Attitudes and Preferences of Young Women With Low and High Fear of Childbirth

Abstract

We examined constructions of labor and birth for 461 Canadian women who attended the University of British Columbia (Canada) and participated in an online survey about pregnancy and birth, using a combination of Likert items and open-ended questions. We performed a content analysis of women's open-ended responses about their feelings toward birth and analyzed comments of women with high and low fear of childbirth separately. Students with high fear of birth described childbirth as a frightening and painful ordeal and viewed obstetric interventions as a means to make labor and birth more manageable. Students with low fear constructed birth as a natural event and regarded interventions more critically. Students in both groups supported women's autonomous maternity care decisions. Our findings contribute to care providers' and educators' knowledge about preferences and fears expressed by the next generation of maternity care consumers and potential strategies to reduce their fear of childbirth.

Cross-cultural development and psychometric evaluation of a measure to assess fear of childbirth prior to pregnancy

“…Recent studies of young women and men planning to have children indicate that attitudes towards pregnancy and birth are well developed in this population (11)(12)(13)(14)(15) and the same positive association between prenatal preferences for elective interventions and fear of childbirth is seen among men and women who plan to have children and pregnant women (14,15,19). These findings suggest that addressing fear of birth during pregnancy might be too late, and earlier intervention is necessary.…”

“…High childbirth fear in the pre-pregnant Canadian population is estimated at 13.6% among young women and 3.5% among young men (14). These estimates are based 5 on a survey that included a 6-item fear of birth scale and a mixture of open-ended and pre-defined Likert type questions.…”

“…High fear was defined as scores greater than one standard deviation above the mean and low fear as scores greater than one standard deviation below the mean. Criterion sampling was used to select a subsample of young women with high and low fear of birth (n=461) (14).…”

“…Thematic analysis of Canadian women's comments revealed that participants with high fear of birth expressed feeling vulnerable and afraid when thinking about labour and birth, because of the potential for physical damage (e.g., vaginal tearing and stretching) and intolerable pain (14). Young women with high fear tended to describe pregnancy and birth as unpredictable and risky, whereas respondents with low fear regarded these processes as normal and natural.…”

“…While women in both groups believed labour to be painful, women with low fear expected to be able to manage the pain, whereas women with high fear were frightened by the prospect of pain and concerned about their ability to cope with pain. Some women with high fear expressed fears about panicking and being out of control and not knowing what to do (14).…”