Factors associated with low childbirth self-efficacy for normal birth amongst women attending an urban prenatal clinic in Eastern Uganda

Abstract

ObjectiveWhile childbirth self-efficacy is a very important feature for normal birth, this concept has received limited scholarly attention, particularly in developing countries. This study explored childbirth self-efficacy and the associated factors amongst pregnant women. DesignA descriptive cross-sectional study. We used the Childbirth Self-Efficacy Inventory to assess childbirth self-efficacy for normal birth. and determined the associated factors. SettingJinja regional referral hospital, Uganda. Participants425 pregnant women at ≥ 28 weeks of gestation were included. MeasurementsParticipants with summated self-efficacy scores ≥ median were considered to have high childbirth self-efficacy, and those with less than the median summated score were considered to have low childbirth self-efficacy. Bivariate and multivariate binary logistic regressions were used to determine the factors associated with low childbirth self-efficacy. FindingsThe Childbirth Self-Efficacy Inventory items consistently measured childbirth self-efficacy with a Cronbach's α 0.934. Childbirth self-efficacy scores ranged from 84 to 303 with a median score of 233 and a mean score of 228.7 (SD: 40.9). Dissatisfaction with prenatal care (aOR = 2.687; 95% CI: 1.124–6.427; P = 0.026), perception of community social support for women during childbirth as lacking (aOR = 2.274; 95% CI: 1.159–4.458; P = 0.017) and use and/or intention to use herbal medicines in the current pregnancy (aOR = 2.850; 95% CI: 1.553–5.232; P = 0.001) were associated with low childbirth self-efficacy for normal birth. Conclusion and implications for practiceLow childbirth self-efficacy for normal birth was associated with dissatisfaction with prenatal care, lack of community social support for women during childbirth and use or intention to use herbal medicines in the current pregnancy. Identifying the associated characteristics and developing interventions for low childbirth self-efficacy is of clinical importance to promote normal birth.