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Elsharkawy NB, Alruwaili MM, Mohamed Elsayed Ramadan O, Alruwaili AN, Ouda MMA, Oraby FA, Mansy AMA, Abdelaziz EM. Prevalence and determinants of fear of childbirth among pregnant women in Egypt: A cross-sectional study. Midwifery 2024; 136:104088. [PMID: 38968683 DOI: 10.1016/j.midw.2024.104088] [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: 02/11/2024] [Revised: 06/06/2024] [Accepted: 06/28/2024] [Indexed: 07/07/2024]
Abstract
PROBLEM Fear of childbirth (FOC) is a significant public health concern, and understanding its determinants is crucial for developing effective interventions to support women during pregnancy and childbirth. BACKGROUND Fear of childbirth (FOC) is increasingly recognized as an essential psychological health concern among pregnant women globally. However, research elucidating the prevalence and multifaceted determinants of FOC in the Egyptian context remains scarce. This knowledge is pivotal to informing maternal health practices. AIM This study aimed to investigate FOC prevalence and its determinants among pregnant women in Egypt. METHODS A cross-sectional study was conducted among 460 low-risk pregnant women attending antenatal clinics in El-Beheira Governorate, Egypt, from February 2023 to July 2023. Data were collected using structured questionnaires on sociodemographic and obstetric profiles, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the Multidimensional Scale of Perceived Social Support. RESULTS The prevalence of FOC ranged from mild to severe, with 70.4% of women displaying some degree of fear and 11.3% exhibiting severe FOC. Key determinants associated with greater FOC were younger age, nulliparity, unplanned pregnancy, negative previous birth experiences, and preference for cesarean delivery. An inverse relationship was found between FOC and childbirth self-efficacy. CONCLUSIONS This study reveals a high FOC prevalence among Egyptian pregnant women, necessitating the need for systematic screening and tailored interventions to mitigate this concern, especially among high-risk groups like young, nulliparous mothers. Fostering childbirth self-efficacy may aid in reducing FOC. These findings can inform the enhancement of holistic maternal health practices in Egypt.
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Affiliation(s)
- Nadia Bassuoni Elsharkawy
- Department of Maternal and Child Health Nursing, College of Nursing, Jouf University, Sakaka, AL-Jouf 72388, Saudi Arabia; Department of Maternal and Newborn Health Nursing, Faculty of Nursing, Cairo University, Cairo 11562, Egypt
| | - Majed Mowanes Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka, AL-Jouf 72388, Saudi Arabia
| | - Osama Mohamed Elsayed Ramadan
- Department of Maternal and Child Health Nursing, College of Nursing, Jouf University, Sakaka, AL-Jouf 72388, Saudi Arabia.
| | - Abeer Nuwayfi Alruwaili
- Department of Nursing Administration and Education, College of Nursing, Jouf University, Sakaka, AL-Jouf 72388, Saudi Arabia
| | - Marwa Mohamed Ahmed Ouda
- Department of Maternal and Child Health Nursing, College of Nursing, Jouf University, Sakaka, AL-Jouf 72388, Saudi Arabia; Department of Pediatric Nursing, Faculty of Nursing, Damanhur University, Damanhur 22516, Egypt
| | - Fatma Ali Oraby
- Department of Maternal and Newborn Health Nursing, Faculty of Nursing, Misr University for Science and Technology, 6th of October city, Giza 12566, Egypt
| | - Azza Medhat Aziz Mansy
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Damanhur University, Damanhur 22516, Egypt
| | - Enas Mahrous Abdelaziz
- Department of Psychiatric Mental Health Nursing, Faculty of Nursing, Cairo University, Cairo 11562, Egypt; Department of Psychiatric Mental Health Nursing, College of Nursing, Jouf University, Sakaka, AL-Jouf 72388, Saudi Arabia
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Bakhteh A, Jaberghaderi N, Rezaei M, Naghibzadeh ZAS, Kolivand M, Motaghi Z. The effect of interventions in alleviating fear of childbirth in pregnant women: a systematic review. J Reprod Infant Psychol 2024; 42:5-21. [PMID: 35435061 DOI: 10.1080/02646838.2022.2059458] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Fear of Childbirth (FOC) is regarded as a general problem, which affects women's health and well-being, justifying demanding caesarean section. Several primary studies have been performed in relation to the interventions performed to reduce the fear of childbirth, which show contradictions between the results of these studies. OBJECTIVE This review aims to provide a comprehensive review of the different types of interventions used to reduce the fear of childbirth in pregnant mothers. METHODS In this study, systematic review of study information related to the effect of different therapies on reducing the fear of childbirth using subject-related keywords and validated with MeSH in SID, MagIran, IranMedex, IranDoc, Embase, ProQuest, Scopus, PubMed, Web of Science (ISI) databases and Google Scholar Search Engine were extracted without any time limit until February 2021. RESULTS After removing duplicates and irrelevant works from among the 5396 articles found, 63 articles remained in the study. The participants in these 63 articles were 5415 cases and 5770 controls. In addition, three studies were on epidural anesthesia, 33 on the effects of psychotherapy, 19 on the effects of education, and eight on the influence of other interventions on alleviating FOC. As shown by the results, psychotherapy intervention and education decreased FOC significantly. CONCLUSION According to the results of this study, to prevent the fear of childbirth, pregnancy training and prenatal preparation courses are recommended to empower pregnant women. It also seems beneficial to use psychotherapy approaches for women who are afraid of childbirth.
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Affiliation(s)
- Azam Bakhteh
- Student Research Center, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nasrin Jaberghaderi
- Department of Clinical Psychology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Department of Biostatistics, School of Health & Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Mitra Kolivand
- Department of Reproductive Health, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Motaghi
- Reproductive Health Department, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Elgzar WT, Alshahrani MS, Ibrahim HAF. Mode of delivery preferences: the role of childbirth fear among nulliparous women. Front Psychol 2023; 14:1221133. [PMID: 38034315 PMCID: PMC10687373 DOI: 10.3389/fpsyg.2023.1221133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction The increasing Cesarean Section (CS) rates may be attributed to women's increasing requests for elective CS. High Fear of Childbirth (FOC), especially among nulliparous women, may be significantly associated with CS preference without medical indications. The current study aims to investigate the impact of childbirth fear on the mode of delivery preference among nulliparous women. Methods A cross-sectional correlational study was performed in the Maternal and Children Hospital (MCH) from the beginning of October 2022 to the end of February 2023 and incorporated a convenience sample of 342 nulliparous women. The data was collected using a self-reported questionnaire comprising participants' demographic and obstetrics characteristics and the FOC questionnaire. A logistic regression model examined the relationship between CS preference and the other independent variables. Results The results indicated that 74.3% of the nulliparous women preferred vaginal delivery, while 25.7% preferred Cesarean Section. Concerning childbirth-related fear, the highest mean scores were related to fear of clinical procedures, fear of harming or distressing the infant, and fear of pain 5.19 ± 1.13, 5.12 ± 1.27, and 5.09 ± 1.22, respectively. High FOC was present among 74.6%, moderate in 17.3%, and severe in 6.7% of the participants. Logistic regression analysis showed maternal age and monthly income were the significant sociodemographic determinants of choosing CS as the preferred delivery mode (p < 0.05). Moreover, the participants who had increased fear of harming or distressing the infant, fear from pain, fear from the body's ability to give birth, fear from not being involved in decision-making, and overall FOC had a higher probability of choosing CS as the preferred delivery mode compared to the participants who had lower fear (p < 0.05). Discussion Having high FOC increases the CS preference among nulliparous women. Increased fear of harming or distressing the infant, fear from pain, fear from the body's ability to give birth, and fear from not being involved in decision- making seem to be significant dimensions of childbirth fear associated with CS preference among nulliparous women.
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Affiliation(s)
- Wafaa Taha Elgzar
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran, Saudi Arabia
| | - Majed Saeed Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Heba Abdel-Fatah Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran, Saudi Arabia
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Alizadeh-Dibazari Z, Abdolalipour S, Mirghafourvand M. The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy Childbirth 2023; 23:541. [PMID: 37501120 PMCID: PMC10373291 DOI: 10.1186/s12884-023-05867-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/22/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Antenatal education provides parents with strategies for pregnancy, childbirth, and parenthood. There is not enough evidence of the positive effect of prenatal education on childbirth and maternal outcomes. The present scoping review using a systematic approach, evaluates the effectiveness of prenatal education on fear of childbirth, pain intensity during labour, childbirth experience, and postpartum psychological health. METHODS We used Google Scholar and systematically reviewed databases such as PubMed, Web of Science, Cochrane, Scopus, and SID (Scientific Information Database). Randomized controlled and quasi-experimental trials examining the effect of structured antenatal education and routine prenatal care compared to routine prenatal care were reviewed. The participants included pregnant women preferring a normal vaginal delivery and had no history of maternal or foetal problems. The outcomes considered in this study included fear of childbirth, pain intensity during labour, childbirth experience (as primary outcomes) and postpartum psychological health (as secondary outcomes). The grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence. RESULTS Overall, 3242 studies were examined, of which 18 were qualified for the final analysis. The meta-analysis showed that providing prenatal education and routine care compared to only routine care may decrease the fear of childbirth, postpartum depression, and pain intensity during labour. However, we found no study examining the outcome of the childbirth experience. In addition, the inconsistency of included studies prevented conducting a meta-analysis on the rest of the outcomes. CONCLUSIONS Our investigations showed that there are very few or no studies on the effect of prenatal education on outcomes such as childbirth experience, postpartum anxiety, and maternal attachment, and the existing studies on the effect of prenatal education on outcomes such as the fear of childbirth, postpartum depression, and pain intensity during labour lack sufficient quality to make definitive conclusions. Therefore, high-quality, randomized trials with a more extensive sample size are suggested to provide clear reports to make definitive decisions. PROSPERO ID CRD42022376895.
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Affiliation(s)
- Zohreh Alizadeh-Dibazari
- Midwifery Department, Faculty of Nursing and Midwifery, Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Abdolalipour
- Midwifery Department, Faculty of Nursing and Midwifery, Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Turan A, Kaya C. Effect of maternal cortisol levels on fetal heart rate patterns in primiparous pregnant women in the third trimester. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20221610. [PMID: 37222328 DOI: 10.1590/1806-9282.20221610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/03/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This study aimed to determine whether maternal cortisol levels affect fetal heart rate patterns in primiparous pregnant women in the third trimester. METHODS This cross-sectional descriptive study included 400 primiparous pregnant women with uncomplicated pregnancies between November and December 2022. The study included primiparous pregnant women over 18 years old in the third trimester who had not exercised for at least 2 h before the fetal heart rate monitoring and had a healthy pregnancy without consuming any food or drink. Fetuses with decelerating heartbeats and pregnant women who showed uterine contraction and cervical dilation during the fetal heart rate monitoring were excluded from the study. Research data were collected with the data collection form. The fetal heart rate data were collected using a cardiotocograph. At least two accelerations during the 20-min nonstress test period were the basis for diagnosing a reactive nonstress test. About 5 mL of maternal saliva for cortisol measurements was collected before fetal heart rate monitoring. Research data were analyzed with IBM SPSS Statistics for Macintosh, Version 28.0. A p-value of <0.05 was considered significant. RESULTS There were no significant differences in the comparison of the groups in terms of education and income status, family type, fetal gender, pregnancy planning status, BMI and age averages, or gestational week averages (p>0.05). The number of at least two accelerations required for the diagnosis of reactive NST was also higher in Group 1 (maternal salivary cortisol level ≤24.20). A moderately positive relationship between fetal heart rate and maternal salivary cortisol was observed (r=0.448, p=0.000). In total, 11.9% of the total change in fetal heart rate level is explained by maternal cortisol (R2=0.119). Maternal cortisol increases fetal heart rate level (ß=0.349). CONCLUSION These findings suggest that stress in primiparous pregnant women with high cortisol levels may influence fetal heart rate patterns. It was revealed that the increase in cortisol level, considered a stress hormone, may be a harbinger of fetal tachycardia.
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Affiliation(s)
- Ayşenur Turan
- Istanbul Medipol Üniversitesi, Faculty of Health Sciences, Department of Midwifery - Istanbul, Turkey
| | - Cihan Kaya
- Acıbadem Mehmet Ali Aydınlar Üniversitesi, Acıbadem Bakırköy Hospital, Department of Obstetrics and Gynecology - Istanbul, Turkey
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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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Moshki M, Esmailzadeh-Asali F, Rahmani-Bilandi R, Esmaily H, Dehnoalian A, Jafari A. The effect of prenatal education in two ways, face-to-face and virtual, on the fear of natural childbirth in pregnant women. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-9. [PMID: 37361301 PMCID: PMC10088583 DOI: 10.1007/s10389-023-01866-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/23/2023] [Indexed: 06/28/2023]
Abstract
Aims This study was designed and implemented to compare the effect of prenatal education on the fear of natural birth in pregnant women. Subject and method This research was a semi-experimental study with a control group conducted on 96 pregnant women in Mashhad. People were randomly allocated to face-to-face and virtual groups. The Wijma childbirth experience/expectation questionnaire version A and the midwifery personal information form were used as pre-test and post-test tools. Results In the face-to-face and virtual groups, the average scores before and after the intervention were different, which indicated a decrease in fear of Natural childbirth in pregnant women, which was statistically significant. The changes in fear of natural childbirth score were significantly different between the three groups, and these changes were higher in the face-to-face group than in the other two groups. Conclusion Attendance in natural childbirth preparation classes in face-to-face and virtual training methods positively affects the fear of natural childbirth. Therefore, encouraging and supporting women to participate in training courses increase the women's desire for natural childbirth.
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Affiliation(s)
- Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Farzaneh Esmailzadeh-Asali
- Department of Health Education and Health Promotion, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Roghaieh Rahmani-Bilandi
- Department of Midwifery, Faculty of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atefeh Dehnoalian
- Department of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
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Ayala NK, Schlichting L, Lewkowitz AK, Kole-White MB, Gjelsvik A, Monteiro K, Amanullah S. The Association of Antenatal Depression and Cesarean Delivery among First-Time Parturients: A Population-Based Study. Am J Perinatol 2023; 40:356-362. [PMID: 36228650 PMCID: PMC9970759 DOI: 10.1055/a-1960-2919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Antenatal depression (AD) has been considered a risk factor for cesarean delivery (CD); however, the supporting data are inconsistent. We used a large, nationally representative dataset to evaluate whether there is an association between AD and CD among women delivering for the first time. STUDY DESIGN We utilized the 2016 to 2019 Multistate Pregnancy Risk Assessment Monitoring System (PRAMS) from the Centers for Disease Control. First-time parturients who reported depression in the 3 months prior to or at any point during their recent pregnancy were compared with those who did not. The mode of delivery was obtained through the birth certificate. Maternal demographics, pregnancy characteristics, and delivery characteristics were compared by the report of AD using bivariable analyses. Population-weighted multivariable regression was performed, adjusting for maternal age, race/ethnicity, insurance, pregnancy complications, preterm birth, and body mass index (BMI). RESULTS Of the 61,605 people who met the inclusion criteria, 18.3% (n = 11,896) reported AD and 29.8% (n = 19,892) underwent CD. Parturients with AD were younger, more likely to be non-Hispanic white, publicly insured, use tobacco in pregnancy, deliver earlier, have lower levels of education, higher BMIs, and more medical comorbidities (hypertension and diabetes). After adjustment for these differences, there was no difference in risk of CD between those with AD compared with those without (adjusted odds ratio: 1.04; 95% confidence interval: 0.97-1.13). CONCLUSION In a large, population-weighted, nationally representative sample of first-time parturients, there was no association between AD and CD. KEY POINTS · Antenatal depression is increasingly common and has multiple known morbidities.. · Prior data on antenatal depression and cesarean delivery are mixed.. · We found no association between depression and cesarean delivery..
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Affiliation(s)
- Nina K. Ayala
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
- Address for correspondence Nina K. Ayala, MD Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island101 Dudley Street, Providence, RI 02905
| | - Lauren Schlichting
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, Rhode Island
| | - Adam K. Lewkowitz
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Martha B. Kole-White
- Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Annie Gjelsvik
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, Rhode Island
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Siraj Amanullah
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Providence, Rhode Island
- Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Health Services, Policy and Practice, Brown School of Public Health, Providence, Rhode Island
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Tokophobia: Case Reports and Narratives of Ten Japanese Women. Healthcare (Basel) 2023; 11:healthcare11050696. [PMID: 36900701 PMCID: PMC10001124 DOI: 10.3390/healthcare11050696] [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: 01/09/2023] [Revised: 02/12/2023] [Accepted: 02/18/2023] [Indexed: 03/03/2023] Open
Abstract
Intense fear of childbirth by expectant women is called tokophobia. Because there are no qualitative studies targeting women with an intense fear of childbirth in Japan, it is unknown whether there is any link between the type of fear of objects/situations among tokophobic women and their psychological/demographic background. Furthermore, there is no available summary of the lived experience of Japanese women with tokophobia. This study aims to identify the intensity patterns of various types of fear among the participants and summarize the lived experience of having intense fear of childbirth. A qualitative descriptive study was conducted using a semi-structured interview. Pregnant women with an intense fear of childbirth participated in individual interviews facilitated by a psychiatrist and a midwife. Audio recordings of the interviews were transcribed and analyzed using a content analysis approach. The number of participants was ten. The types of feared objects varied individually and these were categorized as being related to either prospective or retrospective fear. The participants' experiences were grouped into three categories: difficulty in daily life, preoccupied negative expectation towards childbirth, and psychological adaptation to the upcoming childbirth. The results imply that women with tokophobia continuously suffer from fear in their daily life; hence, a special approach is needed to detect and reduce their fear.
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Bašková M, Urbanová E, Ďuríčeková B, Škodová Z, Bánovčinová Ľ. Selected Factors of Experiencing Pregnancy and Birth in Association with Postpartum Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2624. [PMID: 36767994 PMCID: PMC9916054 DOI: 10.3390/ijerph20032624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/24/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The aim of the study is to analyse the risk of postpartum depression using dimensions of perceived support (information, emotional, and physical), antenatal education (satisfaction and attitude), and attitude toward pregnancy (wanted or unwanted). METHODS A cross-sectional study was carried out among 584 postpartum women in two university birth centres in Slovakia. The Edinburgh Postnatal Depression Scale (EPDS) score was used. Descriptive statistics and analysis of variance, as well as logistic regression, were employed in the study. Found associations were adjusted for education level, type of birth, psychiatric history, and age. RESULTS As many as 95.1% of women reported their pregnancy as being wanted. Antenatal education, particularly satisfaction with it, showed a negative association with the EPDS score level. No significant differences in depression levels were found considering attitude toward pregnancy and perceived support. CONCLUSIONS The study pointed out the significance of antenatal education to lower the risk of the postpartum depression. One of the important criteria of effective education is a woman's subjective satisfaction with it.
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Hatamleh R, AbdelMahdi AbuAbed AS, Abujilban S, Joseph R. Using Social Media Platforms to Enhance the Delivery of a Childbirth Education Program. J Perinat Neonatal Nurs 2023; 37:36-43. [PMID: 36707746 DOI: 10.1097/jpn.0000000000000700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of a childbirth education program on self-efficacy and state anxiety among first-time Jordanian mothers. METHODS A randomized controlled trial was conducted using pretest/posttest design with 128 low-risk, first-time Jordanian mothers. The experimental group (N = 64) received a childbirth education program, while those in the control group (N = 64) received standard care in antenatal clinics. Data were collected at two different time points: at recruitment and 3 weeks after attending the program. RESULTS The mean score of the experimental group on outcome expectancy (posttest) (139.91, SD = 15.586) was significantly higher than that of the control group (110.16, SD = 28.33) (F = 72.356, P = .003, partial Eta squared = .37). On the efficacy expectancy, the mean score of the experimental group (133.33, SD = 16.246) was also higher than that of the control group (92.06, SD = 27.07) (F = 144.282, P = .000, partial eta squared = .54). On the state anxiety scale, the mean score of the experimental group was significantly lower than that of the experimental group (F = 89.715, P = .002, partial eta squared = .42). CONCLUSION The childbirth education program improved the coping ability of mothers during childbirth and decreased their state of anxiety.
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Affiliation(s)
- Reem Hatamleh
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan (Dr Hatamleh); Obstetrics and Gynecology Department, AL-Hussein Hospital, King Hussein Medical Center, Royal Medical Services, Amman, Jordan (Ms AbdelMahdi AbuAbed); Faculty of Nursing, Hashemite University, Zarga, Jordan (Dr Abujilban); and Liberty University School of Nursing, Lynchburg, Virginia (Dr Joseph)
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Mohaghegh Z, Javadnoori M, Najafian M, Abedi P, Kazemnejad Leyli E, Montazeri S, Bakhtiari S. Effect of birth plans integrated into childbirth preparation classes on maternal and neonatal outcomes of Iranian women: A randomized controlled trial. Front Glob Womens Health 2023; 4:1120335. [PMID: 37091299 PMCID: PMC10117766 DOI: 10.3389/fgwh.2023.1120335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Background Involvement of women in the decision-making process during childbirth plays an important role in their physical and psychosocial preparation. A birth plan allows the woman to express her expectations and facilitates her participation in her own care. The present study is the first to assess the implementation of birth plans integrated into childbirth preparation classes in Tehran, Iran. Methods This study is a randomized controlled clinical trial performed on 300 pregnant women at 32-33 weeks of gestation referring to four public health centers in Tehran, Iran. The participants were randomly allocated into intervention and control groups using block randomization method. A training session on the items of the birth plan checklist was held in the fifth session of childbirth preparation classes for the participants in the intervention group. Accordingly, a birth plan was prepared according to the requests of mothers. The birth plan was implemented after the women were admitted to the maternity ward. The primary outcomes were frequency of vaginal birth, mean duration of labor stages, and mean score of childbirth satisfaction. We used a checklist of maternal and neonatal outcomes, Mackey's childbirth satisfaction questionnaire, and a partogram form for data collection. Independent t-test, Mann-Whitney U-test, Chi-square test, Fisher's exact test, and logistic regression were used for data analysis. Results Vaginal birth rates were significantly higher in women who had birth plans compared with those without (81.9% vs. 48.7%, p < 0.001). Also, the lengths of the first and the second stages of labor were significantly shorter in women having a birth plan (p = 0.02). Women in the birth plan group were significantly more satisfied with the process of labor and childbearing (p < 0.001), and started breastfeeding after birth earlier than those in the control group (p < 0.001). Conclusion Having a birth plan and attending childbirth preparation classes can increase the rate of normal vaginal birth. Also, according to our results, women's participation in the decision- making process and fulfilling their preferences during birth can improve maternal and neonatal outcomes and childbirth satisfaction.Trial registration: IRCT20190415043283N2. 2020-12-07.
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Affiliation(s)
- Zaynab Mohaghegh
- Department of Midwifery, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Javadnoori
- Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Correspondence: Mojgan Javadnoori
| | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Department of Midwifery, Menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Kazemnejad Leyli
- Department of Biostatistics, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Simin Montazeri
- Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Bakhtiari
- Midwifery Department, Rosie Hospital, Cambridge University Hospitals NHS, Cambridge, United Kingdom
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A preliminary investigation into testing a transdiagnostic cognitive model of fear of childbirth (FOC): a multiple indicators multiple causes (MIMIC) model. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cruz Neto J, Santos PSPD, Silva MCBE, Cruz RDSBLC, Beltrão ICSLD, Oliveira DRD. Nursing Diagnoses and Interventions in Women with Hypertensive Disorders of Pregnancy: A Scoping Review. AQUICHAN 2022. [DOI: 10.5294/aqui.2022.22.3.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To map the diverse scientific evidence on nursing diagnoses and interventions in women with pregnancy hypertensive disorders under Primary Health Care. Materials and method: A scoping review was conducted through nine stages in seven databases and the thesis and dissertation catalog of the Coordinating Office for Improving Higher Education Personnel. The search was performed from January to March 2021. Results: A total of 2,505 articles were retrieved, of which five were included in the final review. Nine primary diagnoses from the 2009-2011 version of NANDA-I were identified. Each diagnosis was classified according to physical, psychological, behavioral, and environmental characteristics. The interventions were related to controlling pain, anxiety, hemodynamic dysfunctions, self-esteem level, fluid replacement, patient/environment hygiene, and sleep-rest ratio. Conclusions: The nursing diagnoses and interventions presented in this study corroborate the clinical practice and aid nursing professionals’ reasoning.
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Kananikandeh S, Amin Shokravi F, Mirghafourvand M, Jahanfar S. Factors of the childbirth fear among nulliparous women in Iran. BMC Pregnancy Childbirth 2022; 22:547. [PMID: 35794544 PMCID: PMC9260972 DOI: 10.1186/s12884-022-04870-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fear of childbirth is an anxiety associated with childbirth, which manifests itself in physical and concentration problems. It is often associated with requesting a cesarean section, and it is prevalent in nulliparous women. This is a study aimed to summarize the published research on the factors for fear of childbirth in nulliparous women in Iran. METHODS This study was conducted based on the PRISMA statement. A literature search was performed on nine electronic databases (Web of Sciences, Since Direct, Scopus, PubMed, Cochrane Library, ProQuest, and Persian databases including Scientific Information Database, Irandoc, and Magiran) using keywords related to fear of childbirth, factors, nulliparous, and Iran from 2000 to 2020. This study included cross-sectional studies with full-text in English or Persian in Iran. The quality of the selected studies was evaluated independently by two authors and via the STROBE checklist. RESULTS In this study, 93 articles were identified,13 duplicate articles were excluded, 80 articles were screened by title and abstract, 62 were excluded, and the full-text of 18 articles was assessed for analysis. Of these, 12 were excluded, and six articles were reviewed. Six studies were conducted in different provinces of Iran. Based on the study results, factors of the fear of childbirth in nulliparous women were: biological (the process of labor and childbirth and labor pain, concern for the baby (harm to the baby and baby infirmity), psychological (painful injections during labor and suturing in childbirth), and individual (loss of control during labor). CONCLUSIONS This study identified four main factors that affect fear of childbirth status in nulliparous women, and concern for the baby was a more common factor in this study. In conclusion, these factors can be reduced by increasing their assurance about child health, training during pregnancy, talking about positive experiences, and holding workshops.
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Affiliation(s)
- Safieh Kananikandeh
- Health Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farkhondeh Amin Shokravi
- Health Education and Health Promotion, Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mojgan Mirghafourvand
- Reproductive Health, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, USA
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Ciochoń A, Apanasewicz A, Danel DP, Galbarczyk A, Klimek M, Ziomkiewicz A, Marcinkowska UM. Antenatal Classes in the Context of Prenatal Anxiety and Depression during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095073. [PMID: 35564465 PMCID: PMC9101236 DOI: 10.3390/ijerph19095073] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 02/05/2023]
Abstract
Perinatal maternal anxiety and depression negatively affect intrauterine fetal development, birth outcome, breastfeeding initiation, duration, and milk composition. Antenatal classes potentially reduce the anxiety of pregnant women and may thus contribute to healthy infant development. The study investigates the relationship between participation in online or in-person antenatal classes and levels of anxiety and depression in Polish women during the COVID-19 pandemic. The study group included 1774 adult, non-smoking pregnant women. We compared the state anxiety (STAI-State) and depression levels (EPDS) in women who (i) attended antenatal classes in-person, (ii) attended online classes, and (iii) did not attend any of them. The statistical analyses included a GLM model and trend analysis, while controlling for maternal trait anxiety, age, pregnancy complications, trimester of pregnancy, previous pregnancies, and COVID-19 infections. We observed statistically significant differences in the level of anxiety (and depression). Women who did attend antenatal classes in person had the lowest levels of anxiety and depression. Considering the importance of maternal mental well-being on fetal development, birth outcome, and breastfeeding, in-person participation in antenatal classes should be recommended to pregnant women.
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Affiliation(s)
- Aleksandra Ciochoń
- Department of Environmental Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (A.C.); (A.G.); (M.K.); (U.M.M.)
| | - Anna Apanasewicz
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.A.); (D.P.D.)
| | - Dariusz P. Danel
- Department of Anthropology, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wrocław, Poland; (A.A.); (D.P.D.)
| | - Andrzej Galbarczyk
- Department of Environmental Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (A.C.); (A.G.); (M.K.); (U.M.M.)
| | - Magdalena Klimek
- Department of Environmental Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (A.C.); (A.G.); (M.K.); (U.M.M.)
| | - Anna Ziomkiewicz
- Laboratory of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, 30-387 Kraków, Poland
- Correspondence: ; Tel.: +48-12-6645070
| | - Urszula M. Marcinkowska
- Department of Environmental Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, 31-066 Kraków, Poland; (A.C.); (A.G.); (M.K.); (U.M.M.)
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Relationship between Primigravid women’s awareness, attitude, fear of childbirth, and mode of delivery preference. Eur J Obstet Gynecol Reprod Biol X 2022; 14:100143. [PMID: 35141516 PMCID: PMC8814374 DOI: 10.1016/j.eurox.2022.100143] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Fear of childbirth is the main factor, which has decreased the tendency toward selecting natural birth. The immoderate increase in the number of C-sections has increased maternal and neonatal morbidity and mortality. The present study investigates the relationship between awareness, attitude, fear of childbirth, and mode of delivery preference in Primigravid women referring to healthcare centers in Khorramabad, Iran. Method In this descriptive-analytic study, 179 nulliparous pregnant women with the gestational age of> 2,0 weeks who visited selected healthcare centers in Khorramabad for routine pregnancy care in 2020 were selected in two stages and studied. The data were collected via the childbirth attitude questionnaire (CAQ), awareness, attitude, demographic characteristics, current pregnancy characteristics, midwifery history, and history of infertility treatment questionnaires. The data were analyzed via the Chi-squared test. Results The participants had a mean gestational age of 33.73 ± 4.71 weeks. There was a significant different between the level of awareness, and mode of delivery preference (p = 0.005). The majority of the participants (57.5%) had a moderate level of awareness about the mode of delivery. There was a significant different between the level of, attitude, and mode of delivery preference (p = 0.001).) Most of the participants (71.5%) had a negative attitude towards the mode of delivery. There was also a significant different between fear of childbirth and mode of delivery preference (p < 0.001), and most of the participants (71.5%) showed fear of childbirth. Conclusion According to the results of this study, the majority of participants had afraid of childbirth, moderate awareness of mode of delivery, and negative attitudes. So, the healthcare providers should pay special attention to the fear of childbirth and the relevant factors during pregnancy.
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Iwanowicz-Palus G, Mróz M, Korda A, Marcewicz A, Palus A. Perinatal Anxiety among Women during the COVID-19 Pandemic-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052603. [PMID: 35270296 PMCID: PMC8909536 DOI: 10.3390/ijerph19052603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has changed the way prenatal education and obstetric care are provided. Pandemic-related anxiety, restrictions, limitations in perinatal care, and the inability to be accompanied by a loved one can have negative psychological consequences for future parents and their child. The aim of this study was to analyze the determinants and assess the anxiety of pregnant women in individual trimesters, as well as to learn about the sources of support and medical personnel proceeding methods. MATERIALS AND METHODS This research was conducted as a diagnostic survey, using the State-Trait Anxiety Inventory (STAI), Childbirth Anxiety Questionnaire (CAQ), and a standardized interview questionnaire, on 534 pregnant women in Poland. Resultsand Conclusions: The pregnant women, regardless of the trimester of pregnancy, are characterized by: increased anxiety level influenced by the current epidemiological situation, psychophysical condition, previous maternal experiences, participation in classes preparing for childbirth, organization of perinatal care, their relationship with a partner, and the presence of a loved one during childbirth. A negative correlation was shown between the level of childbirth anxiety and maternal experience, as well as the support of a doctor and midwife.
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Affiliation(s)
- Grażyna Iwanowicz-Palus
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica Str., 20-081 Lublin, Poland; (G.I.-P.); (A.M.)
| | - Mariola Mróz
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica Str., 20-081 Lublin, Poland; (G.I.-P.); (A.M.)
- Correspondence: ; Tel.: +48-81-448-6840
| | - Aleksandra Korda
- Students’ Scientific Circle at the Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Agnieszka Marcewicz
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica Str., 20-081 Lublin, Poland; (G.I.-P.); (A.M.)
| | - Agnieszka Palus
- Medical Doctor in Medical Center in NowyDwór Mazowiecki, Faculty of Medicine, Warsaw Medical University, 02-091 Warsaw, Poland;
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Related Psychosocial Factors and Delivery Mode of Depression and Anxiety in Primipara in Late Pregnancy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3254707. [PMID: 34646324 PMCID: PMC8505059 DOI: 10.1155/2021/3254707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
Studies in recent years show that the delivery process, the choice of delivery mode, and the delivery outcome of primiparas are affected by their mental state. With the transformation of the medical model from the single biomedical model to the biopsychosocial medical model, the influence of social psychological factors on maternal psychological state has aroused heated discussion among clinical scholars. In this study, 480 cases of normal primiparas who had regular prenatal examination and delivered in hospital were selected as the research object. The Hospital Anxiety and Depression Scale (HAD) was used to record the depressive anxiety state of all study subjects in the third trimester, and we analyzed the effects of age, education background of pregnant women and their spouses, the nature of jobs, family income, prenatal and pregnancy health status, medical insurance status, attend pregnant women's school, and accompanying status of family member on their depressive anxiety state. The influence of depression and anxiety on delivery mode was analyzed. The result showed that the age, health status during prenatal and pregnancy, accompanying status of family members, and attend pregnant women's school are the independent risk factors affecting depression and anxiety status of primiparas during late pregnancy. Antenatal depression and anxiety have certain influence on the choice of the delivery mode of pregnant women. Targeted psychological intervention for primiparas with high-risk factors is helpful to improve their psychological state and reduce the rate of cesarean section.
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