Wijma Delivery Expectancy/Experience Questionnaire Research Articles

The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic

We aimed to investigate how factors such as age, education level, planned delivery method and fear of childbirth were affected in pregnant women before and during the pandemic. This cross-sectional study compared a pre-pandemic pregnant group (July 2019 and December 2019) and a pandemic group (November 2020 and May 2021) of patients at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant women in their second trimester were included in the study. All of them were literate and voluntarily agreed to participate in the study. Data were collected with the Wijma delivery expectancy/experience questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face. The mean age of the pregnant women participating in the study was 31.6 ± 6.8 years. While the total Wijma score was 62.1 ± 25.1 in the pre-pandemic group, it was 61.3 ± 26.4 in the pandemic group, and there was no significant difference between the two groups (p = 0.738). Upon analyzing the fear of childbirth among groups based on education level, no statistically significant differences were observed between the pre-pandemic and pandemic periods within any of the groups. While 25.7% (n = 179) of all participants had a normal fear of childbirth, 22% (n = 153) had a mild fear of childbirth, 27% (n = 188) had a moderate fear of childbirth, and 25.3% (n = 176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth was unchanged in pregnant women at all education levels (p = 0.079, p = 0.957, p = 0.626, p = 0.539, p = 0.202). When comparing fear of childbirth before and after the pandemic, it was found that patients with a high school education level have a significantly higher fear of childbirth. To alleviate the fear of childbirth in pregnant women who have completed high school, training or psychosocial support interventions may be prioritized.

Effect of Supportive Midwifery Care in Primiparous on Post-Traumatic Stress Disorder and Fear of Childbirth in Labour

Introduction: This study was conducted to determine the effect of supportive midwifery care in primiparous on posttraumatic stress disorder and fear of childbirth in labour. Methods: The study was conducted in the delivery room of a maternity hospital in eastern Turkey. The data were collected between January and November 2018. This study is a quasi-experimental study, in which pregnant women were sampled from the relevant population using the non-probability random sampling method. The sample consisted of 164 women, including 82 in the experimental group and 82 in the control group. The women in both groups were asked to complete a personal information form and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Version A. Those in the experimental group received midwifery support during labour. The women in both groups were then given the Wijma Delivery Expectancy/Experience Questionnaire Version B and the Impact of Event Scale-Revised 6–8 hours after childbirth. Results: The mean prenatal W-DEQ version A score was 47.15±19.68 in the experimental group and 63.23±23.10 in the control group. There was a significant difference in mean scores between the groups (p

Validity and reliability of the Greek version of Wijma delivery expectancy/experience questionnaire (Version A) among low-risk pregnant women

BackgroundFear of childbirth is a frequent health issue for pregnant women. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is a widely used instrument to measure the fear of childbirth during the antenatal period. The aim of the study was to assess the psychometric properties of the W-DEQ (version A) in a sample of Greek pregnant women.MethodsLow-risk pregnant women in the second or third trimester of pregnancy (N = 201) were invited to participate in the study and to complete a booklet of questionnaires including the Greek versions of W-DEQ-A, State-Trait Anxiety Inventory (STAI), Coping Orientations to Problems Experienced (Brief COPE), Perceived Stress Scale (PSS-10) and Edinburgh Postnatal Depression Scale (EPDS). Exploratory (EFA) and confirmatory factor analysis (CFA) was performed.ResultsThe mean age of participants was 34.2 years (SD = 4.3 years). EFA yielded six factors (“Lack of self-efficacy”, “Lack of positive anticipation”, “Lack of feeling lonely”, “Concerns about delivery and losing control”, “Calmness”, and “Concern for the child”) of 33 items of W-DEQ-A. CFA confirmed the multidimensionality of the instrument. All Cronbach’s alpha were over 0.7, indicating acceptable reliability of the factors. All factors were significantly correlated with each other, and convergent validity was demonstrated by a significant association with stress, anxiety, and depression among low-risk pregnant women.ConclusionThe Greek version of W-DEQ-A proved to be a valid and reliable instrument of fear of childbirth among Greek low-risk pregnant women.

Effect of emotional freedom technique on the fear of childbirth in Iranian primiparous women: a randomized controlled trial.

Fear of childbirth is one of the main causes of women's emotional difficulty experienced in the perinatal period, especially those having their first child. The aim of this study was to investigate the effect of emotional freedom technique (EFT) on the fear of childbirth among primiparous women in Ahvaz, Iran. This randomized clinical trial was conducted on 116 primiparous women. The participants were randomly divided into intervention (n = 58) or control (n = 58) groups. The intervention group received daily stimulation of certain points in their body for 12 weeks using EFT. The fear of childbirth was measured at the beginning of the study and 12 weeks after the intervention using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A) and at the first postpartum visit with WDEQ-B. Data were analyzed using independent t-test, paired t-test, Chi-square or Fisher's exact test, and analysis of covariance (ANCOVA). After intervention, the mean score of fear of childbirth in the intervention group decreased from 49.39 ± 8.21 to 40.42 ± 13.43 (p < 0.0001), while the same rate in the control group increased from 49.47 ± 9.06 to 52.09 ± 7.73 (p = 0.002). The mean score of fear of childbirth after delivery in the control group (45.88 ± 7.10) was higher than that in the intervention group (27.13 ± 5.08) (p < 0.0001). Based on the findings of this study, EFT can be considered as an effective method to reduce the fear of childbirth score in primiparous women.

The relationships of spiritual health, pregnancy worries and stress and perceived social support with childbirth fear and experience: A path analysis

Background Given maternal health is a major health indicator, the present research aimed at determining the causal relationships of spiritual health, worries, stress and perceived social support with the fear and experience of childbirth in pregnant women. Methods The present longitudinal prospective research recruited 352 pregnant women presenting to selected health centers in Qazvin, Iran in 2021. The data were collected using the Childbirth Experience Questionnaire-2 (CEQ-2), the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Persian version of the Pregnancy Worries and Stress Questionnaire (PWSQ), the Spiritual Health Questionnaire, the Socioeconomic Status (SES) questionnaire and a sociodemographic checklist, and were analyzed in SPSS-25 and Lisrel-8.8. Results The mean age of the participants was 28.1±6.8 years. According to the results of the path analysis, among the variables related to fear of childbirth, childbirth experience (B = -0.37, CI:-0.44;-0.22) in the direct path and perceived social support (B = -0.51, CI:-0.58;-0.43) in both direct and indirect paths demonstrated the most significant negative relationship. Among the variables related to childbirth experience, pregnancy worries and stress had a negative causal relationship (B = -0.06, CI:-0.079;-0.043) in the direct path, spiritual health showed the highest significant positive relationship (B = 0.01, CI: 0.008; 0.012) in the indirect path, and perceived social support (B = 0.112, CI: 0.092; 0.131) and the number of children (B = 0.32,CI: 0.30; 0.34) demonstrated the highest significant positive relationship in both direct and indirect paths. In other words, childbirth experience becomes more desirable as spiritual health, social support, and the number of children increases, and it becomes less desirable as pregnancy worries and stress rise. Conclusion According to the present findings, various psychological, social, and spiritual factors are associated with childbirth fear and experience. It is thus necessary to utilize appropriate methods and promote training and support to reduce the adverse outcomes of childbirth.

A structural equation model analysis of the relationship between expectant fathers' fear of COVID-19 and their fear of childbirth: The mediating role of maternal fear of childbirth

BackgroundPregnancy and childbirth may provoke various emotional responses in expectant fathers including excessive fear of childbirth. It is not unreasonable to assume that fear of contracting the virus during the COVID-19 pandemic, may have intensified fathers' fear of childbirth. This study aims to determine the mediating role of the expectant mothers’ fear of childbirth in the relationship between expectant fathers’ fear of COVID-19 and their fear of childbirth. MethodsThis cross-sectional study was conducted on 270 pregnant women and their spouses attending health centers from Aug 2021 to April 2022. Fathers’ fear of childbirth scale (FFCS), Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-A), and Fear of COVID-19 Scale (FCV-19S) were used to collect data. To examine the relationships between variables and to develop the final model, we used the structural equation model (SEM). ResultsThe prevalence of severe fear of childbirth in fathers and their female spouses were 40.9% and 22.4%, respectively. The mean score and standard deviation of fear of childbirth in the fathers and their female spouses were 49.2 ± 17.1 and 62.5 ± 29.4, respectively. Results showed that fathers’ fear of COVID-19 was directly (B = 0.44, p = 0.004) and indirectly (B = 0.13, p = 0.015) associated with fathers’ fear of childbirth. Also, women's fear of childbirth was positively associated with fathers’ fear of childbirth (B = 0.45, p = 0.030). In the final model, the values of χ2/df, CFI, PCFI, RMSEA, and SRMR were equal to 2.32, 0.94, 0.76, 0.07, and 0.06, respectively. ConclusionsWe found a high prevalence of severe fear of childbirth in Iranian expectant fathers which means that fathers’ fear of childbirth is a national health concern that needs to be addressed. The findings of the present study indicate that mothers’ fear of childbirth has a mediating role in the relationship between fathers’ fear of COVID and fear of childbirth. Therefore, to alleviate fathers’ fear of childbirth, interventions to reduce fathers’ fear of COVID-19 and women's fear of childbirth should be developed and implemented. The impact of fathers’ mental health on the fear of childbirth in expectant couples should be further investigated.

Measuring Fear of Childbirth Among a Diverse Population in the United States: A Revised Wijma Delivery Expectancy/Experience Scale (WDEQ-10).

The current gold standard instrument used to measure fear of childbirth is the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ). However, the existing scale is long, has translational challenges, and lacks data specific to experiences of a diverse population in the United States, making it challenging to assess how fear of childbirth impacts perinatal health care disparities. The objective of this study was to revise the WDEQ and analyze its reliability and validity for use in the United States. The questionnaire was revised using qualitative data from a previously published study of fear of childbirth within a racially, ethnically, and economically diverse group of pregnant or postpartum people in the United States. Psychometric properties were analyzed in terms of construct validity, reliability, and factor analysis from a group of 329 participants. The revised and shortened 10 item WDEQ-10 comprises 3 subscales: fear of environmental factors, fear of death or injury, and fear of how they feel. The results indicate that the WDEQ-10 demonstrates good reliability and validity and confirmed the multidimensionality of fear of childbirth through a 3-factor solution. The WDEQ-10 is a readable and accessible instrument that will allow health care providers and researchers to accurately measure complex components of how pregnant people experience fear of childbirth.

The Effect of CAM Methods Plan to Apply by Pregnant Women in Order to Cope with Birth Pain on Fear of Childbirth and Childbirth Self-Efficacy

Objective: In the study, it was aimed to determine the effect of CAM methods planned to be used by pregnant women in order to cope with birth pain on fear of childbirth and childbirth self-efficacy &#x0D; Material-Method: &#x0D; The cross-sectional study was completed with 455 pregnant women. The study data were collected through Identifying Information Form, which also aimed to determine CAM methods planned to be used, The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Version A, and Childbirth Self-Efficacy Inventory (CBSEI). &#x0D; Results: &#x0D; In the study, it was determined that the pregnant women planned to use mind-body based CAM methods by 31.4%, manipulative and body-based methods by 25, biologically based methods by 1.1%, energy therapy methods by 0.9%, and alternative medicine methods by 0.7%. In addition, it was determined that there was a significant difference between CBSEI efficacy and outcome expectancy subscales mean scores and CBSEI total scale mean score of the pregnant women who did not plan to apply CAM methods to reduce their labor pain compared to those who planned to use these methods. &#x0D; Conclusion: &#x0D; It was found in the study that the pregnant women planned to use mind-body based methods the most in order to cope with labor pain in childbirth. It was also determined that there was no significant difference between the groups in terms of fear of childbirth according to their planning to use CAM methods to cope with labor pain in childbirth, and that childbirth self-efficacy levels of those who planned to use CAM methods were significantly low.

The Chichewa Wijma delivery expectancy/experience questionnaire: a factor analytic study for postpartum women in Malawi

Objective To test the validity and reliability of the Chichewa Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) in Malawian postpartum women. Methods A cross-sectional study of postnatal women (N= 415) at 1 day after vaginal birth was conducted at a district hospital in Malawi. The W-DEQ, Edinburgh Postnatal Depression Scale and the World Health Organization Quality of Life Scale were used to measure fear of birth (FOB), depressive symptoms and quality of life (QoL). Principal component analysis (PCA) and confirmatory factor analysis (CFA), Cronbach’s alpha, the average variance extracted (AVE) and the composite reliability (CR) and Pearson correlation were used to test the construct validity, reliability, convergent and divergent validity of the Chichewa W-DEQ (CW-DEQ). Results The participants had a mean age of 28.3 ± 6.7 years. A multidimensional structure containing three factors – a lack of positive feelings, fear and concerns about childbirth – with an appropriate model fit was reported for the CW-DEQ version. The Cronbach’s α of the CW-DEQ was 0.87. The AVE and CR values were highly acceptable in lack of positive feelings – 0.17 (0.68), and concerns about childbirth – 0.79 (0.88) factors which proved the convergent validity of each; however, was marginally acceptable in the fear factor – 0.14 (0.53). Low range of correlations between the CW-DEQ constructs (r = 0.27 ∼ 0.42, p < .001), confirmed the divergent validity. Conclusions In this study, we found the CW-DEQ to be a reliable and valid tool for assessing FOB in postpartum women.

A longitudinal case-control analysis of pain symptoms, fear of childbirth, and psychological well-being during pregnancy and postpartum among individuals with vulvodynia

ObjectiveLittle research has examined changes in chronic vulvar pain (vulvodynia) symptoms with pregnancy and childbirth, nor fear as it relates to pregnancy/delivery amongst individuals with vulvodynia. The purpose of this study was to examine change in pain symptoms from pregnancy to postpartum amongst women with vulvodynia, as well as pain anxiety, fear of childbirth, and anxiety and depressive symptoms. DesignProspective Case-Control Study. SettingOnline survey. ParticipantsFifty-Seven pregnant individuals with a diagnosis of vulvodynia, and 41 pregnant control participants who reported being free of vulvar pain. Participants were recruited from the community and from hospital-based clinics for this study. Measurements and FindingsOnline surveys were administered to women diagnosed with vulvodynia and pain-free control participants during pregnancy and at three and six months postpartum. The survey contained both investigator-developed items and validated questionnaires, including the Pain Anxiety Symptoms Scale (PASS-20), the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) to assess fear of childbirth, the Generalized Anxiety Disorder-7 (GAD-7) measure to assess symptoms of anxiety, and the Patient Health Questionnaire (PHQ-9) to assess symptoms of depression. Linear mixed models with random intercepts for longitudinal analyses indicated statistical improvements for most of the vulvar pain outcomes in the postpartum period amongst women with vulvodynia, including reduced pain intensity at three (p = 0.005) and six months (p = 0.013) postpartum for those women who delivered vaginally. The mean change in pain intensity corresponded though to only a minimal clinical change. Compared to controls, women with vulvodynia reported higher levels of fear of childbirth on the W-DEQ (p = 0.024). In both groups, increases in general anxiety on the GAD-7 were found from pregnancy to three (p = 0.005) and six months (p = 0.033) postpartum. Mode of birth moderated the findings for pain-related anxiety as measured by the PASS-20: only individuals who delivered via caesarean section reported increases in pain anxiety between pregnancy and six months postpartum (p < 0.001). Key ConclusionsPregnant women with vulvodynia experienced postpartum improvements in vulvar pain symptoms. Mode of birth may play a role in symptom trajectory. Implications for PracticeIndividuals with vulvodynia often have concerns about how pregnancy and childbirth will impact their symptoms. The current findings can be used to help such individuals make reproductive decisions knowing there may be improvements in vulvar pain and increases in anxiety that can occur postpartum. The statistical versus clinical significance of the pain intensity results also highlight the importance of asking each individual what changes in pain symptoms they experience and the meaning of such changes for that person.

Comparing the effect of childbirth preparation courses delivered both in-person and via social media on pregnancy experience, fear of childbirth, birth preference and mode of birth in pregnant Iranian women: A quasi-experimental study.

Rates of cesarean section in Iran are unnecessarily high largely due to fear of childbirth (FOC), yet this may be reduced through education. Iranian women are keen to obtain information about pregnancy and birth online though sources may not be reliable. Consequently, the present study aimed to compare the effect of childbirth preparation courses delivered both online via the social media platform 'Telegram' and in-person on pregnancy experience, FOC, birth preference, and mode of birth. This quasi-experimental study included 165 primiparous pregnant women referred to the prenatal clinic in Tehran, Iran. Convenience sampling was used to recruit participants, who were subsequently divided into three groups; (A) social media-based educational intervention (n = 53); (B) in-person educational intervention (n = 52), and (C) a control group who received no prenatal education (n = 50). During the 18th and 20th weeks of pregnancy, demographic questions along with the pregnancy experience scale (PES), and version A of the Wijma delivery expectancy/experience questionnaire (WDEQ‑A) were completed. In the 36th and 38th weeks of pregnancy, the PES and WDEQ‑A questionnaires, as well as birth preference form were further completed. Mode of birth was recorded in the first few days of postpartum. The Fisher's exact test, along with ANOVA and Chi-square tests were used to determine associations between variables. A paired t-test was used to examine within-group comparisons. The Kruskal-Wallis non-parametric test was used to investigate the intervening effect of economic status. Post intervention, the mean score of pregnancy experience and FOC did not differ significantly between the three groups. Also, 86.8% of participants in group A, 90.4% of participants in group B, and 62% of participants in the control group preferred to give birth vaginally, which was statistically significant (p = 0.001). Moreover, 66% of participants in group A, 61.5% of participants in group B, and 50% of participants in the control group ultimately gave birth vaginally. None of the participants in group A underwent an elective cesarean section, while this rate was 7.7% and 24% for groups B and control, respectively (p = 0.002). Despite the non-significant differences identified between the three groups in terms of pregnancy experience and FOC, prenatal education delivered via social media may be usefully offered to Iranian women keen to receive education flexibly online. Name of the Registry: Iranian Registry of Clinical Trials. Trial registration number: IRCT20180427039436N2. Date of registration: 15/06/2018. URL of trial registry record: https://www.irct.ir/trial/30890.

The impact of the Covid-19 pandemic on peripartum affective psychopathology

Introduction Despite COVID-19 pandemic significantly impacting mental health, few studies evaluated effects on perinatal mental health.ObjectivesTherefore, we aimed at assessing pregnant and puerperal women during first and second COVID-19 waves.Methods70 women (41 pregnant and 29 puerperal) consecutively afferent to our outpatient service for Perinatal Mental Health (March 2020-March 2021) were administered Edinburgh Postnatal Depression Scale (EPDS), Fear of COVID-19 (FCV-19-S), Coronavirus Anxiety Scale (CAS) and Wijma Delivery Expectancy/Experience questionnaire (WDEQ).ResultsWomen who reported last menstruation date (LMD) in 2019 second semester showed higher EPDS scores (p=0.026), those with estimated delivery date (EDD) in 2021 second semester showed higher CAS scores than those with EDD in 2020 first semester (p=0.020) or in 2021 first semester (p&lt;0.001). Women with clinically significant EPDS Scores reported higher FCV-S-19 (p=0.005) and CAS (p=0.003). Subjects with a previous psychiatric hospitalization showed higher FCV-S-19 (p=0.003). A weak positive correlation (r=0,290; R2=0,084; p=0.015) has been observed between FCV-S-19 and EPDS. Furthermore, there was a strong positive correlation (r=0,377; R2=0,142; P=0.001) between CAS and EPDS and between CAS and FCV-S-19 (r=0,641; R2=0.410; p&lt;0.001). All subjects showed high scores for tocophobia after experiencing delivery.ConclusionsCOVID-19 pandemic significantly impacted pregnant and/or postpartum women also without a previous psychiatric condition. Early identification and screening tools should be routinely provided to all pregnant and postpartum women.DisclosureNo significant relationships.

Association of Fear of Childbirth with the Preference for Cesarean Section; A Cross Sectional Study

Objective: To determine the fear of childbirth (FOC) amongst pregnant women and its association with preference for cesarean section.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Department of Obstetrics and Gynecology Pak Emirates Military Hospital, Rawalpindi from Jan 2018 to Jun 2018.&#x0D; Methodology: Demographic and reproductive data of the patients including mode of delivery, was noted. The intensity of fear of childbirth was measured by Wijma delivery expectancy/experience questionnaire (W-DEQ), and a score was allotted. The total sum of scoring ranged from 0 to 165. A score of &gt;85-99 indicated an intense fear of childbirth, and ≥100 indicated very intense fear. The frequency of requests for cesarean section in women suffering from fear of childbirth was calculated.&#x0D; Results: A total of 335 patients were included. The mean age was 28.74 ± 3.58 years, and the mean gestational age was 39.50 ± 1.43 weeks. The mean W-DEQ score was 94.59 ± 9.86. The fear of childbirth calculated by W-DEQ in the third trimester of pregnancy showed no fear in 233 (69.55%) participants, intense fear in 42 (12.54%) and very intense fear in 60 (17.91%) women. The requests for cesarean section in women suffering from intense fear were made by 5 (11.90%) women and in women suffering from very intense fear of childbirth was 19 (31.67%) (p-value &lt;0.001).&#x0D; Conclusion: This study concluded that the intensity of fear of childbirth calculated by W-DEQ amongst pregnant women in the third trimester of pregnancy was relatively high, with a much higher rate ...

Effect of nursıng support gıven to pregnant women on labor paın and bırth expectancy.

Nurses support pregnant women in coping with their labor pain. The aim of the quasi-experimental correlational design study was to identify the effect of the nursing support provided on labor pain and birth expectations to primiparous pregnant women. This study was carried out with an intervention (n=51) and control group (n=51) of primiparous women who were in their 37-41 weeks of pregnancy. In the first stage of labor (latent phase-active phase) (3-7 cm dilatation), the following procedures were applied respectively. Focusing, imagery, massage, sacral pressure, and breathing-relaxation-pushing exercises were explained to the pregnant women in the intervention group by the researcher and the exercises were practised one-on-one with them. The control group only received standard care in the ward without any intervention. The population of the study consisted of 102 pregnant women aged 18 years and above who had a vaginal delivery between February 15- August 15, 2018.The data of the study were collected using the Pregnancy Diagnosis Form, the Visual Analog Scale (VAS) (labor VAS1, post-natal VAS2) to determine the pain level of the participants, and WIJMA Labor Expectancy/Experience Questionnaire Version B to determine their expectations. SPSS 22.0 for Windows was used for the data analysis while frequency and percentage distribution, arithmetic means were calculated. Mann-Whitney U test, Kruskal- Wallis test, Spearman correlation analysis were performed. The statistical significance level was accepted as p <0.05. The socio-demographic and obstetric characteristics of the pregnant women in the study were similar. VAS1 was 6.0 1.3 in the intervention group and 6.4 .1 in the control group. VAS2 was 0.9 0,8 in the intervention group and 1.31 1,029 in the control group. Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Version B was found to be7.3 14.9 in the intervention group and 117.1 23.9 in the control group. The study results showed that the pregnant women in the intervention group described their labor more positively, that the postpartum perceived pain, fear levels of pregnant women who received nursing support were lowerthanthosewhoreceivedstandardcare.

Comparing the effect of in-person and virtual childbirth preparation trainings on the fear of childbirth (FOC) and pregnancy experience of pregnant women: protocol for a quasi-experimental feasibility study

BackgroundChildbirth preparation trainings are an important component of prenatal education, and pregnant women are increasingly interested in seeking information from online sources. The aim of this study is to compare the feasibility and the effects of in-person and virtual childbirth preparation training courses on the pregnancy experience, fear of childbirth (FOC), birth preference, and type of delivery among pregnant women.MethodsIn total, 165 primiparous women referring to a prenatal clinic at Milad Hospital in Tehran, will be included in this study. The subjects will be selected using the convenience sampling method and will be divided into three groups of study A, study B, and control. The study groups A and B will receive virtual and in-person childbirth training with similar content, respectively. The control group will receive only routine prenatal care. In the 18th and 20th weeks of pregnancy, the demographic information, pregnancy experience scale (PES), and version A of the Wijma delivery expectancy/experience questionnaire (WDEQ-A) will be completed, and in the 36th and 38th weeks of pregnancy, the PES and WDEQ-A questionnaires, as well as birth preference form will be completed. The type of delivery will be recorded in the first few days of postpartum.ConclusionThis quasi-experimental clinical trial will investigate the effect of virtual childbirth preparation training on primiparous women. The expected outcomes will include the difference in pregnancy experience measured by the brief version of PES, the difference in FOC measured by WDEQ-A, the birth preference, and the type of delivery.Trial registrationIRCT.ir: IRCT20180427039436N2;

Mediating effects of social support between antenatal depression and fear of childbirth among nulliparous woman.

Although gestation and childbirth are progressive physical processes for most pregnant women, there are both physical and great psychosocial challenges throughout the process, which increase the sensitivity and vulnerability of women. Even for women with low-risk pregnancies, it is common to experience degrees of fear, especially for primipara women when faced with childbirth. During their first pregnancy, women may have no relevant health knowledge or experience with delivery and have difficulty identifying prenatal depression and other existing mental health factors; a fear of childbirth (FOC) may engender adverse outcomes for mothers and babies. Social support is a very important influential factor for prenatal depression. This study adopted a descriptive cross-sectional design. The participant cohort involved 609 primipara women (≥18 years old) who had received routine prenatal care and visited a tertiary care hospital in Xi'an. The participants completed structured questionnaires, including the 10-item Edinburgh Postnatal Depression Scale (EPDS), 12-item Multidimensional Scale of Perceived Social Support (MSPSS), and 33-item Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), alongside contribution of information regarding their demographic characteristics. Descriptive and correlation analyses were adopted to verify the correlations among these variables. Multiple regression models were examined by the SPSS PROCESS procedure with bootstrapping to confirm the significance of the mediation effect. The widespread prevalence of FOC in healthy pregnant women was 22.3% (WDEQ score ≥85). The mean scores of depression, social support, as well as FOC scores of participants were 9.50 (5.19), 70.91 (9.25), and 70.43 (20.88), respectively. Remarkable correlations were identified between pregnancy depressive symptoms, social support, and FOC. Results presented an indirect effect, indicating that the impacts of antenatal depression on FOC were mediated by social support. Perceived social support played a mediating role between antenatal depression and FOC among healthy primipara women. Techniques and suggestions for boosting social support may be expected to have a positive impact on the depressive symptoms of pregnant women with FOC.

Implementation of Virtual and Face-to-Face Childbirth Preparation Training for the Spouses of the Primiparous Women to Reduce the Fear of Childbirth, Improve the Pregnancy Experience, and Enhance Mother- and Father-Infant Attachment: Protocol for a Quasiexperimental Clinical Trial.

Background Men have a special role to play in promoting maternal and child health during pregnancy, childbirth, and postpartum period. The health of women also requires the participation and cooperation of men. The aim of this study is to compare the effect of virtual and face-to-face childbirth preparation training for spouses of the primiparous women on the pregnancy experience, fear of childbirth (FOC), and mother- and father-infant attachment. Methods The primiparous women attending the prenatal clinics of Lolagar Hospital and Azadi and Tehransar health centers of Tehran along with their husbands will be studied. The inclusion criteria for the women's husbands are the first experience of becoming a father, being at least 18 years of age, and the ability to read and write. The exclusion criteria for women's husbands are the history of physical/mental illness; being a smoker; and consuming alcohol, drugs, or psychotropic substances. The participants will be selected by the convenience sampling method and will be divided into three groups of study A, study B, and control. Spouses in study groups A and B will receive childbirth training through virtual and face-to-face methods with similar content, respectively. The control group only receives ordinary prenatal care. At the 18–20 weeks of gestation, demographic information, pregnancy experience scale (PES), and version A of Wijma delivery expectancy/experience questionnaire (WDEQ-A) will be completed. At 37-38 weeks of gestation, the PES and WDEQ-A questionnaires will be completed again and maternal postnatal attachment scale (MPAS) and postnatal paternal-infant attachment questionnaire (PPAQ) will be completed by the parents 12 weeks after the delivery. Discussion. Improving the experience of pregnancy, especially reducing the FOC and creating a positive attitude towards it, is a vital strategy to promote vaginal childbirth and reduce the number of cesarean sections requested by women. Achieving this will reduce the cost of health care and improve the quality of life during pregnancy, after childbirth, and during the growth and development of infants. Ethics and Dissemination. This research has been funded by the Iran University of Medical Sciences, approved by the Thailand Registry of Clinical Trials, and will commence in May 2020. Results will be disseminated through peer-reviewed journals and shared with the academic and medical community to pregnancy and childbirth outcomes. This trial is registered with TCTR20200515011.

Reliability and validity study of the Spanish adaptation of the "Wijma Delivery Expectancy/Experience Questionnaire" (W-DEQ-A).

The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ-A) is an instrument that evaluates fear of childbirth through the expectations of women in relation to childbirth and their experience during the birth. The objective of this study was to translate the W-DEQ-A into Spanish and analyse its reliability and validity. The study was carried out in two phases: (1) adapting the questionnaire to Spanish and (2) a transversal study in a sample of 273 pregnant women in the Sexual and Reproductive Health centres in the Metropolitan Northern Barcelona in Catalonia (Spain). The psychometric properties were analysed in terms of reliability and construct validity. The confirmatory factorial analysis did not confirm the unidimensionality of the original structure of the WDEQ-A, as happened with the other studies in which it has previously been validated. The result of the exploratory factorial analysis suggests four factors, or dimensions, very similar but not identical to those obtained in other analysis studies of the W-DEQ-A. The Cronbach alpha and the omega scale were also adequate for all the scales and for each of the dimensions. The results of this study confirm the findings of other studies that suggest that the W-DEQ-A is multi-dimensional. In the Spanish version of the W-DEQ-A four dimensions have been identified to explore fear of childbirth in pregnant women. The Spanish version of the WDEQ-A (WDEQ-A-Sp) is reliable and valid for the measurement of fear of childbirth in clinical practice and for use in future research.

Mental health problems and fear of childbirth: A cohort study of women in an inner‐city maternity service

AbstractObjectivesTo estimate the population prevalence of severe fear of childbirth (FOC) during pregnancy and investigate its association with: (a) antenatal common mental disorders (depression and anxiety disorder) and (b) elective cesarean birth.Methods545 participants from an inner‐city London maternity population were interviewed soon after their first antenatal appointment (mean gestation: 14 weeks). Current mental disorders were assessed using the Structured Clinical Interview DSM‐IV. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ‐A) at approximately 28 weeks gestation (n = 377), with severe FOC defined using a cutoff of WDEQ‐A ≥ 85. Birth mode information was collected at 3 months post‐delivery using an adapted Adult Service Use Schedule. Linear regressions were used to model associations, adjusting for the effects of covariates (age, parity, relationship status, education, and planned pregnancy). Sampling weights were used to adjust for bias introduced by the stratified sampling. We also accounted for missing data within the analysis.ResultsThe estimated population prevalence of severe FOC was 3% (95% CI: 2%‐6%) (n = 377). Depression and anxiety were significantly associated with severe FOC after adjustment for covariates (45% vs 11%; coefficient: 15.75, 95% CI: 8.08‐23.42, P &lt; .001). There was a weak association between severe FOC and elective cesarean birth.ConclusionsSevere FOC occurs in around 3% of the population. Depression and anxiety are associated with FOC. Pregnant people with depression and anxiety may be at increased risk of experiencing severe FOC. Attitudes toward childbirth should be assessed as part of routine clinical assessment of pregnant people in contact with mental health services.

Simulation-based childbirth education for Chinese primiparas: A pilot randomized controlled trial

ObjectiveTo evaluate the effectiveness and feasibility of simulation-based childbirth education (SBCE) on reducing fear of childbirth (FOC) of Chinese primiparas. MethodsA total of 56 primiparas completed the trial including 26 in the intervention group and 30 in the control group. The intervention group received four sessions of SBCE while the control group received routine prenatal care. Chinese versions of the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A) and Childbirth Self-Efficacy Inventory (CBSEI) were used to evaluate FOC and childbirth self-efficacy. Birth outcomes including delivery method, labor duration and Apgar scores were collected. ResultsScores on the WDEQ-A of the intervention group were statistically lower than those of the control group (P < 0.05). The CBSEI scores of the intervention group were significantly higher than those of the control group (P < 0.05). The cesarean birth rate of the intervention group was lower than that of the control group (34.61% vs 46.67%, P > 0.05). ConclusionSimulation-based childbirth education alleviates FOC, increases childbirth self-efficacy and improves birth outcomes, providing a new perspective to alleviate FOC of primiparas in the future. Practice implicationsSimulation-based childbirth education is an effective and feasible method to educate women about childbirth. Its integration into routine prenatal care of Chinese primiparas should be encouraged to reduce FOC.