bias. Interventions were categorised into six broad groups: cognitive behavioural therapy, other talking therapies, antenatal education, enhanced midwifery care, alternative interventions and interventions during labour. Results from the meta-analysis showed that most interventions reduced FOC, regardless of the approach (mean effect size = −1.27; z = −4.53, p < 0.0001) and that other talking therapies may reduce caesarean section rates (OR 0.48, 95% CI 0.48–0.90). Conclusions Poor methodological quality of studies limits conclusions that can be drawn; however, evidence suggests that most interventions investigated reduce FOC. Future high-quality randomised controlled trials are needed so that clear conclusions can be made.
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Hildingsson I, Rubertsson C. Testing the birth attitude profile scale in a Swedish sample of women with fear of birth. J Psychosom Obstet Gynaecol 2021; 42:132-139. [PMID: 32081051 DOI: 10.1080/0167482x.2020.1729118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to explore the "Birth Attitude Profile Scale (BAPS)" in a selected sample of women with fear of birth. Another aim was to develop profiles of women according to their birth attitudes and levels of childbirth fear in relation to background characteristics. METHODS A secondary analysis of data collected in two different samples of women with fear of birth. Data were collected by a questionnaire in gestational week 36 and background data from mid-pregnancy. A principal component analysis and a cluster analysis were performed of the combined sample of 195 women. RESULTS The principal component analysis revealed four domains of the BAPS: "personal impact, birth as a natural event, freedom of choice and safety concerns". When adding the fear of birth scale, two clusters were identified: one with strong attitudes and lower fear, labeled "self-determiners"; and one with no strong attitudes but high levels of fear, labeled "fearful." Women in the "Fearful" cluster more often reported previous and current mental health problems, which were the main difference between the clusters. CONCLUSION The BAPS instrument seems to be useful in identifying birth attitudes in women with fear of birth and could be a basis for discussions and birth planning during pregnancy. Mental health problems were the main difference in cluster membership; therefore, it is important to ask women with fear of childbirth about physical, mental and social aspects of health. In addition, a qualitative approach using techniques such as focus groups or interviews is needed to explore how women come to form their attitudes and beliefs about birth.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Christine Rubertsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Health Science, Lund University, Lund, Sweden
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18
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Onchonga D, Várnagy Á, Amer F, Viktoria P, Wainaina P. Translation and validation of the Swahili version of the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A). SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100626. [PMID: 33971430 DOI: 10.1016/j.srhc.2021.100626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/28/2021] [Accepted: 04/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Prenatal fear of childbirth is a common health concern that negatively affects the emotional wellbeing of women during pregnancy. Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A) is used extensively to measure fear of childbirth during pregnancy. Nevertheless, previous studies have not evaluated its psychometric characteristics among the Swahili-speaking pregnant women. Therefore, the aim was to translate and test the validity and reliability of the questionnaire into Swahili as the popular language in Kenya. METHODS In the current descriptive cross-sectional study, the W-DEQ-A, together with the Edinburgh Postnatal Depression Scale (EPDS) and Beck Anxiety Inventory (BAI) were administered to a group of 628 pregnant women to explore the dimensionality of W-DEQ-A using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), respectively. RESULTS EFA and CFA of the Swahili version of W-DEQ-A identified five-factor loadings: lack of self-efficacy, fear, negative emotions, negative appraisal, and social isolation. However, this model failed to support the unidimensional structure of the original W-DEQ-A. The Swahili version of the W-DEQ-A correlated well with EPDS and BAI at acceptable levels. The Cronbach alpha values of the subscales ranged from 0.867 to 0.967, an indication of an excellent internal consistency of the instrument. CONCLUSION The current study findings provide support for the Swahili version of the W-DEQ-A to be considered as a valid and reliable measuring tool for the fear of childbirth among Swahili-speaking pregnant women in Kenya, and the entire East and Central African region. Also, due to its multidimensional structure, the original W-DEQ-A should not be used in its original form.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary.
| | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary
| | - Faten Amer
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary
| | - Prémusz Viktoria
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary
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19
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Liu Y, Li T, Guo N, Jiang H, Li Y, Xu C, Yao X. Women's experience and satisfaction with midwife-led maternity care: a cross-sectional survey in China. BMC Pregnancy Childbirth 2021; 21:151. [PMID: 33607963 PMCID: PMC7893951 DOI: 10.1186/s12884-021-03638-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 02/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low risk pregnancy ending in a vaginal birth is best served and guided by a midwife. Utilizing a midwife in such cases offers many emotional and economic advantages and does not increase the risks for mother or neonate. However, women's experience and satisfaction of midwife-led maternity care is rarely reported in China. The primary objective of this study is to describe the experience of Chinese women receiving midwife-led maternity care, and to report their satisfaction level of the experience. METHODS The study is a cross-sectional survey of 4192 women who had natural birth from March-June 2019 in a maternity care center, Shanghai, China. We used a self-administered questionnaire addressing items related to women's experience during childbirth, as well as their satisfaction with midwife-led maternity care. We also included demographic and perinatal characteristics of each participant. Descriptive statistics and correlations analysis between groups of different experience and satisfaction were used. RESULTS In this sample, 87.7% of women had a Doula and a family member present during childbirth. Epidural anesthesia was used in 75.6% and episiotomy was needed in 23.2%. Free positioning during the first stage of labor and free positioning during the second stage of labor and delivery were adopted in 84.3 and 67.9% of the cases, respectively. Moderate to severe perineal pain and moderate to severe perineal edema were reported in 43.1 and 12.2% of the participants, respectively. High satisfaction level was found when there was midwife-led prenatal counseling and presence of Doula and family member, Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during the first stage of labor, and midwifes' postpartum guidance. Negative satisfaction was seen with perineal pain and edema. CONCLUSION Women in this survey generally had high satisfaction with midwife-led maternity care. This satisfaction is probably felt because of the prenatal counseling by the midwife and allowing a Doula and a family member in the room during childbirth. Other intangible factors to improve the satisfaction level were Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during first stage of labor, and early skin to skin contact.
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Affiliation(s)
- Ying Liu
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Tengteng Li
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Nafei Guo
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Hui Jiang
- Nursing Department, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China.
| | - Yuehong Li
- Delivery Room, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Chenying Xu
- Delivery Room, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
| | - Xiao Yao
- Delivery Room, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Pudong New Area, Shanghai, 201204, China
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20
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Onchonga D. Prenatal fear of childbirth among pregnant women and their spouses in Kenya. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 27:100593. [DOI: 10.1016/j.srhc.2020.100593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/09/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022]
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21
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Yoosefi Lebni J, Khalajabadi Farahani F, Solhi M, Ebadi Fard Azar F. Causes and Grounds of Childbirth Fear and Coping Strategies Used by Kurdish Adolescent Pregnant Women in Iran: A Qualitative Study. J Reprod Infertil 2021; 22:47-56. [PMID: 33680885 PMCID: PMC7903670 DOI: 10.18502/jri.v22i1.4995] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/31/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Fear of childbirth is one of the most common problems among pregnant women that can threaten their and their baby's health. Therefore, the purpose of this study was to explore the causes and grounds of childbirth fear and the strategies used by pregnant adolescent women in Iran to overcome such fears. METHODS In this study, which was conducted among primiparous Kurdish women in Iran, conventional qualitative content analysis was used. Data were selected through purposive sampling and semi-structured interviews. Data saturation was reached with 15 participants. The Lincoln and Guba criteria were used to strengthen the research. RESULTS After analyzing the data, two main categories were resulted. The first category was fear of childbirth with subcategories of fear of child health, fear of childbirth process, fears about inappropriate medical staff performance, fears about hospital environment, and postpartum fears. The second category was strategies to reduce childbirth fear with subcategories of choosing appropriate medical centers, increasing information on childbirth, avoiding stressful sources, improving self-care, getting prepared for delivery day in advance, and resorting to spirituality. CONCLUSION Pregnancy in adult age is better than adolescent age. The women's fear can be reduced by increasing their assurance about child health, providing appropriate training during pregnancy, explaining the whole process of childbirth and making it easier, improving the hospital environment and medical staff specialization, as well as providing appropriate conditions for further care and support after birth.
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Affiliation(s)
- Javad Yoosefi Lebni
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farideh Khalajabadi Farahani
- Department of Population and Health, National Population Studies and Comprehensive Management Institute, Tehran, Iran
| | - Mahnaz Solhi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farbod Ebadi Fard Azar
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
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22
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Kim B, Kang SJ. Comparison of professionalism and job satisfaction between Korean midwives in birthing centers and midwives in hospitals. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2020; 26:222-230. [PMID: 36313173 PMCID: PMC9328580 DOI: 10.4069/kjwhn.2020.09.08] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose: Midwives working in hospitals (MWH) have limited roles in managing and assisting births independently. To find the reason for this and to find ways to successfully integrate midwifery into care systems, exploring midwives’ work-related perceptions might be the first step. The purpose of this study was to compare professionalism and job satisfaction among midwives working in birthing centers (MWBC) and MWH.Methods: A descriptive comparative design was used, querying 19 MWBC and 53 MWH in Korea. Data accrued from October 2017 to November 2017 using the Professionalism Inventory Scale and the job satisfaction scale. Results: Age, marital status, monthly income, length of career as a midwife, and length of career in the current workplace were significantly different between MWBC and MWH. The level of professionalism among MWBC showed significant differences by position at the birthing center (t=16.19, p=.001). Professionalism and job satisfaction among MWH showed significant differences depending on perceived professional performance (F=9.95, p<.001 and F=11.04, p<.001, respectively). Levels of professionalism and job satisfaction were higher for MWBC than for MWH.Conclusion: Educational programs designed to enhance professionalism and expand the role of MWH are suggested. Also, a need exists to develop policy for midwives at hospitals and a legal system so MWH in Korea can perform their midwifery jobs and be properly reimbursed.
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Affiliation(s)
| | - Sook Jung Kang
- Corresponding author: Sook Jung Kang College of Nursing, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea Tel: +82-02-3277-2882 E-mail:
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Wigert H, Nilsson C, Dencker A, Begley C, Jangsten E, Sparud-Lundin C, Mollberg M, Patel H. Women's experiences of fear of childbirth: a metasynthesis of qualitative studies. Int J Qual Stud Health Well-being 2020; 15:1704484. [PMID: 31858891 PMCID: PMC6968519 DOI: 10.1080/17482631.2019.1704484] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose: Women’s experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women’s experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women’s experiences of fear of childbirth interpreted through the metaphor “being at a point of no return”. Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other’s experiences will not happen to them.
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Affiliation(s)
- Helena Wigert
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Nilsson
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Anna Dencker
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cecily Begley
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Chair of Nursing and Midwifery, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Elisabeth Jangsten
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Carina Sparud-Lundin
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Margareta Mollberg
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Harshida Patel
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Hildingsson I, Rubertsson C. Childbirth experiences among women with fear of birth randomized to internet-based cognitive therapy or midwife counseling. J Psychosom Obstet Gynaecol 2020; 41:205-214. [PMID: 31244352 DOI: 10.1080/0167482x.2019.1634047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background: Although women with fear of birth often report negative birth experiences, few studies have focused on their experiences in the long term. The aim of this study was to compare birth experiences a year after childbirth in two groups of women receiving treatment for experiencing fear of birth during pregnancy.Methods: As part of the U-CARE: Pregnancy Trial, a prospective multicenter randomized controlled trial comparing the effects of internet-based cognitive behavioral therapy (iCBT) and standard care among pregnant women with fear of birth. Women were recruited at three Swedish hospitals following a screening procedure that assessed their fear of birth. Data were collected online with the Childbirth Experience Questionnaire (CEQ), one question about the overall birth experience, and questions about personal background, collected before randomization.Results: A total of 181 women responded to the follow-up questionnaire a year after childbirth. Approximately half of participants reported a less positive birth experience. Preferred mode of birth, actual mode of birth, marital status and psychiatric history were associated with the domains of the CEQ. However, no statistically significant differences emerged between the treatment groups.Conclusions: Being randomized to receive iCBT or counseling with midwives for fear of birth was not associated with perceptions of the birth experience assessed a year after birth. Most participants reported less-than-positive birth experiences and scored low on the domain of the CEQ reflecting Own capacity. In response, additional research remains necessary to identify the best model of care that might facilitate positive experiences with giving birth among women with fear of birth.
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Affiliation(s)
- Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Christine Rubertsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Health Science, Lund University, Lund, Sweden
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O'Connell MA, Khashan AS, Leahy-Warren P. Women's experiences of interventions for fear of childbirth in the perinatal period: A meta-synthesis of qualitative research evidence. Women Birth 2020; 34:e309-e321. [PMID: 32522443 DOI: 10.1016/j.wombi.2020.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022]
Abstract
ISSUE Fear of childbirth (FOC) can be debilitating, impacting women's lives in pregnancy, the puerperium and beyond. Research investigated various interventions for FOC in the perinatal period, but there been no synthesis of the experiences of women who engaged with these interventions, which would inform clinical practice guidance and the development of future interventions. AIM To conduct a review and synthesis of qualitative studies of interventions for fear of childbirth in the perinatal period and women's experiences of them. METHODS A meta-synthesis was performed to examine all relevant qualitative studies describing women's experiences of interventions for FOC, in all languages. A comprehensive search of relevant databases from 1978 to 2019 was conducted. In total, following appraisal, seven qualitative studies were eligible for inclusion. The findings were integrated using thematic synthesis for the final stages in the thematic analysis. FINDINGS One overarching theme "Ownership of Childbirth" and three analytical themes "Facing the fear", "Feeling empowered", "Managing the fear with a sense of security" were generated through the synthesis. There were no studies outside of Scandinavia located. DISCUSSION This meta-synthesis provides a new way to describe the process of moving from fear to "Ownership of childbirth". The first step in the process appears to be acknowledging and identifying the individual's fears. Women can be empowered to self-manage FOC but may be influenced by external factors such as the support of partners and staff. CONCLUSION These findings provide evidence to inform the development of future interventions for FOC and highlight the need for further qualitative research globally.
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Affiliation(s)
- Maeve A O'Connell
- School of Nursing and Midwifery, Royal College of Surgeons Ireland in Bahrain, Adliya, Bahrain; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, Wilton, Cork, Ireland; Dept of Obstetrics & Gynaecology, College of Medicine & Health, University College Cork, Cork, Ireland.
| | - Ali S Khashan
- School of Public Health, University College Cork, Western Rd., Cork, Ireland; Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, Wilton, Cork, Ireland
| | - Patricia Leahy-Warren
- School of Nursing and Midwifery, University College Cork, College Rd., Cork, Ireland
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Wahlbeck H, Kvist LJ, Landgren K. Art Therapy and Counseling for Fear of Childbirth: A Randomized Controlled Trial. ART THERAPY 2020. [DOI: 10.1080/07421656.2020.1721399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lyckestam Thelin I, Lundgren I, Nilsson C. To challenge oneself as a childbearing woman-the lived experience of vaginal birth after caesarean section in Sweden. Int J Qual Stud Health Well-being 2019; 14:1605784. [PMID: 31046655 PMCID: PMC6507961 DOI: 10.1080/17482631.2019.1605784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2019] [Indexed: 01/05/2023] Open
Abstract
PURPOSE There is a need to gain deeper knowledge about women's experience of vaginal birth after caesarean section (VBAC). Considerable research has been conducted on VBAC; however, only a few qualitative studies focus on women's experiences. Therefore, the aim of this study was to describe the lived experiences of VBAC among women resident in Sweden, a country with a high VBAC rate. METHOD This studywas performed in accordance with a phenomenological reflective lifeworld approach. Interviews were conducted with nine women in an urban region of Sweden one year after their VBAC birth. RESULTS The essential meaning of the studied phenomenon is "to challenge oneself as a childbearing woman", which is further described by its four constituents: "striving for support from professionals", "desiring the experience", "contrasting and comparing memories of two different births" and "being part of the birthing culture". CONCLUSIONS The experience of VBAC meant regained trust in the ability to give birth vaginally. The women lacked follow-up and support after the caesarean section (CS), during the subsequent pregnancy and the forthcoming VBAC. Enhanced support could be a key factor in helping women meeting the challenge and feel confident about giving birth vaginally despite their previous experiences of CS. ABBREVIATIONS VBAC: vaginal birth after caesarean section; CS: caesarean section.
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Affiliation(s)
- Ida Lyckestam Thelin
- Institute of Health and Care Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingela Lundgren
- Institute of Health and Care Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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A known midwife can make a difference for women with fear of childbirth- birth outcome and women’s experiences of intrapartum care. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 21:33-38. [DOI: 10.1016/j.srhc.2019.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/08/2019] [Accepted: 06/14/2019] [Indexed: 11/20/2022]
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Women's experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth. Women Birth 2019; 33:e227-e233. [PMID: 31160244 DOI: 10.1016/j.wombi.2019.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive Behaviour Therapy with midwifery led counselling as standard care has been conducted. OBJECTIVE The aim of this study was to describe women's experiences of guided internet-delivered Cognitive Behaviour Therapy for Fear of Birth and to describe the content of their fear. METHODS The present study is a qualitative, follow-up interview study following the randomized controlled trial, the U-CARE Pregnancy Trial. In total 19 women allocated to internet-delivered Cognitive Behaviour Therapy for Fear of Birth were interviewed by telephone. A semi-structured interview guide was used and the transcripts were analyzed with thematic analysis. RESULTS The women's descriptions of Fear of Birth differed, however their fear was most often associated with fear of losing control, fear for the baby's life or health or own life threatening events. The experiences of internet-delivered Cognitive Behaviour Therapy for Fear of Birth varied, some women were positive to its flexibility although most women preferred a face-to face meeting. The treatment did not pin-point their fears, it was challenging to maintain motivation and to work with the treatment in solitude. CONCLUSIONS Women's descriptions of Fear of Birth varied. Most women undergoing internet-delivered Cognitive Behaviour Therapy would have preferred a face-to-face meeting which they imagined would have soothed their fear. Internet-delivered Cognitive Behaviour Therapy for Fear of Birth may be an alternative for some women.
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O'Connell MA, O'Neill SM, Dempsey E, Khashan AS, Leahy-Warren P, Smyth RMD, Kenny LC. Interventions for fear of childbirth (tocophobia). THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2019. [DOI: 10.1002/14651858.cd013321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Maeve Anne O'Connell
- P.O. Box 15503; RCSI Bahrain; Adliya Bahrain
- University College Cork; Irish Centre for Fetal and Neonatal Translational Research; Cork Ireland
| | - Sinéad M O'Neill
- Health Information and Quality Authority; Health Technology Assessment Directorate; Unit 1301, City Gate Mahon Cork Munster Ireland T12 Y2XT
| | - Eugene Dempsey
- Cork University Maternity Hospital; Neonatology; Wilton Cork Ireland
| | - Ali S Khashan
- University College Cork; School of Public Health; Cork Ireland
| | - Patricia Leahy-Warren
- University College Cork; School of Nursing and Midwifery; Brookfield Health Sciences Complex Cork Ireland
| | - Rebecca MD Smyth
- The University of Manchester; Division of Nursing Midwifery and Social Work; Jean McFarlane Building Oxford Road Manchester UK M13 9PL
| | - Louise C Kenny
- University of Liverpool; Faculty of Health and Life Sciences; Foundation Building, 765 Brownlow Hill Liverpool Merseyside UK
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