Childbirth Attitudes Questionnaire Research Articles

Prevalence and determinants of fear of childbirth among pregnant women in Egypt: A cross-sectional study

ProblemFear of childbirth (FOC) is a significant public health concern, and understanding its determinants is crucial for developing effective interventions to support women during pregnancy and childbirth. BackgroundFear of childbirth (FOC) is increasingly recognized as an essential psychological health concern among pregnant women globally. However, research elucidating the prevalence and multifaceted determinants of FOC in the Egyptian context remains scarce. This knowledge is pivotal to informing maternal health practices. AimThis study aimed to investigate FOC prevalence and its determinants among pregnant women in Egypt. MethodsA cross-sectional study was conducted among 460 low-risk pregnant women attending antenatal clinics in El-Beheira Governorate, Egypt, from February 2023 to July 2023. Data were collected using structured questionnaires on sociodemographic and obstetric profiles, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the Multidimensional Scale of Perceived Social Support. ResultsThe prevalence of FOC ranged from mild to severe, with 70.4% of women displaying some degree of fear and 11.3% exhibiting severe FOC. Key determinants associated with greater FOC were younger age, nulliparity, unplanned pregnancy, negative previous birth experiences, and preference for cesarean delivery. An inverse relationship was found between FOC and childbirth self-efficacy. ConclusionsThis study reveals a high FOC prevalence among Egyptian pregnant women, necessitating the need for systematic screening and tailored interventions to mitigate this concern, especially among high-risk groups like young, nulliparous mothers. Fostering childbirth self-efficacy may aid in reducing FOC. These findings can inform the enhancement of holistic maternal health practices in Egypt.

Validation of the Chinese version of the Fear of Birth Scale among pregnant women

Aim: Adapt Fear of Birth Scale (FOBS) for the Chinese context, evaluate psychometric properties and determine optimal cutoff point for pregnant women in 3rd trimester.Design: This is a descriptive cross-sectional study. Cultural guidelines informed the development of the Chinese version of FOBS (FOBS-C) incorporating validation on translation, equivalence index, content validity index, and cognitive debriefing. Thirty pregnant women took a test-retest survey and another 1019 took three cross-sectional surveys. Convergent validation of the FOBS-C involved comparison with Childbirth Attitudes Questionnaire (CAQ), Wijma Delivery Expectancy Questionnaire (WDEQ-A), Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder Scale (GAD-7), and physiological indicators. Cutoff points for FOBS-C were identified using receiver operating characteristic analysis against medical indicators.Findings: FOBS-C demonstrated high translation equivalence (0.833–1), content validity (0.800–0.933), internal consistency (0.897), and test-retest reliability (0.860). Convergent validity was supported by statistically significant correlations between FOBS scores, heart rate, skin conductance changes, as well as scores from WDEQ-A, CAQ, EPDS, and GAD-7. Known-group validity was observed with different medical indicators. FOBS-C cutoff points indicating severe fear of childbirth were identified as 65, 68, 71, and 56, respectively, against WDEQ-A ≥ 85, CAQ ≥ 52, preference for C-section birth, and preference for analgesia, demonstrating known-group validity. A cutoff point of 65 showed the FOBS-C's strongest known-group validity.Conclusion: The FOBS-C exhibits robust psychometric properties, making it a valid screening tool for identifying severe fear of birth. Establishing a cutoff point at 65 facilitates effective screening.

Identification of the effect of childbirth education classes on pregnant women’s childbirth attitudes and happiness

Objective: This study aims to identify the effect of childbirth education classes on pregnant women’s childbirth attitudes and happiness. Materials and Methods: This study is a quasi-experimental research with a control group. Thirty-four participants were included in both the control and the experimental groups (N = 68). Data were collected through the Personal Information Form, the Oxford Happiness Questionnaire (OHQ), and the Childbirth Attitudes Questionnaire (CAQ).Results: In the 1st, 2nd, and 3rd interviews, the difference between the pregnant women’s OHQ total mean scores was not statistically significant in the experimental and the control group (p>0,05). In the 1st and 2nd interviews, the difference between the pregnant women's CAQ total mean scores was not statistically significant in the experimental and control groups (p>0,05). In the 3rd interview, the CAQ total mean score of the pregnant women in the experimental group was found 26.85±8.5 while that of the control group was 38.14±10.18; the difference between the groups was found to be statistically significant (p

Effect of Theory of Planned Behavior on Fear of Vaginal Delivery: A Randomized Educational Trial

Background: Fear of childbirth is a common problem in pregnant women, which usually results in increased request for Cesarean section deliveries. The present study was conducted to evaluate the effect of education based on the theory of planned behavior on fear of childbirth and choosing vaginal delivery among pregnant women. Methods: One hundred pregnant women at 20-36 weeks’ gestation who were covered by the health centers of Aleshtar, Iran were selected using simple random sampling. After pretest using two valid and reliable questionnaires (one researcher-made questionnaire and the Childbirth Attitudes Questionnaire (CAQ)), the samples were randomly allocated to intervention and control groups. The intervention group attended four educational sessions. Then, after the intervention, the above questionnaires were administered in both groups once again. Data were analyzed using one-way analysis of variance, t test, chi-square test, Mann-Whitney test, and Wilcoxon test. Results: There was no significant difference in the constructs of the theory between the two groups before the intervention while significant differences were observed in the scores of knowledge , attitude, and perceived behavioral control (P = 0.001), intention to choose vaginal delivery (P = 0.004), and vaginal delivery (P = 0.001) between the two groups. Conclusions: Education based on the theory of planned behavior could significantly affect the fear of childbirth and increase the vaginal delivery rate.

Effect of Intolerance of Uncertainty on Fear of Childbirth in Primiparas : A Moderated Mediating Model

To explore the mediating effect of childbirth self-efficacy on the impact pathway of intolerance of uncertainty on the fear of childbirth in primiparas in the second and third trimesters and the potential moderating effect of perceived partner responsiveness. A total of 429 primiparas in their second and third trimesters completed the survey, which included general information questionnaire, Intolerance of Uncertainty Scale, Childbirth Self-Efficacy Inventory, Perceived Partner Responsiveness Scale, and Childbirth Attitudes Questionnaire. Rank sum test was used to compare the scores for the fear of childbirth among different groups and Spearman's correlation was used to analyze the scores for all the scales. In addition, the data were centrally processed by using PROCESS V3.4.1 Model 4 (a simple mediation model), Model 5 (the direct path of the mediation model was regulated), and non-parametric Bootstrap method to test the mediation effect and moderation effect. The study showed that 54.31% of the participants experienced fear of childbirth. Their scores for intolerance of uncertainty, childbirth self-efficacy, and perceived partner responsiveness were 15.00 (8.00), 240.00 (75.00), and 72.00 (19.00), respectively. There were significant differences in the scores for the fear of childbirth scale among pregnant women of different age groups, gestational weeks, employment statuses, and average per capita monthly income of the family ( P<0.05). According to our findings, intolerance of uncertainty directly and positively impacted on fear of childbirth ( β=0.76, P<0.001), with childbirth self-efficacy playing partial mediation role between them, its indirect effect being 0.05 and the contribution rate being 6.17%. In addition, after the scores of Perceived Partner Responsiveness Scale were added to the model, perceived partner responsiveness had no significant predictive effect for fear of childbirth, but the product term of the scores for Perceived Partner Responsiveness Scale and Intolerability Uncertainty Scale had significant predictive effect for fear of childbirth ( β=0.01, P<0.05), which suggested that perceived partner responsiveness also played a moderating role between intolerance of uncertainty and fear of childbirth. Health care providers can help primiparas reduce fear of childbirth and improve their childbirth experience by reducing perceived intolerance of uncertainty, improving family support, and teaching coping strategies.

Psychometric properties of the Chinese version of the fathers' fear of childbirth scale: A cross-sectional study.

Fear of childbirth (FOC) is one of the most common mental health concerns among expectant fathers, which can cause adverse consequences for themselves and their families. A valid and accurate tool is the key to the identification of FOC. This study aimed to translate and culturally adapt the fathers' fear of childbirth scale (FFCS) into simplified Chinese and test the scale's psychometric properties among expectant fathers in mainland China. Researchers obtained translation permission and followed the multiphase translation guidelines to develop the Chinese version of the fathers' fear of childbirth scale (C-FFCS). Relevant psychometric properties were selected for the scale's psychometric validation on the basis of the Consensus-based Standards for the Selection of Health Status Measurement Instruments checklist. In this cross-sectional study, two samples of expectant fathers were collected in a university-affiliated hospital in Hangzhou between September and October 2022. A total of 381 expectant fathers completed the C-FFCS, resulting in an effective response rate of 95.6%. The C-FFCS is a 3-factor structure consisting of 16 items, which explained 66.374% of the total variance. The content validity index of items ranged from 0.833 to 1.00, and the scale-level content validity index was 0.931. The confirmatory factor analysis confirmed the scale's 3-factor structure. Evidence of convergent validity (average variance extracted = 0.508-0.780) as well as discriminant validity offered excellent psychometric support. The Cronbach's α coefficient, McDonald's ω coefficient, intraclass correlation coefficient, Spearman-Brown coefficient, and Guttman split-half coefficient are within the satisfactory range (> 0.80). Significant correlations between the scores of the C-FFCS and Childbirth Attitude Questionnaire (r = 0.658, p < 0.01) and Fear of Birth Scale (r = 0.555, p < 0.01) both revealed good concurrent validity. The structure of C-FFCS was invariant across different parity groups, with no floor and ceiling effect. The C-FFCS was demonstrated to be a sound instrument with good reliability and validity for measuring Chinese expectant fathers' FOC levels. However, further studies are advocated to verify the C-FFCS among a larger sample that is more representative of the Chinese expectant father population.

Levels and Determinants of Antenatal Breastfeeding Attitudes among Pregnant Women: A Cross-Sectional Study

Breastfeeding attitudes are strong predictors of breastfeeding behavior. Gaining a deeper understanding on the levels and determinants of antenatal breastfeeding attitudes is crucial. This cross-sectional study involved 124 pregnant women at a tertiary hospital in Hunan, China. A self-administered questionnaire, the Iowa Infant Feeding Attitude Scale, the Edinburgh Postnatal Depression Scale, the Pregnancy Stress Rating Scale, the Childbirth Attitude Questionnaire, the Perceived Social Support Scale, and the Breastfeeding Knowledge Questionnaire were assessed during their first-trimester, second-trimester, and third-trimester hospital visit. Multiple linear regression was conducted to identify the determinants of breastfeeding attitudes. The participants reported neutral (56.39 ± 5.69) levels of breastfeeding attitudes. The determinants of antenatal breastfeeding attitudes were other family members' support for exclusive breastfeeding: moderate (β = 0.278, p < 0.05), depressive symptoms (β = -0.191, p < 0.05), and breastfeeding knowledge (β = 0.434, p < 0.001). The variables explained 33.9% (adjusted R2) of the total variation in breastfeeding attitudes scores (F = 4.507, p < 0.001). Namely, other family members' support for EBF was a negative influence on positive breastfeeding attitudes. The women whose other family members were moderate of EBF had more positive attitudes toward breastfeeding compared to those whose other family members were very supportive of EBF. The depressive symptoms were negatively associated with positive breastfeeding attitudes, and lower levels of depressive symptoms were associated with higher levels of positive breastfeeding attitudes among pregnant women. Additionally, breastfeeding knowledge was positively associated with positive breastfeeding attitudes. The more knowledgeable about breastfeeding, the more positive the attitude towards breastfeeding. Health professionals should identify these modifiable factors that may contribute to poorer breastfeeding attitudes, which is useful in targeting promotions of breastfeeding.

Associations among fear of childbirth, resilience and psychological distress in pregnant women: A response surface analysis and moderated mediation model.

Prenatal psychological distress is prevalent during pregnancy. This study aimed to estimate the associations among fear of childbirth, resilience and psychological distress. A total of 1,060 Chinese pregnant women were enrolled from Be Resilient to Postpartum Depression (ChiCTR2100048465) and the following instruments were administered to them: Childbirth Attitudes Questionnaire, Connor-Davidson Resilience Scale, Perceived Social Support Scale, General Self-Efficacy Scale, Adverse Childhood Experience scale and Hospital Anxiety and Depression Scale. A dominance, a response surface analysis and a moderated mediation analysis were performed. In terms of psychological distress, resilience and fear of childbirth could explain 41.6% (0.148/0.356) and 33.1% (0.118/0.356), respectively. Pregnant women with high resilience-low fear of childbirth had significantly lower levels of psychological distress than those with low resilience-high fear of childbirth. The indirect effects of fear of childbirth on psychological distress through resilience was significantly (B = 0.054, 95% CI 0.038 to 0.070). The interactions between fear of childbirth and adverse childhood experiences (β = 0.114, 95% CI -0.002 to 0.231, p = 0.054) and between resilience and adverse childhood experiences (β = -0.118, 95% CI -0.222 to -0.012, p < 0.05) were significant. Resilience, fear of childbirth and adverse childhood experiences may be three important factors to psychological distress in Chinese pregnant women.

Correlation between Fear of Childbirth and Childbirth Self-Efficacy during Labor

Background: The research on fear of childbirth and childbirth self-efficacy of pregnant women in China mainly concentrates on the late pregnancy, and there is a lack of research on the psychology of women during labor. This study aimed to investigate the correlation between fear of childbirth and childbirth self-efficacy during labor. Methods: 378 pregnant women in labor were selected by convenience sampling. They were investigated using a self-designed questionnaire, the Chinese version of Childbirth Attitudes Questionnaire, and the Childbirth Self-Efficacy Inventory. Results: The total score of fear of childbirth during labor was 31.95 ± 9.01, and the total score of childbirth self-efficacy was 212.03 ± 59.64. The total score of fear of childbirth and the score of each dimension were significantly negatively correlated with those of childbirth self-efficacy (R2 = –0.354 to –0.155, p &lt; 0.01). Conclusions: Fear of childbirth during labor should arouse attention of medical staffs. It is necessary to enhance psychological support and childbirth self-efficacy during labor to reduce the fear of childbirth.

The Prevalence of Fear of Childbirth and Its Association With Intolerance of Uncertainty and Coping Styles Among Pregnant Chinese Women During the COVID-19 Pandemic.

BackgroundFear of childbirth (FOC) is one of the most common psychological symptoms among pregnant women and significantly relates to cesarean section, anxiety, and depression. However, it is not clear the prevalence and risk factors of FOC among Chinese pregnant women since the outbreak of the COVID-19 pandemic.AimsThe objective of this study was to examine the associations between coping styles, intolerance of uncertainty, and FOC.MethodFrom December 2021 to April 2022, a cross-sectional survey was conducted in two hospitals in China through convenient sampling. The cross-sectional survey was conducted among 969 pregnant women, which included the Childbirth Attitude Questionnaire (CAQ), Intolerance of Uncertainty Scale-12 (IUS-12), and Simplified Coping Style Questionnaire (SCSQ).ResultsThe total prevalence of FOC was 67.8%. The percentages of women with mild (a score of 28–39), moderate (40–51), and severe FOC (52–64) were 43.6, 20.2, and 4.0%, respectively. The regression results indicated that primiparas, unplanned pregnancy, few spousal support, intolerance of uncertainty, and negative coping styles were significant risk factors of FOC. Women who adopt positive coping strategies experienced a lower level of childbirth fear.ConclusionThese findings suggest that cultivating positive coping styles and obtaining sufficient childbirth information may be helpful for mothers' mental health. Regular screening assessment of perinatal psychological symptoms, such as the high level of intolerance of uncertainty and negative coping styles, should be adopted to reduce the risk of fear of childbirth.

Associations of Musical Activities and Positive Affect With Fear of Childbirth: A Structural Equation Modeling Approach

BackgroundFear of childbirth is a prevalent issue among women, with a wide range of interventions to dispel it. Here we explored a novel and beneficial intervention and one possible influence mechanism of it.MethodsThe cross-sectional study recruited 1,053 pregnant women from one tertiary-grade A class hospital between March to August 2021. The questionnaire included demographic characteristics, a self-made musical activities questionnaire, the Positive affect subscale, and the Childbirth Attitudes Questionnaire. We parceled the eight musical activities into three items by item parceling methodology. The associations of musical activities and positive affect with fear of childbirth were evaluated by a structural equation modeling approach.ResultsOur analyses demonstrated the effectiveness of musical activities, which was notably correlated with the increase in positive affect (β = 0.309, P < 0.01). On the contrary, positive affect predicted a decrease in fear of childbirth (β = −0.085, P = 0.019). Additionally, positive affect mediated the effect of musical activities on fear of childbirth (β = −0.026, P = 0.030). However, the direct effect of musical activities on fear of childbirth was not found (β = 0.029, P = 0.514).ConclusionsRelying on musical activities alone may not be adequate to alleviate the fear of childbirth, and positive affect played a pivotal role between musical activities and fear of childbirth. The results showed that musical activities would be an effective non-pharmaceutical way to alleviate the fear of childbirth and positive affect can not be ignorant in future childbirth fear reduction programs.

Validation of the Slade Fear of Childbirth Scale for Pregnancy in a Sample of Iranian Women: A Crosssectional Study

Objectives: The existence of a valid scale of fear of childbirth (FOC) has an effective role in identifying women at risk, so this study was conducted to determine the validation of the Slade FOC scale for pregnancy in a sample of Iranian women. Materials and Methods: In this cross-sectional study, initially, the Slade scale was translated based on a forward-backward approach. For sampling among pregnant women in Anbarabad city, 820 pregnant women were selected by multistage cluster sampling method. The research questionnaire included (a) demographic information, (b) Slade FOC scale (new scale), (c) childbirth attitude questionnaire (validated scale), and (d) Wijma scale (validated scale). Face validity, content validity, construct validity (using factor analysis), convergent validity, and concurrent validity (by calculating the present scale correlation with childbirth attitude questionnaire and Wijma scale were used to determine the validity of the scale. Internal consistency (Cronbach’s alpha), split-half, and stability (test-retest) methods were used for scale reliability. SPSS software version 22 and LISREL version 8.8 were used for data analysis. Results: Target population comments were applied in face validity, the impact score of face validity was in the range of 1.6-4.5. Content validity ratio (CVR) values (81%-100%) and content validity index (CVI) value (83%) were acceptable. The exploratory factor analysis (EFA) showed that the scale had four factors which include uncertainty and injury with 18.39%, the unprofessional behavior of maternity staff with 14.51%, the unpredictable with 14.44%, and negative emotions with 10.54% of the variance. The scale had acceptable convergent validity and the correlation between items and the total score was between 0.41-0.63. The correlation coefficient between the present scale with the childbirth attitude questionnaire and Wijma scale was 0.81 and 0.79, respectively. The reliability result showed an acceptable internal consistency (Cronbach’s alpha = 0.84), acceptable split-half (0.71 for the first half of scale and 0.78 for the second half of scale) and acceptable stability (r = 0.78). Conclusions: The results showed that the Slade scale has acceptable validity and reliability. Therefore, this scale can be used in scientific research and screening for FOC.

Fear of childbirth and its predictors in re-pregnant women after cesarean section: a cross-sectional multicenter study in China

BackgroundSince the implementation of China’s two-child policy in 2016, the number of re-pregnant women after cesarean section has increased significantly. These women are more prone to fear of childbirth compared with primiparas due to their history of scarred uterus leading to a more complicated delivery process, which poses a great threat to their physical and mental health. However, there is currently limited research on the problem in China. The aim of this study was to assess fear of childbirth and its predictors in re-pregnant women after cesarean section in China.MethodsA cross-sectional multicenter study was conducted in three hospitals from June 7 to December 7, 2020, in Changsha, China. Study hospitals were selected using a random sampling technique. Participants were selected using a convenience sampling technique. Three hundred fifty-eight women during the third trimester of pregnancy who were older than 18 years, having a history of CS(s), and not having major physical or mental health problems were included. Fear of childbirth and its predictors were evaluated using the Childbirth Attitude Questionnaire, the short form of the 32-item Chinese Childbirth Self-Efficacy Inventory, the Social Support Rating Scale, and the demographic-obstetric data sheet. After checking for completeness, data were exported to statistical software for analysis. Both univariate analysis and multiple linear regression analysis were computed to assess fear of childbirth and its predictors. Statistical significance was declared at a P-value of < 0.05.ResultsThe average score of fear of childbirth was 43.76 (standard deviation = 5.27, range 17–58). Number of cesarean sections, experience with previous cesarean section, childbirth self-efficacy and social support were significantly associated with fear of childbirth (P < 0.05).ConclusionsIn this study, re-pregnant women after cesarean section in China had moderate fear of childbirth, and the number of cesarean sections, experience with previous cesarean section, childbirth self-efficacy and social support were predictors of fear of childbirth. It is important for healthcare professionals to find re-pregnant women after cesarean section at high risk of fear of childbirth and provide appropriate services during pregnancy.

Effect of the Mindfulness-Based Stress Reduction program on stress, anxiety, and childbirth fear in pregnant women diagnosed with COVID-19

ObjectiveThis study aims to examine the effectiveness of a live online Mindfulness-Based Stress Reduction (MBSR) program in preventing distress, anxiety and childbirth fear in pregnant women diagnosed with COVID-19. Material and methodsDesigned as a randomized-controlled trial, this study was performed with the participation of pregnant women who were diagnosed with COVID-19. The sample comprised 84 pregnant women, including 42 in the experimental group and 42 in the control group. The online MBSR program composed of eight sessions and lasting four weeks was provided to the pregnant women in the experimental group, whereas such an initiative was not provided to the control group. The data were collected via the Revised Prenatal Distress Questionnaire (NuPDQ), the Beck Anxiety Inventory (BAI), and the Childbirth Attitudes Questionnaire (CAQ). ResultsAfter the MBSR program, the mean NuPDQ, BAI and CAQ scores of the pregnant women in the experimental group were significantly lower than the mean scores of those in the control group (p < 0.001). ConclusionThe online MBSR program may be utilized to reduce the distress, anxiety and childbirth fear levels of pregnant women diagnosed with COVID-19. By using the MBSR program, health professionals might improve the psychological well-being of pregnant women diagnosed with COVID-19.

Relationship between Primigravid women's awareness, attitude, fear of childbirth, and mode of delivery preference.

IntroductionFear of childbirth is the main factor, which has decreased the tendency toward selecting natural birth. The immoderate increase in the number of C-sections has increased maternal and neonatal morbidity and mortality. The present study investigates the relationship between awareness, attitude, fear of childbirth, and mode of delivery preference in Primigravid women referring to healthcare centers in Khorramabad, Iran.MethodIn this descriptive-analytic study, 179 nulliparous pregnant women with the gestational age of> 2,0 weeks who visited selected healthcare centers in Khorramabad for routine pregnancy care in 2020 were selected in two stages and studied. The data were collected via the childbirth attitude questionnaire (CAQ), awareness, attitude, demographic characteristics, current pregnancy characteristics, midwifery history, and history of infertility treatment questionnaires. The data were analyzed via the Chi-squared test.ResultsThe participants had a mean gestational age of 33.73 ± 4.71 weeks. There was a significant different between the level of awareness, and mode of delivery preference (p = 0.005). The majority of the participants (57.5%) had a moderate level of awareness about the mode of delivery. There was a significant different between the level of, attitude, and mode of delivery preference (p = 0.001).) Most of the participants (71.5%) had a negative attitude towards the mode of delivery. There was also a significant different between fear of childbirth and mode of delivery preference (p < 0.001), and most of the participants (71.5%) showed fear of childbirth.ConclusionAccording to the results of this study, the majority of participants had afraid of childbirth, moderate awareness of mode of delivery, and negative attitudes. So, the healthcare providers should pay special attention to the fear of childbirth and the relevant factors during pregnancy.

The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis

BackgroundFear of childbirth (FOC) occurs before, during and after pregnancy and is harmful to both the pregnant woman and the fetus. Identifying the prevalence and predictors of FOC can help us generate strategies for alleviating women’s FOC.MethodsA cross-sectional study was conducted among a convenience sample of 646 pregnant women receiving antenatal care at a subordinate hospital of a university in China. Data were collected using a basic information form, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the 10-item Connor-Davidson Resilience Scale. The minimum and maximum total scores of the Childbirth Attitude Questionnaire are 16 and 64, respectively, with higher scores reflecting a greater degree of FOC. We conducted hierarchical regression analysis to explore the predictors of FOC and used a structural equation model to further examine the direct and indirect associations between FOC, resilience and childbirth self-efficacy.ResultsThe total prevalence of FOC was 67.1%. The percentages of women with mild (score of 28–39), moderate (40–51), and severe FOC (52–64) were 45.4, 19.5, and 2.2%, respectively. The average score on the Childbirth Attitude Questionnaire was 32.49, indicating mild FOC. The final regression analysis revealed six variables predicting FOC that explained 64.5% of the variance in FOC: age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy. Furthermore, childbirth self-efficacy mediated the relationship between resilience and FOC, and the mediation effect rate was 53.5%.ConclusionsA high prevalence of FOC among pregnant Chinese women was found in this study. Age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy were predictors of FOC. It is suggested that healthcare professionals should pay close attention to FOC and implement targeted interventions in accordance with these predictors, especially resilience and childbirth self-efficacy.

A comparison of maternal fear of childbirth, labor pain intensity and intrapartum analgesic consumption between primiparas and multiparas: A cross-sectional study

ObjectivesTo describe and compare fear of childbirth and in-labor pain intensity between primiparas and multiparas and explore the association between the amount of actual pain relief and fear of childbirth. MethodsA convenience sampling method was used. A total of 260 women undergoing spontaneous or induced labor, including 97 primiparas and 163 multiparas, were recruited in a large academic specialized hospital in Guangzhou, China, from February 2018 to August 2019. The clinical data of maternal and neonatal were extracted from a structured electronic medical record system. Other demographic information, such as employment and family monthly income, was collected by a questionnaire. The Numeric Rating Scale (NRS) and the Chinese version of the Childbirth Attitude Questionnaire (C-CAQ) were applied to assess maternal in-labor pain intensity and fear of childbirth. The analgesic consumption and the frequency of manual boluses as rescue analgesia were stored and collected from the analgesia pump. ResultsEighty-two (84.5%) primiparas and ninety-nine (60.7%) multiparas received epidural analgesia (P < 0.001). In the epidural subgroup, the primiparous average fear of childbirth (36.46 ± 10.93) was higher than that of the multiparas (32.06 ± 10.23) (P = 0.007). However, multiparas reported more intense in-labor pain [8.0 (8.0, 9.0) vs. 8.0 (7.0, 8.0)], had more successful manual boluses per hour [2.68 (1.65, 3.85) vs. 1.77 (0.90, 2.47)], more hourly analgesic consumption [23.00 (16.00, 28.25) vs. 17.24 (11.52, 21.36) mL] and more average analgesic consumption [0.35 (0.24, 0.45) vs. 0.26 (0.19, 0.35) mL/(h·kg)] than the primiparas (P < 0.05). Spearman’s correlation analysis showed that the maximum in-labor pain was weakly positively correlated with fear of childbirth (r = 0.09) (P < 0.05), hourly analgesic consumption (r = 0.16) (P < 0.01) and average analgesic consumption (r = 0.17) (P < 0.05). No statistically significant association was uncovered between analgesic consumption and maternal fear of childbirth. ConclusionsFear of childbirth is a potential predictor of labor pain intensity. Further study is needed to explore its role and value in pain management during delivery. Parity is not a determinant of pain relief use and should not be a preconceived preference of obstetric care team members to determine the distribution of epidural analgesia, especially when analgesia resources are insufficient.

Fear of Childbirth and Associated Risk Factors in Healthy Pregnant Women in Northwest of China: A Cross-Sectional Study.

AimFear of childbirth (FOC) is an extreme state of anxiety, distress and worry about childbirth. Despite its common occurrence, the prevalence and risk factors for FOC are inadequately understood in the northwestern region of China.PurposeThis study aimed to examine the prevalence and risk factors for fear of childbirth (FOC) in a cohort of pregnant women in northwest of China.Patients and MethodsA total of 922 healthy pregnant women were included in this cross-sectional study. Participants filled out a questionnaire on socio-demographic characteristics, as well as the Childbirth Attitudes Questionnaire (CAQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Pregnancy Pressure Scale (PPS). Psychosocial factors were analyzed to determine their association with fear of childbirth. Optimal scale regression analysis was used to determine the risk factors associated with FOC.ResultsThe mean score on the CAQ was 33.92 ± 10.17. A total of 72% of participants reported low to mild FOC. Six percent (n=51/922) and 22% (n=199/922) of pregnant women reported severe and moderate FOC, respectively. Based on optimal scaling regression analysis, the factors most strongly associated with FOC were residence, marital status, parity, gestational age, relationship with partner, pregnancy stress, social support and depressive symptoms.ConclusionThis study indicates the high prevalence of FOC (70.3%, ranging from mild to severe) in healthy pregnant women in northwest of China. FOC showed a positive correlation with pregnancy-related stress and depressive symptoms and a negative correlation with social support. Screening for FOC and helping pregnant women identify a support system early in pregnancy could reduce a woman’s stress level and severity of depression.

The effect of antenatal education on expectant mother’s childbirth attitudes, maternal role attainment, and self-confidence levels

We aim to determine the effect of antenatal education on the attitudes of expectant mothers toward birth, maternal role attainment and self-confidence levels. We carried out this quasi-experimental, non-randomized, prospective study in a hospital located in Istanbul, in the pre- and post-education model. Women in the education group (EG = 60) attended 6 weeks of education. Women in the control group (CG = 60) participated in a periodic follow-up visit. We collected the data using Childbirth Attitudes Questionnaire (CAQ), Pharis Self-Confidence Scale (PSCS), and Semantic Differential Scale-Myself as Mother (MMS). We made three measures in total: in the first visit, after six weeks and in the sixth week postpartum. We found the mean scores of second measurement of CAQ, PSCS, third measurement of MMS statistically significant in favor of EG (p < 0.05). Antenatal educations positively affect childbirth attitude, maternal role attainment and self-confidence levels.

Psychometric properties of the Persian version of delivery fear scale (DFS) in Iran

BackgroundThe aim of the present study was to evaluate the psychometric properties of the Persian version of delivery fear scale (DFS) among Iranian women population.MethodsThis is a methodological study that was conducted to evaluate the psychometric properties of DFS. Convenience sampling was used to select 200 pregnant women from the maternity ward of Razi Hospital in Ahvaz, Iran. In the first step, the scale was translated into Persian using backward-forward translation method. Afterwards, the following types of validity were examined: face validity based on impact score, construct validity based on confirmatory factor analysis (CFA), and concurrent validity. The Pearson correlation test was used to determine the correlation of DFS with pregnancy-related anxiety questionnaire (PRAQ), Childbirth Attitude Questionnaire (CAQ), Spielberger’s state-trait anxiety inventory (STAI), and the short form of Lowe’s childbirth self-efficacy inventory. Reliability of DFS was assessed by determining internal consistency (Cronbach’s alpha) and split-half method.ResultsCFA had satisfactory validity considering x2⁄df < 5 and the RMSEA < 0.08. /the obtained Cronbach’s alpha coefficient was 0.77. The split-half coefficient of the questionnaire was 0.83, indicating an acceptable reliability for the questionnaire. The results showed that DFS had a direct significant correlation with the CAQ (r = 0.72), PRAQ (r = 0.74), STAI-Y1 (r = 0.71) and STAI-Y1 (r = 0.63) and a reverse significant correlation with subscales of the short form of Lowe’s childbirth self-efficacy inventory including outcome expectancy (r= -0.75) and self-efficacy expectancy (r= -0.76).ConclusionsThe findings of the present study confirm the validity and reliability of the Persian version of DFS as an instrument for measuring fear of childbirth (FOC) in Iranian women population.