Abstract
Background: Fear or phobia of childbirth is a significant distressing psychological disorder encountered among 14% of women of childbearing age. It is known as Tokophobiamaleusiophobia and parturiphobia. It is more common among primigravida women and can influence their decision on the mode of delivery. Little attention has been given to primigravida women's fear of childbirth and its effect on their decision regarding mode of delivery. The aim of this study: was to assess primigravida women's fear of childbirth and its effect on their decision regarding the mode of delivery. Subjects and Method: The study was conducted in Egypt at 3 outpatient clinics of Obstetric and Gynecological Departments of Tanta University Hospital, El-Menshawy General Hospital and Kom-Hamade General Hospital (Ministry of Health and Population). Convenient subjects of 240 women who fulfilled the inclusion criteria were included in this study. They were selected from the previously mentioned settings, (80) from each setting. Five tools were developed and used to collect the study data: Tool (I): Socio-demographic and reproductive structured interview schedule. Tool (II) pregnant women fear of childbirth questionnaire. Tool (III) Anxiety scale for pregnancy (ASP). Tool (IV): Beck Anxiety Inventory were used to measure primigravida women's level of anxiety and its effect on pregnant women' body. Tool (V): Pregnant women's decision on the mode of delivery. Results: The results of the present study revealed that primigravida women experienced various levels of fear of childbirth that effected their decision regarding mode of delivery. Conclusion and recommendations: Primigravida women experienced high level of fear of childbirth. Thus, it is recommended that providing comprehensive antenatal care including psycho-educational nursing intervention, especially for primigravida and their husbands or partners is very important.
Highlights
Pregnancy and childbirth are considered as a matter of life and death especially, in places with limited resources
Related to the total score of level of fear of childbirth encountered among the studied primigravidas, the results of the present study revealed that nearly two fifths had high level, about one half had moderate level, and nearly one fifth had low level of fear of childbirth
Relating to the total score of the studied primigravida women's decision on the preferred mode of delivery, the present study displays that nearly two fifths decided vaginal delivery as a preferred mode, while slightly more than three fifths preferred CS delivery with a mean ± SD. = 12.57 ± 2.55 and 14.87 ± 3.17 respectively. These results agree with Al-Diwan, and Mehedi(2019) who stated that the cesarean section rate in the primigravida women was much higher than the ideal rate recommended by the World Health Organization[45]
Summary
Pregnancy and childbirth are considered as a matter of life and death especially, in places with limited resources. - Low level of anxiety = 0 - - Moderate level of anxiety = - 35 - High level of anxiety ≥ 60 Tool (V): Pregnant women's decision on the mode of delivery This tool was developed by researcher after reviewing relevant literatures [34,35,36]to evaluate primigravida' decision toward mode of delivery It composed of 20 items related to knowledge, attitude and preferences of pregnant women regarding mode of delivery, such as vaginal delivery is natural and accepted mode of delivery, vaginal delivery is better in long term, cesarean section is preferred in absence of economic problem, preferred birth type, main reason of choosing cesarean section is fear, and I lack of knowledge about normal vaginal delivery.The scores were calculated by the sum of the items as follows: Bad = 0, Neutral: it didn’t bother me much = 1, Good: it bothered me = 3 Scoring system: - Good decision on the mode of delivery = ≥ 75%.
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