Fear of childbirth: prevalence and associated factors in pregnant women of a maternity hospital in southern Brazil

Abstract

Background: The fear of childbirth (FOC) harms maternal and fetal health, however it has been little studied in Brazil. This research aimed to determine the prevalence of FOC in a maternity hospital in southern Brazil and identify its associated factors.

Methods: The Wijma Delivery Expectancy Questionnaire - W-DEQ(A) was used to assess the prevalence of FOC, and its relationship with sociodemographic variables, gestational history, aspects of the current pregnancy, knowledge about childbirth, anxiety symptoms (Beck Anxiety Inventory), depressive symptoms (Edinburgh Postnatal Depression Scale), and perception of social support (Multidimensional Scale of Perceived Social Support) was investigated. Questionnaires about the content of FOC and information sources regarding childbirth were also applied.

Results: We interviewed 125 pregnant women between 28 and 36 weeks of pregnancy between July and September of 2021, and 12% of them scored ≥ 85 on the W-DEQ(A), indicating severe FOC. There was a significant correlation between FOC and anxiety symptoms (r = 0.50, p < 0.001), depressive symptoms (r = 0.34, p < 0.001), and poor social support (r = -0.23, p = 0.008). FOC was lower in pregnant women with complete elementary education when compared to those with higher education (p = 0.003), however, those with negative experiences in previous deliveries had more FOC than those who had had positive experiences (p = 0.001). More than 85% of them fear fetal distress.

Conclusions: FOC is a prevalent condition that impacts the mental health of pregnant women. Therefore, health professionals should recognize and address it during prenatal care to provide integral maternal-fetal care and improve the childbirth experience.

Keywords: Fear of childbirth; Maternal mental health; Pregnancy; Prenatal care; Tocophobia.

Fig. 1

Flowchart for the Study Population ¹153 eligible pregnant women accepted to participate in the research; of these, 13 withdrew. ²Among the 140 pregnant women who responded to the survey, 15 were excluded for leaving the W-DEQ(A) scale incomplete. ³Among the 125 participants who completed the W-DEQ(A) scale, 12 were excluded from analyses of specific variables because they left incomplete data. Analysis of anxiety symptoms (n = 123), social support (n = 124), social class (n = 123), pregnancy planning (n = 120), and abortion history (n = 123). ⁴Among the 125 participants who completed the W-DEQ(A) scale, 79 were multiparous, and 78 answered the question about previous childbirth experience. ⁵Other topics (depressive symptoms, marital status, education, gestational history, desired mode of delivery, gestational risk, history of physical and/or sexual violence, content of fear of childbirth, knowledge about modes of delivery, and knowledge of pregnant women's rights) had no incomplete data and excluded participants (n = 125). Created with Google Drawings

Fig. 2

Main source of knowledge about delivery methods. 30% of pregnant women reported that their knowledge about the delivery methods (vaginal, normal, or cesarean) was acquired in the first place through information from family members and friends. 29% through previous childbirth experience(s). 16% with an explanation from the gynecologist. 18% internet. 7% other sources of information Created with MSOffice

Fig. 3

Second main source of knowledge about delivery methods. 24% of pregnant women reported that their knowledge about the delivery methods (vaginal, normal, or cesarean) was acquired, secondly, through information from family members and friends. 23% through previous childbirth experience(s). 21%with an explanation from the gynecologist. 18% internet. 7% visual media. 7% other sources of information Created with MSOffice