Fear of birth in clinical practice: A structured review of current measurement tools

Richens, Yana; Smith, Debbie; Lavender, Dame Tina

doi:10.1016/j.srhc.2018.02.010

Cited by 61 publications

(63 citation statements)

References 56 publications

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“…However many of the currently used scales are missing crucial components for valid measurement of FOC within the UK population. It is clear that effective tools not only need to consider the content but also the structure and accessibility of the language for women [ 6 , 7 ]. In addition to issue of content validity this study substantiates previous studies that suggest that clarity and understandability can be compromised when measures are translated directly from other languages, and this needs to be carefully considered before such measures are routinely adopted at service level.…”

Section: Discussionmentioning

confidence: 99%

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Identifying fear of childbirth in a UK population: qualitative examination of the clarity and acceptability of existing measurement tools in a small UK sample

Slade

Balling

Sheen

et al. 2020

BMC Pregnancy Childbirth

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Background Fear of childbirth is related to but not synonymous with general anxiety, and represents a superior predictor for maternal and infant outcomes. There is a need to improve the identification and provision of support for women experiencing high fear of childbirth. However it is uncertain as to whether existing measurement tools have appropriate content validity (i.e. cover the relevant domains within the construct), practical utility, and whether they are acceptable for use with a UK population. This study aimed to (1) identify the utility and acceptability of existing measures of fear of childbirth (FOC) with a small UK sample and (2) map the content of existing measures to the key concepts of fear of childbirth established by previous research. Methods Ten pregnant women; five with high and five with low fear of childbirth participated in a cognitive interview covering four most commonly used measures of fear of childbirth: 1. The Wijma Delivery Expectancy Questionnaire (WDEQ A), 2. The Oxford Worries about Labour Scale (OWLS), 3. The Slade-Pais Expectations of Childbirth Scale – fear subscale (SPECS) and 4. The Fear of Birth scale (FOBS). Each measure was also reviewed by participants for ease and clarity of understanding and acceptability. The measures were then reviewed against the key domains identified in the fear of childbirth literature to ascertain the adequacy of content validity of each measure. Interviews were analysed using thematic analysis for each scale item. Results All measures except the FOBS, included items that either women did not understand or, if where there was understanding the meanings were inconsistent across women. All measures demonstrated limited acceptability and content validity for the specific construct of FOC. Therefore, none of the measurement tools currently used within the UK met criteria for understanding, acceptability and content validity for measurement of FOC. Conclusions Findings emphasise a need to develop a specific fear of childbirth tool with good clarity which demonstrates appropriate content validity, and that is acceptable in presentation and length for pregnant women in a UK population.

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Section: Discussionmentioning

confidence: 99%

“…Research on prevalence rates for FOC show extensive worldwide variation, ranging from 1.9 to 30% [ 4 – 6 ]. This may be due to genuine cultural differences, or a reflection of the lack of clarity in the definition of the term FOC alongside (or in conjunction with) the diversity and adequacy of measurement tools [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying fear of childbirth in a UK population: qualitative examination of the clarity and acceptability of existing measurement tools in a small UK sample

Slade

Balling

Sheen

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…The concept of fear of childbirth is broad, with no exact definition of the condition (Nilsson et al, 2018;O'Connell, Leahy-Warren, Khashan, Kenny, & O'Neill, 2017). There is lack of conformity in the tools used for measuring it (Richens, Lavender, & Smith, 2018), which, together with cultural differences, leads to variation in the global prevalence of women's fear of childbirth.…”

Section: Introductionmentioning

confidence: 99%

Women’s experiences of fear of childbirth: a metasynthesis of qualitative studies

Wigert

Nilsson

Dencker

et al. 2019

International Journal of Qualitative Studies on Health and Well

112

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Purpose: Women's experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women's experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women's experiences of fear of childbirth interpreted through the metaphor "being at a point of no return". Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other's experiences will not happen to them.

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“…Despite international recognition about the impact and implications of FOC, the construct is poorly defined and current methods of identifying fear during pregnancy are varied [2, 17, 18]. In the United Kingdom, present recommendations include identifying depression and general anxiety during pregnancy [19].…”

Section: Introductionmentioning

confidence: 99%

Establishing a valid construct of fear of childbirth: findings from in-depth interviews with women and midwives

Slade

Balling

Sheen

et al. 2019

BMC Pregnancy Childbirth

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BackgroundFear of childbirth (FOC) can have a negative impact on a woman’s psychological wellbeing during pregnancy and her experience of birth. It has also been associated with adverse obstetric outcomes and postpartum mental health difficulties. However the FOC construct is itself poorly defined. This study aimed to systematically identify the key elements of FOC as reported by women themselves.MethodsSemi-structured interviews with pregnant women (n = 10) who reported to be fearful of childbirth and telephone interviews with consultant midwives (n = 13) who regularly work with women who are fearful of childbirth were conducted. Interviews were analysed using thematic analysis for each group independently to provide two sources of information. Findings were reviewed in conjunction with a third source, a recently published meta-synthesis of existing literature of women’s own accounts of FOC. The key elements of FOC were determined via presence in two out of the three sources at least one of which was from women themselves, i.e. the reports of the women interviewed or the meta-synthesis.ResultsSeven themes were identified by the women and the consultant midwives: Fear of not knowing and not being able to plan for the unpredictable, Fear of harm or stress to the baby, Fear of inability to cope with the pain, Fear of harm to self in labour and postnatally, Fear of being ‘done to’, Fear of not having a voice in decision making and Fear of being abandoned and alone. One further theme was generated by the women and supported by the reports included the meta-synthesis: Fear about my body’s ability to give birth. Two further themes were generated by the consultant midwives and were present also in the meta-synthesis: Fear of internal loss of control and Terrified of birth and not knowing why.ConclusionsTen key elements in women’s FOC were identified. These can now be used to inform development of measurement tools with verified content validity to identify women experiencing FOC, to support timely access to support during pregnancy.Electronic supplementary materialThe online version of this article (10.1186/s12884-019-2241-7) contains supplementary material, which is available to authorized users.

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Fear of birth in clinical practice: A structured review of current measurement tools

Cited by 61 publications

References 56 publications

Identifying fear of childbirth in a UK population: qualitative examination of the clarity and acceptability of existing measurement tools in a small UK sample

Identifying fear of childbirth in a UK population: qualitative examination of the clarity and acceptability of existing measurement tools in a small UK sample

Women’s experiences of fear of childbirth: a metasynthesis of qualitative studies

Establishing a valid construct of fear of childbirth: findings from in-depth interviews with women and midwives

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