The Prevalence and Predictors of Fear of Childbirth Among Pregnant Chinese Women: a Hierarchical Regression Analysis

Abstract

Background: Fear of childbirth(FOC) runs through before, during and after pregnancy, which is harmful to both the pregnant woman and fetus. To identify the prevalence and predictors of FOC can help us generate strategies for alleviating women’s FOC.Methods: A cross-sectional study was conducted among a convenience sample of 646 pregnant women attending antenatal care at a subordinate hospital of an university in China. Data were collected using a Basic information form, Childbirth Attitude Questionnaire, Childbirth Self-Efficacy Inventory, and 10-item Connor-Davidson Resilience Scale. We conducted hierarchical regression analysis to explore the predictors of FOC and used a structural equation model to examine the direct and indirect associations between FOC, resilience and childbirth self-efficacy further.Results: The average score on the Childbirth Attitude Questionnaire scale was 32.49 and the total prevalence of FOC was 67.1%. 45.4% women reported a mild level of fear, 19.5% reported moderate fear, and 2.2% reported a severe level of fear. The final regression analysis displayed six variables predicting FOC that explained 64.2% of variance in FOC: age (t=2.795, P<0.05), gestation age (t=2.566, P<0.05), parity (t=-5.191, P<0.01), spousal support (t=-6.119, P<0.01), resilience (t=-10.302, P<0.01) and childbirth self-efficacy (t=-16.435, P<0.01). Furthermore, childbirth self-efficacy mediated the relationship between FOC and resilience, and the mediation effect ratio was 53.5%.Conclusions: A high prevalence of FOC among pregnant Chinese women was found in this study. Age, gestation age, parity, spousal support, resilience and childbirth self-efficacy were predictors of FOC. It is suggested that the health-care professionals should pay close attention to FOC and take targeted interventions according to these predictors especially resilience and childbirth self-efficacy.

Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model

“…Furthermore, the effects of discrepancy in resilience and FOC on psychological distress suggested that low resilience -high FOC leads to higher 10.3389/fpsyt.2022.1091042 psychological distress, while high resilience -low FOC promotes better mental health, indicating that resilience plays a significant role. These results were consistent with Huang's findings (30) that pregnant women with high resilience may actively use their own psychological resources to reduce fear and ultimately maintain better mental health.…”

“…Prior studies suggested that resilience has a protective effect on psychological distress during pregnancy (27)(28)(29). Furthermore, in a Chinese study involving 646 pregnant women has shown that resilience was negatively associated with FOC (30). Meanwhile, a recent research found that resilience served as a moderator between ACEs and psychological distress among pregnant women (22).…”