Testing the birth attitude profile scale in a Swedish sample of women with fear of birth

Ingegerd Hildingsson,Christine Rubertsson

doi:10.1080/0167482x.2020.1729118

Ingegerd Hildingsson, Christine Rubertsson

Open Access

https://doi.org/10.1080/0167482x.2020.1729118

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Abstract

Objective The aim of this study was to explore the “Birth Attitude Profile Scale (BAPS)” in a selected sample of women with fear of birth. Another aim was to develop profiles of women according to their birth attitudes and levels of childbirth fear in relation to background characteristics. Methods A secondary analysis of data collected in two different samples of women with fear of birth. Data were collected by a questionnaire in gestational week 36 and background data from mid-pregnancy. A principal component analysis and a cluster analysis were performed of the combined sample of 195 women. Results The principal component analysis revealed four domains of the BAPS: “personal impact, birth as a natural event, freedom of choice and safety concerns”. When adding the fear of birth scale, two clusters were identified: one with strong attitudes and lower fear, labeled “self-determiners”; and one with no strong attitudes but high levels of fear, labeled “fearful.” Women in the “Fearful” cluster more often reported previous and current mental health problems, which were the main difference between the clusters. Conclusion The BAPS instrument seems to be useful in identifying birth attitudes in women with fear of birth and could be a basis for discussions and birth planning during pregnancy. Mental health problems were the main difference in cluster membership; therefore, it is important to ask women with fear of childbirth about physical, mental and social aspects of health. In addition, a qualitative approach using techniques such as focus groups or interviews is needed to explore how women come to form their attitudes and beliefs about birth.

Highlights

Women’s attitudes to childbirth might influence their perceptions of pregnancy and birth, which is an important factor to consider when promoting womencentered care
This is a secondary analysis of a combined sample of women with fear of birth who completed a similar questionnaire in gestational week 36 and background data from mid pregnancy
Women are usually cared for by the same midwife during approximately nine antenatal visits, and during an uncomplicated pregnancy, there are no visits to a physician

Summary

Introduction

Women’s attitudes to childbirth might influence their perceptions of pregnancy and birth, which is an important factor to consider when promoting womencentered care. One of the foundations in womencentered care is to investigate whether women adhere to a belief that birth is a natural or a medical event [1], as this could influence the level of intervention during birth. Women’s willingness to accept an intervention, when asked in the antenatal period, increases the odds of receiving an intervention [2]. Women with fear of birth are more exposed to birth interventions [3]. Various attempts to treat fear of birth have been investigated, such as counseling with midwives [5], group psycho education [6], telephone support [7], cognitive behavioral therapy [8,9], continuous Labor support [10] and continuity with a known midwife [11]

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Discussion

Conclusion