Prevalence and risk factors for serious birth concerns in unselected population of mothers

Czech version

Authors: Z. Chválna; N. Dominová; M. Ostatníková; P. Pšenková ; K. Kollárová; V. Serátor; B. Balažovjechová; J. Záhumenský
Authors‘ workplace: II. gynekologicko-pôrodnícka klinika LF UK a UN Bratislava, Slovenská republika
Published in: Ceska Gynekol 2023; 88(2): 80-85
Category: Original Article
doi: https://doi.org/10.48095/cccg202380

Overview

Aim: The aim of the study was to determine the prevalence of severe fear of childbirth in a group of pregnant women, to determine the risk factors, and to prove the impact of the fear of childbirth on various obstetrics outcomes in this group. Materials and methods: The study population consists of pregnant women who gave birth at the 2^nd Gynecology and Obstetrics Department of the Faculty of Medicine, Comenius University and University Hospital Bratislava, from January 1^st, 2022, until April 31^st, 2022. After signing an informed consent, the pregnant women were given a Slovak version of the Wijma Delivery Expectancy Questionnaire (S-WDEQ), which is a psychometric tool to evaluate the prevalence of severe fear of childbirth. They were given the S-WDEQ during the 36^th and 38^th week of gestational age. The childbirth data were collected from the hospital information system after the delivery of the baby. Results and conclusion: The studied group consists of 453 pregnant women who fulfilled the inclusion criteria. Extreme fear of childbirth was identified using S-WDEQ in 10.6% (48) of them. Level of education and age were not considered to be significant predictors of fear of childbirth. Statistically significant difference was not found in terms of the age groups and groups with different levels of education. At the edge of the statistical significance were primiparas, who made up 60.4% (RR: 1.29; 95% CI: 1.00–1.68; P = 0.0525) of all women with severe fear of childbirth. Women with a history of cesarean section were significantly more frequent in the group of women with serious concerns about childbirth (RR: 3.83; 95% CI: 1.56–9.40; P = 0.0033). Women who gave birth by cesarean section due to the indication of non-progressive labour were also more often represented in the group of women with serious concerns about childbirth (RR: 3.01; 95% CI: 1.07–8.42; P = 0.0358). A higher S-WDEQ score at the 36th week of gestational age in a group of primiparous women increased the statistical probability of cesarean delivery (P = 0.0030). The statistical results are not showing the impact of fear of childbirth on the induction success and the duration of the first stage of labour in primiparous women. The fear of childbirth prevalence is relatively high and it has impact on the outcome of childbirth. The use of a validated questionnaire as a screening tool to search for women with childbirth fear could positively influence their concerns by following psychoeducational interventions in clinical care settings.

Keywords:

fear of childbirth – anxiety – Fear – Psychometrics – cesarean section – tocophobia – W-DEQ

Sources

1. Olza I, Uvnas-Moberg K, Ekström-Bergström A et al. Birth as a neuro-psycho-social event: an integrative model of maternal experiences and their relation to neurohormonal events during childbirth. PLoS One 2020; 15 (7): e0230992. doi: 10.1371/journal.pone.0230992..

2. Dencker A, Nilsson C, Begley C et al. Causes and outcomes in studies of fear of childbirth: a systematic review. Women Birth 2019; 32 (2): 99–111. doi: 10.1016/j.wombi.2018.07.004.

3. Poggi L, Goutaudier N, Séjourné N et al. When fear of childbirth is pathological: the fear continuum. Matern Child Health J 2018; 22 (5): 772–778. doi: 10.1007/s10995-018-2447-8.

4. Rollè L, Giordano M, Santoniccolo F et al. Prenatal attachment and perinatal depression: a systematic review. Int J Environ Res Public Health 2020; 17 (8): 2644. doi: 10.3390/ijerph17082 644.

5. Martin C, Jones C, Marshall CA et al. Fear of childbirth measurement: appraisal of the content overlap of four instruments. J Reprod Infant Psychol 2022; 40 (4): 329–341. doi: 10.1080/02646838.2020.1861226.

6. Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol 1998; 19 (2): 84–97. doi: 10.3109/01674829809048501.

7. Lukasse M, Schei B, Ryding EL. Prevalence and associated factors of fear of childbirth in six European countries. Sex Reprod Healthc 2014; 5 (3): 99–106. doi: 10.1016/j.srhc.2014.06.007.

8. Takegata M, Haruna M, Matsuzaki M et al. Translation and validation of the Japanese version of the Wijma Delivery Expectancy/Experience Questionnaire version A. Nurs Health Sci 2013; 15 (3): 326–332. doi: 10.1111/nhs.12036.

9. Lai TH, Kwok ST, Wang W et al. Fear of childbirth: validation study of the Chinese version of Wijma delivery expectancy/experience questionnaire version A. Midwifery 2022; 104: 103188. doi: 10.1016/j.midw.2021.103188.

10. Pitel L, Psenkova P, Jones CC et al. Validation of the Slovak version of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), version A. Bratisl Lek Listy 2020; 121 (6): 415–421. doi: 10.4149/BLL_2020_067.

11. Molgora S, Fenaroli V, Prino LE et al. Fear of childbirth in primiparous Italian pregnant women: the role of anxiety, depression, and couple adjustment. Women Birth 2018; 31 (2): 117–123. doi: 10.1016/j.wombi.2017.06.022.

12. Moghaddam Hosseini V, Makai A, Varga K et al. Assessing fear of childbirth and its predictors among Hungarian pregnant women using Wijma Delivery Expectancy/Experience Questionnaire subscales. Psychol Health Med 2019; 24 (7): 879–889. doi: 10.1080/13548506.2019.1572 904.

13. O’Connell MA, Leahy-Warren P, Khashan AS et al. Worldwide prevalence of tocophobia in pregnant women: systematic review and meta--analysis. Acta Obstet Gynecol Scand 2017; 96 (8): 907–920. doi: 10.1111/aogs.13138.

14. Sioma-Markowska U, Zur A, Skrzypulec-Plinta V et al. Causes and frequency of tocophobia – own experiences. Ginekol Pol 2017; 88 (5): 239–243. doi: 10.5603/GP.a2017.0045.

15. Rahne Otorepec I. Tocophobia. J Sex Med 2022; 19 (5): S226. doi: 10.1016/j.jsxm.2022.03. 514.

16. Phunyammalee M, Buayaem T, Boriboonhirunsarn D. Fear of childbirth and associated factors among low-risk pregnant women. J Obstet Gynaecol 2019; 39 (6): 763–767. doi: 10.1080/01 443615.2019.1584885.

17. Sluijs AM, Wijma K, Cleiren MP et al. Preferred and actual mode of delivery in relation to fear of childbirth. J Psychosom Obstet Gynaecol 2020; 41 (4): 266–274. doi: 10.1080/ 0167482X.2019.1708319.

18. O’Connell MA, Leahy-Warren P, Kenny LC et al. The prevalence and risk factors of fear of childbirth among pregnant women: a cross-sectional study in Ireland. Acta Obstet Gynecol Scand 2019; 98 (8): 1014–1023. doi: 10.1111/aogs.13599.

19. Räisänen S, Lehto SM, Nielsen HS et al. Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997–2010. BJOG 2014; 121 (8): 965–970. doi: 10.1111/1471-0528.12599.

20. Størksen HT, Garthus-Niegel S, Adams SS et al. Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth 2015; 15 (1): 221. doi: 10.1186/s12884-015-0655-4.

21. Adams SS, Eberhard-Gran M, Eskild A. Fear of childbirth and duration of labour: a study of 2,206 women with intended vaginal delivery. BJOG 2012; 119 (10): 1238–1246. doi: 10.1111/j.1471-0528.2012.03433.x.

22. O’Connell MA, Khashan AS, Leahy-Warren P et al. Interventions for fear of childbirth including tocophobia. Cochrane database Syst Rev 2021; 7 (7): CD013321. doi: 10.1002/14651858.CD013321.pub2.