Predictors of fear of childbirth and normal vaginal birth among Iranian postpartum women: a cross-sectional study

Abstract

Background Fear of childbirth (FOC) may contribute to postpartum depression, impaired maternal-infant relation, and preference for cesarean in future pregnancies. We aimed to investigate predictors of FOC and normal vaginal birth among postpartum women who had planned for a normal vaginal birth. Methods This cross-sectional study was conducted in 2019 with postpartum women during the first 24 h after the birth. A sample of 662 women, selected using a convenient sampling method, filled out the questionnaire composed of socio-demographic and obstetric questions and the Wijma Delivery-Expectancy Questionnaire (W-DEQ). We used multiple logistic regression analyses to determine predictors of FOC and normal vaginal birth. Results The percentage of women with mild (score ≤ 37), moderate (38–65), high (66–84), severe (85–99), and intense FOC (score ≥ 100) were 7.9, 19.5, 40.9, 21.1, and 10.6% respectively. Predictors of intense FOC were age < 30, primiparity, low maternal satisfaction with pregnancy, and a low level of perceived marital satisfaction. Overall, 21.8% of women gave birth by cesarean. Predictors of normal vaginal birth were birth weight < 4 kg, spontaneous onset of labor pain, mother’s age < 30, term pregnancy, having a doula, multiparity, satisfaction with husband’s support, and overall satisfaction with pregnancy. A high level of perceived marital/sexual satisfaction was a risk factor for cesarean. Mode of birth was not a predictor of postpartum FOC. Conclusions The rate of severe and intense FOC among this group of postpartum women is high. Our findings highlight modifiable factors for reducing FOC and increasing normal vaginal birth. In designing programs to increase the rate of normal vaginal birth, the following factors should be considered: limiting induced labor, encouraging women to recruit a doula to help them at labor, facilitate husband’s attendance throughout antenatal/intrapartum, and postnatal care to support his wife, and pay attention to women’s common misunderstandings about the effect of vaginal birth on marital/sexual relationship. Our findings indicate that seeking novel ways to promote marital/sexual satisfaction and helping women to have a smooth, hassle-free pregnancy may contribute to a reduction in the rate of the FOC.

The Prevalence of Fear of Childbirth and Its Association With Intolerance of Uncertainty and Coping Styles Among Pregnant Chinese Women During the COVID-19 Pandemic

“…Fear of childbirth has become one of the most common psychological symptoms. It is confirmed that FOC leads to significant anxiety, depression, and loneliness (1,2,4,52). We found that the prevalence of FOC was 67.8% (Childbirth Attitude Questionnaire, CAQ ≥ 28) in the present study, which is consistent with one research in Chongqing, China (67.1%) (32) and a survey in Guangdong, China (79.4%) (53).…”

“…According to previous reviews and research (2,10,11,(42)(43)(44), age, parity, gestational weeks, and spousal support were associated with FOC. Thus, the exploratory analysis was first conducted to clarify the relationships between sociodemographic and obstetric factors and FOC.…”

“…According to previous reviews and research (2,10,11,(42)(43)(44), we constructed the sociodemographic and obstetrical characteristics questionnaire to collect general information of pregnant women. It included age, employment status, educational level, monthly income (CNY), marital status, residence, medical insurance, gestational week, parity, planning of pregnancy, family's opinion of a childbirth mode, the preferred mode of childbirth, prenatal spousal support, access to childbirth information, and a regular prenatal visit.…”

“…Fear of childbirth (FOC), a spectrum of anxious thoughts and feelings relating to woman's appraisal of labor and birth, was reported to be a prevalence of 14% around the world (1)(2)(3)(4). Prior research has found that mild or high levels of FOC are correlated with prolonged labor, cesarean section, choice of epidural analgesia, prenatal and postpartum depression, and anxiety (5)(6)(7)(8)(9).…”

Perinatal Anxiety among Women during the COVID-19 Pandemic—A Cross-Sectional Study

“…In this same group, 86.4% of respondents felt frustrated because of the COVID-19 pandemic [ 38 ]. In the reports byMortazavi et al, the main predictor of pregnancy being concluded by Cesarean section was the pregnant woman’s fear of childbirth and the pain associated with it [ 39 ]. Research conducted by Størksen also shows that the main reason for a woman choosing Cesarean section without clear medical indication is fear of childbirth [ 40 ].…”