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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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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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Albalawi FD, Faheem WA, Thabet H, Daghash H. Exploring the Relationship Between Childbirth Expectations and Fear Among Primigravida Women in Saudi Arabia. Cureus 2023; 15:e49337. [PMID: 38143635 PMCID: PMC10748853 DOI: 10.7759/cureus.49337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Background Childbirth is a significant life event that is accompanied by fear, particularly among primigravida mothers. However, little is known about the expectations and fears of childbirth of primigravida women in Saudi Arabia. Aim This study aimed to explore expectations and fears of childbirth among primigravidas. Methods An exploratory, descriptive, cross-sectional study involving 369 primigravidas was conducted at antenatal outpatient clinics at the Maternity and Children's Hospital in Tabuk, Saudi Arabia. Results In the current study, most participants were aged 25-34 years 204 (55.3%), married 355 (96.2%), and had secondary or higher education 279 (75.6%). A majority of participants 265 (71.8%) reported financial difficulties and 244 unplanned pregnancies (66.1%), while most were pregnant beyond 30 weeks 254 (66.4%). The results showed that the mean total score on the Wijma Delivery Expectancy Questionnaire (W-DEQ) fear of childbirth scale was 57.56, indicating moderate levels of fear on average among primigravida women, with the highest subscale score for the moment of birth. The mean total score on the Childbirth Expectations Questionnaire (CEQ) childbirth expectations scale was 108.15, also indicating moderate expectations on average, with other significant expectations having the highest subscale score. A significant negative correlation was found between the fear and expectations scales (r=-0.775, p<0.001). Sociodemographic factors such as older age, higher education, income, employment, and planned pregnancy were associated with higher expectations and lower fear, whereas younger age, lower education, income, employment, unplanned pregnancy, and medical issues were associated with higher fear. Conclusions The findings of this study provide valuable insights into the expectations and fears of childbirth of primigravida women in Saudi Arabia. The results could inform healthcare providers and policymakers about the predictors of fear and effective interventions to reduce fear and improve birth experience in primiparous women.
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Affiliation(s)
- Fatimah D Albalawi
- Faculty of Nursing, King Abdulaziz University, Jeddah, SAU
- Training and Academic Affairs, Ministry of Health, Tabuk, SAU
| | - Wafaa A Faheem
- Faculty of Nursing, King Abdulaziz University, Jeddah, SAU
| | - Hala Thabet
- Faculty of Nursing, King Abdulaziz University, Jeddah, SAU
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Zhang T, Liu M, Min F, Wei W, Liu Y, Tong J, Meng Q, Sun L, Chen X. Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study. BMC Psychiatry 2023; 23:574. [PMID: 37553654 PMCID: PMC10408108 DOI: 10.1186/s12888-023-05070-7] [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: 04/07/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Fear of childbirth (FOC) is a prevalent issue among pregnant women and significantly relates to adverse outcomes for the mother and child. However, it is not clear the prevalence and risk factors of FOC among pregnant women in a region with a moderate level of economic development in China. The aim of this study was to investigate the prevalence and risk factors of FOC among pregnant women in the third trimester of pregnancy in Lianyungang city, Eastern China. METHODS A cross-sectional survey was conducted from December 2022 to February 2023 among pregnant women in the third trimester who met the inclusion criteria and visited Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China. A structured questionnaire including sociodemographic characteristics, clinical characteristics, FOC, family function, doctor-patient communication, social support, general self-efficacy, anxiety, depression, insomnia symptoms, and quality of life was used to collect data. A multiple linear regression model was used to identify predictors of FOC. RESULTS This study included 535 pregnant women in the third trimester. The mean score of FOC was 30.67 ± 10.18, and the median score was 29.00. The prevalence of FOC was 56.64%. Multiple linear regression analysis revealed that pregnant women with electronic screen exposure time more than 5 h per day (β = 2.02, 95%CI: 0.50-3.53, P < 0.05), no history of cesarean section (β = 2.66, 95%CI: 0.61-4.71, P < 0.05), likes sour food or hates greasy food (β = 1.75, 95%CI: 0.00-3.50, P < 0.05), anxiety (β = 0.50, 95%CI: 0.21-0.80, P < 0.05) and depression (β = 0.30, 95%CI: 0.04-0.57, P < 0.05) were more likely to have a greater level of FOC than their counterparts. However, a significantly lower level of FOC was observed in pregnant women who were multipara (β=-1.64, 95%CI: -3.27-0.01, P < 0.05), not worrying about delivery without family members (β=-3.75, 95%CI: -5.26-2.25, P < 0.001), had good family function (β=-0.32, 95%CI: -0.64-0.00, P < 0.05) and doctor-patient communication (β=-0.33, 95%CI: -0.64-0.02, P < 0.05). CONCLUSIONS The prevalence of FOC was high in Lianyungang city, Eastern China. FOC is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of FOC in the third trimester of pregnancy, and to pay attention to pregnant women with risk factors for FOC.
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Affiliation(s)
- Teng Zhang
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China
| | - Meilin Liu
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China
| | - Fanli Min
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China
| | - Wei Wei
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China
| | - Yuan Liu
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China
| | - Jiao Tong
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China
| | - Qian Meng
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China
| | - Lizhou Sun
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xu Chen
- Department of Obstetrics, Lianyungang Maternal and Child Health Hospital, 669 Qindongmen Street, Haizhou District, Lianyungang, 222000, Jiangsu, P.R. China.
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Women's sense of control during labour and birth with epidural analgesia: A qualitative descriptive study. Midwifery 2023; 116:103496. [PMID: 36223662 DOI: 10.1016/j.midw.2022.103496] [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: 11/23/2021] [Revised: 09/08/2022] [Accepted: 09/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sense of control during childbirth is a critical issue concerning the association between high-quality maternity care and infant health. This study explored the facilitators of or barriers to a sense of control and the need for interventions to raise women's experience in childbirth. METHODS The data came from 17 participants. Data collection was conducted in the childbirth room and within three days following childbirth, respectively. For tackling the research problems, participant observation and interviewing were applied. Thematic analysis was applied to the data analyzed. RESULTS Two themes were identified: (1) facilitators of or barriers to practice a sense of control and (2) Care needed for a sense of control. The effectiveness of a sense of control is related to energy refill, mental loading subsided, control over decisions, non-pharmacological usage, and support from the meaningful person. Care needed includes showing empathy, providing information, using complementary pain-relief strategies, and adjusting care by parturient conditions. CONCLUSION This study highlights the influencing factors and interventions relating to women's sense of control during childbirth with epidural analgesia. The findings suggest that many approaches, such as white noise, benefit women's sense of control after an epidural. Using non-pharmacological methods, such as a birth ball, should be appropriately regulated by situations to enhance women's sense of control. Through the assessment, education, attention to maternal needs, and recognizing the barriers to a sense of control, women will benefit from the interventions designed to improve their sense of control during childbirth.
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Eidouzaei F, Amiri-Farahani L, Mohammadi A, Pezaro S. Exploring the Effect of Cognitive-Behavioral Educations on Childbirth Self-efficacy, Childbirth Fear, and Adaptation of Maternal Role Among Primiparous Women: A Quasi-Experimental Study. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Calpbinici P, Özçirpan ÇY. The effect of the training program provided to primiparous pregnant women through the motivational interview method on their fear of childbirth, childbirth self-efficacy, and delivery mode: a randomized controlled trial. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03285-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fairbrother N, Albert A, Collardeau F, Keeney C. The Childbirth Fear Questionnaire and the Wijma Delivery Expectancy Questionnaire as Screening Tools for Specific Phobia, Fear of Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084647. [PMID: 35457513 PMCID: PMC9028446 DOI: 10.3390/ijerph19084647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/14/2022] [Accepted: 04/02/2022] [Indexed: 12/04/2022]
Abstract
Background: Perinatal anxiety and related disorders are common (20%), distressing and impairing. Fear of childbirth (FoB) is a common type of perinatal anxiety associated with negative mental health, obstetrical, childbirth and child outcomes. Screening can facilitate treatment access for those most in need. Objectives: The purpose of this research was to evaluate the accuracy of the Childbirth Fear Questionnaire (CFQ) and the Wijma Delivery Expectations Questionnaire (W-DEQ) of FoB as screening tools for a specific phobia, FoB. Methods: A total of 659 English-speaking pregnant women living in Canada and over the age of 18 were recruited for the study. Participants completed an online survey of demographic, current pregnancy and reproductive history information, as well as the CFQ and the W-DEQ, and a telephone interview to assess specific phobia FoB. Results: Symptoms meeting full and subclinical diagnostic criteria for a specific phobia, FoB, were reported by 3.3% and 7.1% of participants, respectively. The W-DEQ met or exceeded the criteria for a “good enough” screening tool across several analyses, whereas the CFQ only met these criteria in one analysis and came close in three others. Conclusions: The W-DEQ demonstrated high performance as a screening tool for a specific phobia, FoB, with accuracy superior to that of the CFQ. Additional research to ensure the stability of these findings is needed.
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Affiliation(s)
- Nichole Fairbrother
- Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
- Correspondence: ; Tel.: +1-250-0519-5390 (ext. 36439)
| | - Arianne Albert
- Women’s Health Research Institute, Vancouver, BC V6H 2N9, Canada;
| | - Fanie Collardeau
- Department of Psychology, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Cora Keeney
- Department of Family Practice, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
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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 A. Midwifery 2021; 104:103188. [PMID: 34749123 DOI: 10.1016/j.midw.2021.103188] [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: 08/22/2020] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Fear of childbirth causes significant distress and impact on women's wellbeing. It contributed to the rising trend of non-medically indicated Caesarean births worldwide. The objective of this study was to translate and validate the Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) (W-DEQ-A), which is a comprehensive instrument for the assessment of fear of childbirth among antenatal women. METHODS The translated questionnaire was finalised after back-translation and review by an expert panel. Hong Kong Chinese women at an antenatal clinic completed the translated questionnaire, Edinburgh Postpartum Depression Scale (EPDS), and State-trait Anxiety Inventory (STAI). The reliability of the translated questionnaire was analysed using Cronbach's alpha coefficient and intraclass correlation coefficient. Convergent validity was measured by Pearson's correlation between the W-DEQ-A and STAI or EPDS scores. The subscales of the questionnaire were determined using exploratory factor analysis. RESULTS One hundred and fifty women completed the study. The Cronbach's alpha coefficient and test-retest reliability of the Chinese version were 0.907 and 0.867, respectively. Convergent validity was demonstrated by the moderate correlation between the translated W-DEQ-A and STAI or EPDS. Exploratory factor analysis of the W-DEQ-A revealed a multi-dimensional structure with four factors: sense of isolation, moment of birth, negative emotion, and lack of positive self-evaluation. Using a standard cut-off of 85, 11.3% of women were found to suffer from fear of childbirth. CONCLUSION The Chinese version of the Wijma Delivery Expectancy/Experience Questionnaire (Version A) is a reliable and valid instrument to measure antenatal fear of childbirth among Chinese women.
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Affiliation(s)
- Theodora Hei Tung Lai
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong
| | - Shuk Tak Kwok
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong
| | - Weilan Wang
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong
| | - Mimi Tin Yan Seto
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong
| | - Ka Wang Cheung
- Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong.
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Effect of antenatal education on childbirth self-efficacy: A systematic-review and meta-analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis. BMC Pregnancy Childbirth 2021; 21:643. [PMID: 34551755 PMCID: PMC8456556 DOI: 10.1186/s12884-021-04123-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022] Open
Abstract
Background Fear of childbirth (FOC) occurs before, during and after pregnancy and is harmful to both the pregnant woman and the fetus. Identifying the prevalence and predictors of FOC can help us generate strategies for alleviating women’s FOC. Methods A cross-sectional study was conducted among a convenience sample of 646 pregnant women receiving antenatal care at a subordinate hospital of a university in China. Data were collected using a basic information form, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the 10-item Connor-Davidson Resilience Scale. The minimum and maximum total scores of the Childbirth Attitude Questionnaire are 16 and 64, respectively, with higher scores reflecting a greater degree of FOC. We conducted hierarchical regression analysis to explore the predictors of FOC and used a structural equation model to further examine the direct and indirect associations between FOC, resilience and childbirth self-efficacy. Results The total prevalence of FOC was 67.1%. The percentages of women with mild (score of 28–39), moderate (40–51), and severe FOC (52–64) were 45.4, 19.5, and 2.2%, respectively. The average score on the Childbirth Attitude Questionnaire was 32.49, indicating mild FOC. The final regression analysis revealed six variables predicting FOC that explained 64.5% of the variance in FOC: age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy. Furthermore, childbirth self-efficacy mediated the relationship between resilience and FOC, and the mediation effect rate was 53.5%. Conclusions A high prevalence of FOC among pregnant Chinese women was found in this study. Age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy were predictors of FOC. It is suggested that healthcare professionals should pay close attention to FOC and implement targeted interventions in accordance with these predictors, especially resilience and childbirth self-efficacy.
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Shakarami A, Mirghafourvand M, Abdolalipour S, Jafarabadi MA, Iravani M. Comparison of fear, anxiety and self-efficacy of childbirth among primiparous and multiparous women. BMC Pregnancy Childbirth 2021; 21:642. [PMID: 34548055 PMCID: PMC8456545 DOI: 10.1186/s12884-021-04114-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/10/2021] [Indexed: 01/21/2023] Open
Abstract
Background The aim of this study was to compare fear of childbirth, state and trait anxiety, and childbirth self-efficacy among primiparous and multiparous women in Ahvaz, southwest of Iran. Methods This cross-sectional study was conducted with 200 pregnant women (100 primiparous and 100 multiparous women) who had been admitted to the maternity ward of hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. The instruments used for data collection in this study included a demographic questionnaire, Delivery Fear Scale (DFS), Spielberger's State-Trait Anxiety Inventory (STAI), and Childbirth Self-Efficacy Inventory (CBSEI). The data were analyzed by chi-square test and independent t-test. Also, the univariate general linear model was used by adjusting for the socio-demographic and obstetric characteristics that were considered as possible confounding variables. Results The mean score of DFS in primiparous women was significantly higher than that of multiparous women. The mean of the overall score of childbirth self-efficacy of primiparous women was significantly lower than that of multiparous women. The mean score of the outcome expectancies and self-efficacy expectancies was significantly lower in primiparous women compared with multiparous women. There was no statistically significant difference between the two groups in terms of the mean score of STAI. After adjusting for possible confounding variables, the differences between the two groups in terms of fear of childbirth scores, overall childbirth self-efficacy score and self-efficacy expectancies remained significant. Conclusion Given the high fear of childbirth and low childbirth self-efficacy in primiparous women compared to the multiparous women, appropriate interventions should be adopted by health care providers in order to reduce fear and improve childbirth self-efficacy in primiparous women.
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Affiliation(s)
- Aazam Shakarami
- Midwifery Department, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Somyieh Abdolalipour
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.,Center for the development of Interdisciplinary Research in Islamic Sciences and Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Iravani
- Midwifery Department, Reproductive Health Promotion Research Center, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Dai L, Shen Q, Redding SR, Ouyang YQ. Simulation-based childbirth education for Chinese primiparas: A pilot randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2021; 104:2266-2274. [PMID: 33663905 DOI: 10.1016/j.pec.2021.02.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 01/11/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate the effectiveness and feasibility of simulation-based childbirth education (SBCE) on reducing fear of childbirth (FOC) of Chinese primiparas. METHODS A total of 56 primiparas completed the trial including 26 in the intervention group and 30 in the control group. The intervention group received four sessions of SBCE while the control group received routine prenatal care. Chinese versions of the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A) and Childbirth Self-Efficacy Inventory (CBSEI) were used to evaluate FOC and childbirth self-efficacy. Birth outcomes including delivery method, labor duration and Apgar scores were collected. RESULTS Scores on the WDEQ-A of the intervention group were statistically lower than those of the control group (P < 0.05). The CBSEI scores of the intervention group were significantly higher than those of the control group (P < 0.05). The cesarean birth rate of the intervention group was lower than that of the control group (34.61% vs 46.67%, P > 0.05). CONCLUSION Simulation-based childbirth education alleviates FOC, increases childbirth self-efficacy and improves birth outcomes, providing a new perspective to alleviate FOC of primiparas in the future. PRACTICE IMPLICATIONS Simulation-based childbirth education is an effective and feasible method to educate women about childbirth. Its integration into routine prenatal care of Chinese primiparas should be encouraged to reduce FOC.
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Affiliation(s)
- Lijing Dai
- School of Health Sciences, Wuhan University, Wuhan, China.
| | - Quan Shen
- School of Health Sciences, Wuhan University, Wuhan, China.
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Çıtak Bilgin N, Coşkun H, Coşkuner Potur D, İbar Aydın E, Uca E. Psychosocial predictors of the fear of childbirth in Turkish pregnant women. J Psychosom Obstet Gynaecol 2021; 42:123-131. [PMID: 32116080 DOI: 10.1080/0167482x.2020.1734791] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION Fear of childbirth (FOC) affects women's emotional health, preparation for birth, and outcomes of birth. Identifying the predictors of FOC can aid in identifying strategies for reducing women's FOC. OBJECTIVE This descriptive, cross-sectional study was aimed at determining the psychosocial predictors of FOC in pregnant women. METHODS The participants were 624 nulliparous and multiparous pregnant women in their last trimester. Data were collected using a personal information form, Wijma Delivery Expectancy/Experience Questionnaire A, Childbirth Self-Efficacy Inventory, Multidimensional Scale of Perceived Social Support, State-Trait Anxiety Inventory, and Prenatal Self-Evaluation Questionnaire. Hierarchical regression analysis was performed to determine the predictors of FOC. RESULTS FOC was high among this study's participants and severe for one fifth of them. The psychosocial variables predicting FOC were self-efficacy and trait anxiety level, and spousal support was found to be a mediator variable in the relationship between self-efficacy and FOC. CONCLUSION The findings suggest that psychosocial variables are key to predicting FOC.
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Affiliation(s)
- Nevin Çıtak Bilgin
- Faculty of Health Sciences, Department of Obstetrics and Gynecology Nursing, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Hamit Coşkun
- Faculty of Arts and Science, Department of Psychology, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Dilek Coşkuner Potur
- Faculty of Health Sciences, Department of Obstetrics Gynecology Nursing, Marmara University, İstanbul, Turkey
| | - Esra İbar Aydın
- Woman and Reproductive Health Unit, Bolu Provincial Health Directorate, Bolu, Turkey
| | - Esra Uca
- Mezitli District Health Directorate, Mersin, Turkey
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Zhao Y, Wu J, Yang H, Yin X, Li D, Qiu L, Sun N, Gong Y. Factors associated with childbirth self-efficacy: a multicenter cross-sectional study in China. Midwifery 2020; 93:102883. [PMID: 33246143 DOI: 10.1016/j.midw.2020.102883] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/24/2020] [Accepted: 11/09/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Childbirth self-efficacy is an important indicator of a woman's choice of mode of delivery, and has been found to be closely related to adverse perinatal outcomes. This study was conducted to evaluate childbirth self-efficacy and its influencing factors among pregnant Chinese women. DESIGN A multicenter cross-sectional study. METHODS Pregnant women were recruited by using a convenience sample in four maternal and child healthcare hospitals, one each from four cities in China between May and June 2018. Women with a singleton pregnancy, aged 18 years and older, and able to read and write the Chinese language were included. Trained investigators used a structured self-administrated questionnaire to collect data. EpiData 3.1 was used to prepare the database, and SAS 9.2 was used for statistical analysis. A one-way ANOVA test or independent sample t-tests were used to test the between-group differences in childbirth self-efficacy scores, as appropriate. Multivariate linear regression analyses were conducted to examine childbirth self-efficacy of the pregnant women, and the socio-demographic and obstetric factors that influence childbirth self-efficacy. FINDINGS A total of 1,796 pregnant Chinese women with singleton pregnancies were recruited into this study. The average childbirth self-efficacy score of the participants was 14.42 (standard deviation = 2.80); 9.35% of the participants scored ≤ 10 points, while 22.49% got more than 15 points. Multivariate linear regression analysis revealed that higher childbirth self-efficacy was significantly associated with younger age (ß = -0.05, P<0.01), lower body mass index (BMI) (ß = -0.06, P <0.01), receiving prenatal education (ß = 0.47, P <0.01), performing physical activity 6-7 times per week (ß = 0.47, P = 0.03), and fair (ß = 0.57, P <0.01) or good (ß = 1.08, P <0.01) self-rated health status. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Childbirth self-efficacy was low among pregnant Chinese women. Women with older age, higher BMI, and worse self-rated health status had lower childbirth self-efficacy. On the other hand, women who frequently exercised, had some prenatal education, and had better self-rated health showed higher childbirth self-efficacy during pregnancy. Interventions concentrating on improving childbirth self-efficacy in China should focus on prenatal education for expectant mothers, and more attention should be given to pregnant women who are older, obese, are less physically active, and are in poor health.
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Affiliation(s)
- Yuxin Zhao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Jianxiong Wu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | | | - Xiaoxv Yin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Dandan Li
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Lei Qiu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Na Sun
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Yanhong Gong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.
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SOH YX, Razak NKBA, CHENG LJ, LAU Y. Determinants of childbirth self-efficacy among multi-ethnic pregnant women in Singapore: A structural equation modelling approach. Midwifery 2020; 87:102716. [DOI: 10.1016/j.midw.2020.102716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 12/18/2022]
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Dai L, Zhang N, Rong L, Ouyang YQ. Worldwide research on fear of childbirth: A bibliometric analysis. PLoS One 2020; 15:e0236567. [PMID: 32726336 PMCID: PMC7390386 DOI: 10.1371/journal.pone.0236567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 07/09/2020] [Indexed: 12/14/2022] Open
Abstract
Objective To review the research on fear of childbirth, analyze and evaluate the publications by means of bibliometric analysis, and provide suggestions and scopes for future study. Data sources Web of Science, PubMed, Embase and the Cochrane Library databases. Study selection All published articles focusing on the fear of childbirth from inception to February 10, 2020. Data extraction A total of 743 articles were included for final analysis. Bibliographic data were exported from databases and then cleaned manually before using Microsoft Excel and VOSviewer to analyze and visualize the findings. Data synthesis It was found that 743 articles have been cited 31515 times (h-index: 98). The volume of publications increased by 29.3 times in the past two decades. Across the globe, Sweden was the most prolific country having 129 articles (17.4%) with six of its institutions in the top ten most prolific institutions in the world. Fifty-two (7.8%) documents were published in Midwifery journal. The most prolific author was Hildingsson, who published 35 articles (4.7%). “Cesarean section,” “experience,” and “factor” were the words that appeared most frequently in titles and abstracts of studies. “Point prevalence of psychiatric disorders during the second trimester of pregnancy: A population-based study” was the most cited article and received 525 citations. Conclusion There is an increasing interest in the research in fear of childbirth during the past two decades. This study has demonstrated that the Swedish authors have a leading role on this topic. Researchers especially in countries with high birth rates, need to promote research projects in this field as it is an important public health issue.
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Affiliation(s)
- Lijing Dai
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Na Zhang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Liu Rong
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Yan-Qiong Ouyang
- School of Health Sciences, Wuhan University, Wuhan, China
- * E-mail:
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