The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis

Abstract

Background Fear of childbirth (FOC) occurs before, during and after pregnancy and is harmful to both the pregnant woman and the fetus. Identifying 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 receiving antenatal care at a subordinate hospital of a university in China. Data were collected using a basic information form, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the 10-item Connor-Davidson Resilience Scale. The minimum and maximum total scores of the Childbirth Attitude Questionnaire are 16 and 64, respectively, with higher scores reflecting a greater degree of FOC. We conducted hierarchical regression analysis to explore the predictors of FOC and used a structural equation model to further examine the direct and indirect associations between FOC, resilience and childbirth self-efficacy. Results The total prevalence of FOC was 67.1%. The percentages of women with mild (score of 28–39), moderate (40–51), and severe FOC (52–64) were 45.4, 19.5, and 2.2%, respectively. The average score on the Childbirth Attitude Questionnaire was 32.49, indicating mild FOC. The final regression analysis revealed six variables predicting FOC that explained 64.5% of the variance in FOC: age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy. Furthermore, childbirth self-efficacy mediated the relationship between resilience and FOC, and the mediation effect rate was 53.5%. Conclusions A high prevalence of FOC among pregnant Chinese women was found in this study. Age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy were predictors of FOC. It is suggested that healthcare professionals should pay close attention to FOC and implement targeted interventions in accordance with these predictors, especially resilience and childbirth self-efficacy.

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

“…Our study identified that primiparas, unplanned pregnancy, and little spousal support were significant risk factors in FOC. In line with previous research ( 2 , 44 , 57 ), primiparity was one of the significant predictors of severe FOC. In contrast, one Finland population-based analysis suggested that multiparous women also tended to have fear of childbirth for previous cesarean section, preterm birth, and unspecified socioeconomic status ( 58 ).…”

“…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.…”

“…Of note, unplanned pregnant women tend to score higher on FOC ( 59 , 60 ). They may consider this pregnancy unintended or unwanted, which is associated with a sense of being unprepared to be a mother ( 44 , 59 ). At the same time, part-time work was significantly related to FOC in multiparous.…”

“…The mean score of the CAQ was 32.76 (SD = 9.842), and 67.8% (n = 657) of women had FOC symptoms with a CAQ score ≥ 28. The percentages of women with mild (score of 28-39), moderate (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51), and severe FOC (52-64) were 43.6, 20.2, and 4.0%, respectively. The mean scores of the SCSQ-P and SCSQ-N were 21.32 (SD = 7.025) and 9.12 (SD = 4.740), respectively.…”

“…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.…”