The role of fear of childbirth in pregnancy related anxiety in Iranian women
A qualitative research
Keywords:
Fear, Childbirth, Pregnancy related anxiety, Normal deliveryAbstract
Introduction: Anxiety disorders have severe complications for a mother and her developing baby. A few studies have focused on pregnancy related anxiety and its risk factors including fear of childbirth. Therefore, the current study aimed to explore components and dimensions of this kind of anxiety.
Methods: This qualitative study (conventional content analysis) was conducted with mothers who referred to health care centers from May to December, 2015. In order to collect data, purposive sampling and face-to-face semi-structured in-depth interviews were used. Data analysis was conducted using MAXQDA software.
Results: Twenty eight pregnant women from different social backgrounds, educational levels and ethnicities aged 18-41 years old participated in this study and after analysis, fear of childbirth was classified into four categories including the process of delivery (fear of pain, prolonged labor, loss of control, being left alone during delivery, fear of her own incompetency), time of delivery (fear of preterm labor, fear of unknown delivery time, fear of late arrival to hospital),delivery complications (fear of bleeding, fear of death, postpartum depression, delivery accidents, genitalia injuries and fetal health problems) and healthcare quality (hospital facilities, lack of trust in maternity staff and lack of trust in obstetricians).
Conclusions: The results suggest that supporting, reassuring and educating pregnant mothers and giving information about delivery room, labor and strategies for coping with fear of pain and childbirth are critical. Changes in maternity care policies are recommended to promote positive attitudes toward normal delivery.
References
Huizink AC, Mulder EJ, Robles de Medina PG, Visser GH, Buitelaar JK. Is pregnancy anxiety a distinctive
syndrome? Early Hum Dev. 2004; 79(2): 81-91. doi: 101016/j.eailhumdev.2004.04.014. PMID: 15394989.
Deklava L, Lubina K, Circenis K, Sudraba V, Miller I. Causes of Anxiety during Pregnancy. Social and
Behavioral Sciences. 2015; 205: 623-6. doi: 10.1016/j/sbrspro.2015.09.097.
Staneva AA, Bogossian F, Wittkowski A. The experience of psychological distress, depression, and anxiety
during pregnancy: A meta-synthesis of qualitative research. Midwifery. 2015; 31(6): 563-73. doi:
1016/j.midw.2015.03.015. PMID: 25912511.
Glover V, Bergman K, Sarkar P, O'Connor TG. Association between maternal and amniotic fluid cortisol is
moderated by maternal anxiety. Psychoneuroendocrinology. 2009; 34(3): 430-5. doi:
1016/j.psyneuen.2008.10.005. PMID: 19019559.
Thomas GO, Jonathon H, Jean G, Michael B, Vivette G. Maternal antenatal anxiety and children’s
behavioural/emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and
Children. Br J Psychiatry. 2002; 180(6): 502–8. doi: 10.1192/bjp.180.6.502.
Thombre MK, Talge NM, Holzman C. Association between pre-pregnancy depression/anxiety symptoms
and hypertensive disorders of pregnancy. J Womens Health (Larchmt). 2015; 24(3): 228-36. doi:
1089/jwh.2014.4902. PMID: 25588112. PMCID: PMC4442555.
Van Bussel JC, Spitz B, Demyttenaere K . Anxiety in pregnant and postpartum women. An exploratory
study of the role of maternal orientations. J Affect Disord. 2009; 114(1-3): 232-42. doi:
1016/j.jad.2008.07.018. PMID: 18793805.
Ali NS, Azam IS, Ali BS, Tabbusum G, Moin SS. Sana SM. Frequency and associated factors of anxiety
and depression in pregnant women. ScientificWorld Journal. 2012; 13: 9-18. doi: 10.1100/2012/653098.
PMID: 22629180. PMCID: PMC3354685.
Bayrampour H, Ali E, McNeil DA, Benzies k, MacQueen G, Though S. Pregnancy related anxiety: A
Concept analysis. Int J Nurs Stud. 2016; 55: 115-30. doi: 10.1016/j.ijnurstu.2015.10.023. PMID: 26626973.
Körükcü O, Ziya Firat M, Kukulu K. Relationship between fear of childbirth and anxiety among Turkish
pregnant women. Procedia-Social and Behavioral Sciences. 2010; 5: 467-70. doi:
1016/j.sbspro.2010.07.125.
Zar M, Wijma K, Wijma B. Relations between anxiety disorders and fear of childbirth during late
pregnancy. Clin Psychol Psychother. 2002; 9(2): 122-30. doi: 10.1002/cpp.305.
Therese H, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective
caesarean section: a population-based study. BMC Pregnancy and Childbirth. 2015; 15: 221: 2-10. doi:
1186/s12884-015-0655-4.
Rouhe H .Fear of child birth Academic dessertation of Midwifery of Helsinki university, 2015, p:41.
Waldenstrom U, Hildingsson I, Ryding EL. Antenatal fear of childbirth and its association with subsequent
caesarean section and experience of childbirth. BJOG. 2006; 113(6): 638-46. doi: 10.1111/j.1471- 0528.2006 .01237.x. PMID: 16709206.
Hall WA, Huuck YL, Carty EM, Huton Ek, Fenwick J, stoll k.Childbitrth fear anxiety,fatique and sleep
depreviation in pregnant women. J Obstet Gynecol Neonatal Nurs. 2009; 38(5): 567-76. doi:
1111/j.1552-6909.2009.01054.x. PMID: 19883478.
Adams SS, Eberhard-Gran M, Eskild A. Fear of childbirth and duration of labor: a study of 2206 women
with intended vaginal delivery. BJOG. 2012; 119(10): 1238-46. doi: 10.1111/j.1471-0528.2012.03433.x.
PMID: 22734617.
Stoll K, Fairbrother N, Carty E, Jordan N, Miceli C, Vostrcil Y, et al. “It’s All the Rage These Days”:
University students’ Attitudes Toward Vaginal and Cesarean Birth. 2009; 36(2). 133-40. doi:
1111/j.1523-536X.2009.00310.x.
Spice K, Jones SL, Hadijiatarpoloulos HD, Kaowalyk K, Stewart SH. Prenatal fear of childbirth and
anxiety sensitivity. J Psychosom Obstet Gynaecol. 2009; 30(3): 168-74. doi: 10.1080/01674820902950538.
PMID: 19591052.
Buist A, Gotman N, Yonkers KA. Generalized anxiety disorder: course and risk factors in pregnancy. J
Affect Disord. 2011; 131(1-3). doi: 10.1016/j.jad.2011.01.003. PMID: 21269708. PMCID: PMC3095713.
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005; 15(9):
–88. doi: 10.1177/1049732305276687. PMID: 16204405.
Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic
imperative. Lippincott Williams & Wilkins. 2011; 470.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and
measures to achieve trustworthiness. Nurse Educ Today. 2004; 24(2): 105-12. doi:
1016/j.nedt.2003.10.001. PMID: 14769454.
Elo S, Kyngäs H. The qualitative content analysis process. J Advanced nursing. 2008; 62(1): 107-115. doi:
1111/j.1365-2648.2007.04569.x. PMID: 183552969.
Mwape L, Macguinness TM, Dixey R. Socio-cultural factors surrounding mental distress during the
perinatal period in Zambia: a qualitative investigation. International Journal of Mental Health Systems.
; 6(12): 2-10. doi: 10.1186/1752-4458-6-12.
Nillson C, Lundgren I. Women's lived experience of fear of childbirth. Midwifery. 2009; 25(2): 1-9. doi:
1016/j.midw.2007.01.017. PMID: 17512645.
Salari P, Firoozi M, Sahebi A. Study of the Stressor associated with pregnancy. Journal Of Sabzevar
University Of Medical Sciences. 2005; 12(3): 34-40.
Faisal I, Matinnia N, Hejar AR, Khodakarami Z. Why do primigravidae request caesarean section in a
normal pregnancy? A qualitative study in Iran. Midwifery. 2014; 30(2): 227-33. doi:
1016/j.midw.2013.08.011. PMID: 24055288.
Abbaspoor Z, Mogaddam L, Ahmadi F, Kazemnejad A. Women's Fear of child birth and its impact on
selection of birth method. A qualitative study. Payesh. 2014; 13(5): 576-85.
Khorsandi M, Vakilian K, Nasirsadeh M. Investigating different factors of fear in normal delivery among
pregnant woman, in Arak-A cross sectional study. Journal of Fasa medical Science. 2014; 4(2): 162-7.
Sjögren B. Reason for anxiety about childbirth in 100 pregnant women . J Psychosom Obstet Gynaecol.
; 18(4): 266-72. PMID: 9443136.
Szeverenyi P, Poka R, Heteg M, Torok Z. Contents of childbirth-related fear among couples wishing the
partner's presence at delivery. J Psychosom Obstet Gynaecol. 1998; 19(1): 38-43. PMID: 9575467.
Sereshti M, Nahidi F, Simbar M, Ahmadi F, Bakhtiari M, Zayeri F. Mothers’ Perception of Quality of
Services from Health Centers after Perinatal Loss. Electronic physician. 2016; 8(2): 2006-17. doi:
19082/2006.
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