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Comparative Study
. 2018 Oct 3;18(1):391.
doi: 10.1186/s12884-018-2023-7.

Childbirth fear and related factors among pregnant and postpartum women in Malawi

Madalitso Khwepeya  1   2 , Gabrielle T Lee  3 , Su-Ru Chen  4 , Shu-Yu Kuo  5
Affiliations
Comparative Study

Childbirth fear and related factors among pregnant and postpartum women in Malawi

Madalitso Khwepeya et al. BMC Pregnancy Childbirth. .

Abstract

Background: Childbirth fear is a health concern in women living in high-income countries; however, little is known about childbirth fear among women living in low-income countries like Malawi. In this study, we explored childbirth fear and associated factors among pregnant and postpartum women in Malawi.

Methods: A cross-sectional study of 152 pregnant and 153 postpartum women was conducted at a district hospital in Malawi. Participants were assessed for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ). Demographic and obstetric variables were collected using a structured questionnaire. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Using a multinomial logistic regression, factors related to childbirth fears were examined, namely demographic and obstetric characteristics, and social support.

Results: The mean age of participants was 26 (standard deviation: 6.4) years. During pregnancy, 39% women reported a low level of fear, 41% reported moderate fear, and 20% reported high fear; while after birth, 49, 41, and 10% women reported low, moderate, and high fear, respectively. Pregnant women who were illiterate (odds ratio (OR): 5.0, p < 0.01) or unemployed (OR: 12.6, p < 0.01) were more likely to report moderate and high fear. Postpartum mothers who were illiterate (OR: 4.2, p < 0.01) or unemployed (OR: 11.8, p < 0.01) were more likely to have moderate and high fear. Furthermore, postpartum women who sustained perineal tears had significantly higher odds of experiencing moderate (OR: 5.3, p < 0.01) or high (OR: 19.9, p < 0.01) fear than their counterparts.

Conclusions: Childbirth fear is common in Malawi, and pregnant women are more likely to experience high levels of fear than postpartum women. This study highlighted the connection between childbirth fear with mother's education, employment, and perineal tears during delivery. Identifying and developing interventions for women with these associated characteristics is of clinical importance for the reduction of childbirth fear before and after childbirth in Malawi.

Keywords: Childbirth; Demographics; Fear; Obstetrics; Postpartum period; Pregnancy; Social support.

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Conflict of interest statement

Authors’ information

MK is a Registered Nurse Midwife at Machinga District Hospital, Malawi, and currently a doctoral student at the School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan. GTL is an Assistant Professor in the Faculty of Education at Western University in London, Canada. She is a licensed psychologist in Michigan, USA and a board certified behavior analyst. SC is an Associate Professor at School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan. SK is the Director and Associate Professor at School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan. SK is a registered nurse in the US and Taiwan and specializes in maternal and child health care.

Ethics approval and consent to participate

Written informed consent was received from participants prior to their participation in the study, and ethical approval (NHSRC #15/5/1456) was obtained from the National Health Science Research Committee, Ministry of Health, Malawi. Furthermore, an approval was obtained from Machinga District Hospital to conduct the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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