Factors contributing to fear of childbirth among pregnant women in Hamadan (Iran) in 2016

Authors

  • Batoul Khodakarami M.Sc. of Midwifery, Department of Midwifery, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran

Keywords:

Childbirth fear, Pregnancy, Related factors

Abstract

Background: Fear of childbirth is a considerable mental, social, and physiological phenomenon among women as well as their families, which can be effective in choosing cesarean section for delivery. 

Aim: To determine some factors contributing to the fear of childbirth among pregnant women.

Method: This cross-sectional study was conducted on 335 pregnant women referred to health centers in Toyserkan in 2016. Pregnant women with the gestational age of 16-40 weeks filled out Harman’s Childbirth Attitude Questionnaire (CAQ) as well as stating demographic and obstetrics characteristics. Data were analyzed by Software SPSS/19 through chi-square, ANOVA, and Pearson’s correlation tests.

Results: The mean age and mean gestational age of the pregnant women were 26.5±4.9 years old and 26.52 weeks, respectively; 89.3% of the women reported fear of childbirth. There was a significant difference among the mean scores of the women’s fear of childbirth and education level, household income adequacy, gravidity, being familiar with the delivery process, and pre-pregnancy cares (p<0.05). 

Conclusion: The present study found the relationship between women’s fear of childbirth and their education level, household income, gravidity, familiarity with delivery process, and pre-pregnancy cares. It is necessary for health caregivers to take into consideration the vulnerable groups, especially nulliparous women during pre-pregnancy care as well as the social, and cultural status of women in order to identify the pregnant women exposed to fear of childbirth and reduce the chance of choosing cesarean section by providing appropriate services.

References

Dick-Read G. Childbirth Without Fear. London: Pinter & Martin; 2013.

World Health Organization. WHO statement on caesarean section rates. 2015. Available from:

http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/cs-statement/en/.

Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of

additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to

universal coverage. Geneva: World Health Organization; 2010.

Angeja AC, Washington AE, Vargas JE, Gomez R, Rojas I, Caughey AB. Chilean women's preferences

regarding mode of delivery: which do they prefer and why? BJOG. 2006; 113(11): 1253-8. doi:

1111/j.1471-0528.2006.01069.x. PMID: 17014679.

Nieminen K, Stephansson O, Ryding EL. Women's fear of childbirth and preference for cesarean section--a

cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. 2009; 88(7):

-13. doi: 10.1080/00016340902998436. PMID: 19488882.

Eynsheykh ZD, Shaahmadi F, Taslimi S, Emamiureh F, Moeinaldini S. Investigating the Relationship

between Demographic Factors and Choice of Delivery Method in Pregnant Women in the City of

Savojbolagh. J Family Reprod Health. 2013; 7(1): 35-8. PMID: 24971100, PMCID: PMC4064745.

Negahban T, Ansari A. Does Fear of Childbirth Predict Emergency Cesarean Section in Primiparous

Women? Hayat. 2009; 14(3-4): 73-81.

Khorsandi M, Vakilian K, Nasir Zadeh M. Investigating Different Factors of Fear in Normal Delivery

among Pregnant Women, in Arak -A Cross Section al Study. JFUMS. 2014; 4(2): 161-7s.

Klein MC, Sakala C, Simkin P, Davis-Floyd R, Rooks JP, Pincus J. Why do women go along with this

stuff? Birth. 2006; 33(3): 245-50. doi: 10.1111/j.1523-536X.2006.00110.x. PMID: 16948725.

Christiaens W, Van De Velde S, Bracke P. Pregnant Women’s fear of childbirth in midwife and

obstetrician-Led care in Belgium and the Netherlands: test of the medicalization hypothesis. Women

Health. 2011; 51(3): 220-39. doi: 10.1080/03630242.2011.560999. PMID: 21547859.

Toohill J, Fenwick J, Gamble J, Creedy DK. Prevalence of childbirth fear in an Australian sample of

pregnant women. BMC Pregnancy Childbirth. 2014; 14: 275. doi: 10.1186/1471-2393-14-275. PMID:

, PMCID: PMC4138382.

Fenwick J, Gamble J, Nathan E, Bayes S, Hauck Y. Pre- and postpartum levels of childbirth fear and the

relationship to birth outcomes in a cohort of Australian women. J Clin Nurs. 2009; 18(5): 667-77. doi:

1111/j.1365-2702.2008.02568.x. PMID: 19239535.

Ryding E, Wirfelt E, Wangborg IB, Sjogren B, Edman G. Personality and fear of childbirth. Acta Obstet

Gynecol Scand. 2007; 68(7): 814-20. doi: 10.1080/00016340701415079. PMID: 17611826.

Haines H, Pallant JF, Karlström A, Hildingsson I. Cross-cultural comparison of levels of childbirth-related

fear in an Australian and Swedish sample. Midwifery. 2011; 27(4): 560-7. doi:

1016/j.midw.2010.05.004. PMID: 20598787.

Laursen M, Hedegaard M, Johansen C. Fear of childbirth: predictors and temporal changes among

nulliparous women in the Danish National Birth Cohort. BJOG. 2008; 115(3): 354-60. doi: 10.1111/j.1471- 0528.2007.01583.x. PMID: 18190372.

Salomonsson B, Bertero C, Alehagen S. Self-efficacy in pregnant women with severe fear of childbirth. J

Obstet Gynecol Neonatal Nurs. 2013; 42(2): 191-202. doi: 10.1111/1552-6909.12024. PMID: 23488555.

Sydsjo G, Sydsjo A, Gunnervik C, Bladh M, Josefsson A. Obstetric outcome for women who received

individualized treatment for fear of childbirth during pregnancy. Acta Obstet Gynecol Scand. 2012; 91(1):

-9. doi: 10.1111/j.1600-0412.2011.01242.x. PMID: 21787365.

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- 0528.2006.00950.x. PMID: 16709206.

Sjogren B, Thomassen P. Obstetric outcome in 100 women with severe anxiety over childbirth. Acta Obstet

Gynecol Scand. 1997; 76(10): 948-52. doi: 10.3109/00016349709034907. PMID: 9435734.

Rouhe H, Salmela-Aro K, Toivanen R, Tokolo M, Halmesmaki E, Saisto T. Obstetric outcome after

intervention for severe fear of childbirth in nulliparous women – randomised trial. BJOG. 2013; 120(1): 75- 84. doi: 10.1111/1471-0528.12011. PMID: 23121002.

Zar M, Wijma K, Wijma B. Pre- and postpartum fear of childbirth in nulliparous and parous women. Scand

J Behav Ther. 2001; 30(2): 75-84. doi: 10.1080/02845710121310.

Nieminen K, Stephansson O, Ryding EL. Women’s fear of childbirth and preference for cesarean section –

a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. 2009; 88(7):

-13. doi: 10.1080/00016340902998436. PMID: 19488882.

Ryding E, Lukasse M, Schei B. Fear of childbirth – does it affect mode of delivery. The BIDENS study –

results from six countries. Acta Obstet Gynecol Scand. 2012; 91: 38.

Hall WA, Hauck YL, Carty EM, Hutton EK, Fenwick J, Stoll K. Childbirth fear, anxiety, fatigue, and sleep

deprivation in pregnant women. J Obstet Gynecol Neonatal Nurs. 2009; 38(5): 567-76. doi:

1111/j.1552-6909.2009.01054.x. PMID: 19883478.

Sjogren B. Reasons for anxiety about childbirth in 100 pregnant women. J Psychosom Obstet Gynaecol.

; 18(4): 266-72. doi: 10.3109/01674829709080698. PMID: 9443136.

Creedy DK, Shochet IM, Horsfall J. Childbirth and the development of acute trauma symptoms: incidence

and contributing factors. Birth. 2000; 27(2): 104-11. doi: 10.1046/j.1523-536x.2000.00104.x. PMID:

Gamble J, Creedy D, Moyle W, Webster J, McAllister M, Dickson P. Effectiveness of a counseling

intervention after a traumatic childbirth: a randomized controlled trial. Birth. 2005; 32(1): 11-19. doi:

1111/j.0730-7659.2005.00340.x. PMID: 15725200.

Zafarghandi N, Hadavand Sh, Torkestani F, Zaeri F, Variji M. Evaluation of anxiety and fear of labor in

postpartum period. J Med Counc I.R.I. 2005; 23(2): 155-60.

Naeimi N, Zare K, Salehi A. Attitude towards Fear of Vaginal Delivery and its Relationship with

Awareness Level of the Pregnant Women Admitted to Social Security Hospital of Zahedan in the Year

J Community Health. 2015; 9(1): 10-8.

Matinnia N, Faisal I, Hanafiah Juni M, Herjar AR, Moeini B, Osman ZJ. Fears related to pregnancy and

childbirth among primigravidae who requested caesarean versus vaginal delivery in Iran. Matern Child

Health J. 2015; 19(5): 1121-30. doi: 10.1007/s10995-014-1610-0. PMID: 25269852.

Najafi F, Abouzari-Gazafroodi K, Jafarzadeh-Kenarsari F, Rahnama P, Gholami Chaboki B. Relationship

between attendance at childbirth preparation classes and fear of childbirth and type of delivery. Hayat.

; 21(4): 30-40.

Khorsandi M, Ghofranipour F, Heidarnia A, Faghihzadeh S, Vafaei M, Rousta F, et al. The effect of

childbirth preparation classes on childbirth fear and normal delivery among primiparous women. AMUJ.

; 11(3): 29-36.

Haines HM, Rubertsson C, Pallant JF, Hildingsson I. The influence of women’s fear, attitudes and beliefs

of childbirth on mode and experience of birth. BMC Pregnancy Childbirth. 2012; 12: 55. doi:

1186/1471-2393-12-55. PMID: 22727217, PMCID: PMC3449179.

Akhlaghi F, Mokhber N, Shakeri MT, Shamsa F. Relation between depression, anxiety, self-esteem,

marital satisfaction, demographical factor and maternal complications with fear of childbirth in nulliparous

women. J Fundam Ment Health. 2012; 14(2(54)): 122-31.

Størksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective

caesarean Section: a population-based study. BMC Pregnancy Childbirth. 2015; 15: 221. doi:

1186/s12884-015-0655-4.

Published

2022-01-18

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