Fear of natural childbirth and its related factors among primigravid women: a mixed-methods study

Document Type : Original Article

Authors

1 Assistant Professor, Department of Reproductive Health, Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.

2 Professor of Reproductive Health, Department of Midwifery And Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

3 Assistant Professor, Department of Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.

4 Resident of Internal Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.

Abstract

Introduction: Fear of natural childbirth is a common problem among pregnant women. The present study was performed with aim to explain fear of natural childbirth and its related factors among primigravid women.
Methods: This sequential-explanatory mixed-methods study with participant selection type was conducted in 2014-2015. At quantitative phase, using a multistage cluster sampling method, 400 primigravid women with 18-32 gestation weeks were selected. To collected data, Childbirth Attitude Questionnaire, demographic characteristics, and Northouse Social Support Questionnaire were used. Data analysis was performed using Chi-square, t-test, Mann-Whitney test, and multivariate logistic regression. At qualitative phase, semi-structured individual interviews using open-ended questions was performed on 15 primigravid women who were selected using purposive sampling method. The data were analyzed using conventional content analysis method.
Results: Mean score of fear of natural childbirth was 37.86±9.44 and its prevalence (CAQ≥28) was 80.8%. According to the results of multivariate logistic regression analysis, a significant relationship was found between lack of sufficient income (p=0.020), not participating in childbirth preparation classes (p=0.040) and selection of delivery method (vaginal delivery) (p<0.001) with fear of childbirth. Analysis of data at the qualitative stage led to three themes including feeling of inability for natural childbirth, confusion in decision making and concerns about natural childbirth complications.
Conclusion: Fear of childbirth was influenced by personal, social and cultural factors. Therefore, it is suggested that health service providers use the results of this study to implement educational programs in order to encourage natural childbirth.

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Main Subjects

References

  1. 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. Journal of clinical nursing 2009; 18(5):667-77.
  2. Declercq E, Young R, Cabral H, Ecker J. Is a rising cesarean delivery rate inevitable? Trends in industrialized countries, 1987 to 2007. Birth 2011; 38(2):99-104.
  3. Katikireddi SV, Gorman DR, Leyland AH. A comparison of trends in caesarean section rates in former communist (transition) countries and other European countries. The European Journal of Public Health 2013; 23(3):381-3.
  4. Liu NH, Mazzoni A, Zamberlin N, Colomar M, Chang OH, Arnaud L, et al. Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study. Reproductive health 2013; 10:1-7.
  5. Moradi M, Nazi A, Mazloumi E. Prevalence and Causes Related to Fear of Vaginal Delivery in Iran: A Systematic Review. Iranian Journal of Nursing Research 2022; 17(1):43-53.
  6. Nilsson C, Hessman E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, et al. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC pregnancy and childbirth 2018; 18:1-15.
  7. Beiranvand SP, Moghadam ZB, Salsali M, Majd HA, Birjandi M, Khalesi ZB. Prevalence of fear of childbirth and its associated factors in primigravid women: A cross-sectional study. Shiraz E-Medical Journal 2017; 18(11).
  8. Stoll K, Edmonds JK, Hall WA. Fear of childbirth and preference for cesarean delivery among young American women before childbirth: a survey study. Birth 2015; 42(3):270-6.
  9. Andaroon N, Kordi M, Kimiaei SA, Esmaeili H. Relationship between Intensity of fear of Childbirth with choosing mode of delivery in Primiparous Women. The Iranian Journal of Obstetrics, Gynecology and Infertility 2017; 20(5):68-75.
  10. Rouhe H, Salmela‐Aro K, Halmesmäki E, Saisto T. Fear of childbirth according to parity, gestational age, and obstetric history. BJOG: An International Journal of Obstetrics & Gynaecology 2009; 116(1):67-73.
  11. Khorsandi M, Vakilian K, Nasir zadeh Masooleh M. Investigating different factors of fear in normal delivery among pregnant women, in arak-a cross sectional study. Journal of Advanced Biomedical Sciences 2014; 4(2):161-7.
  12. Adams SS, Eberhard‐Gran M, Eskild A. Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. BJOG: An International Journal of Obstetrics & Gynaecology 2012; 119(10):1238-46.
  13. Green JM, Baston HA. Have women become more willing to accept obstetric interventions and does this relate to mode of birth? Data from a prospective study. Birth 2007; 34(1):6-13.
  14. Alipour Z, Lamyian M, Hajizadeh E, Vafaei MA. The association between antenatal anxiety and fear of childbirth in nulliparous women: a prospective study. Iranian journal of nursing and midwifery research 2011; 16(2):169.
  15. Khorsandi M, Ghofranipour F, Heydarnia A, FaghihZadeh S, Vafaei M, Rousta F, et al . The effect of childbirth preparation classes on childbirth fear and normal delivery among primiparous women. J Arak Uni Med Sci 2008; 11(3):29-36.
  16. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today 2004; 24(2):105-12.
  17. Creswell JW, Clark VL. Designing and conducting mixed methods research. Sage publications; 2017.
  18. Lowe NK. Self-efficacy for labor and childbirth fears in nulliparous pregnant women. Journal of Psychosomatic Obstetrics & Gynecology 2000; 21(4):219-24.
  19. Tanglakmankhong K, Perrin NA, Lowe NK. Childbirth Self‐Efficacy inventory and childbirth attitudes questionnaire: Psychometric properties of Thai language versions. Journal of advanced nursing 2011; 67(1):193-203.
  20. Akhlaghi F. Relation between depression, anxiety, self-esteem, marital satisfaction, demographical factor and maternal complications with fear of childbirth in nulliparous women. Journal of Fundamentals of Mental Health 2012; 14(54):31-122.
  21. Ghooshchian S, Dehghani M, Khorsandi M, Farzad V. The role of fear of pain and related psychological variables in prediction of cesarean labor. J Arak Univ Med Sci J 2011; 14(56):45.
  22. Heydari S, Salahshourian A, Rafiei F, Hosseini F. Correlation of perceived social support from different supportive sources and the size of social network with quality of life in cancer patients. Iran Journal of Nursing 2009; 22(61):8-18.
  23. Ghodusi M, Heidari M, Hoseini E. Correlation between Body Esteem and perceived social support in patients with multiple sclerosis (MS) Referred to the MS Society in Tehran. Sci J Ilam Univ Med Sci 2013; 21(6):215-3.
  24. Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative. Lippincott Williams & Wilkins; 2011.
  25. Fisher C, Hauck Y, Fenwick J. How social context impacts on women's fears of childbirth: a Western Australian example. Social science & medicine 2006; 63(1):64-75.
  26. Fayazi S, Amerian M, Faghani Aghoozi M, Mohammadi S. Methods of Labor Pain Relief in Iran: A Review. Nursing And Midwifery Journal 2019; 17(6):421-43.
  27. Samavati S, Kazemi F, Aghababaei S, Soltani F. The effect of yoga on fear of childbirth and childbirth self-efficacy in primigravid women: a randomized controlled trial. Iranian Journal of Obstetrics, Gynecology and Infertility 2022; 25(3):75-85.
  28. Mehrabadi M, Masoudifar M, Parvizi A, Rakhshani MH, Mortazavi F. Effects of childbirth preparation classes program based on national guideline on fear of childbirth in pregnant women: a randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility 2020; 23(1):58-68.
  29. Serçekuş P, Okumuş H. Fears associated with childbirth among nulliparous women in Turkey. Midwifery 2009; 25(2):155-62.
  30. Munro S, Kornelsen J, Hutton E. Decision making in patient-initiated elective cesarean delivery: the influence of birth stories. Journal of midwifery & women's health 2009; 54(5):373-9.
  31. Saisto T, Salmela-Aro K, Nurmi JE, Halmesmäki E. Psychosocial characteristics of women and their partners fearing vaginal childbirth. British Journal of Obstetrics and Gynaecology 2001; 108(5):492-8.
  32. Stoll K, Hall W. Vicarious birth experiences and childbirth fear: does it matter how young Canadian women learn about birth?. The Journal of perinatal education 2013; 22(4):226.
  33. Serçekuş P, Mete S. Turkish women's perceptions of antenatal education. International Nursing Review 2010; 57(3):395-401.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 27, Issue 3
May 2024
Pages 21-36

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