Wijma Delivery Expectancy/Experience Questionnaire Research Articles

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.

Validation of the Wijma delivery expectancy/experience questionnaire for pregnant women in Malawi: a descriptive, cross-sectional study

BackgroundFear of childbirth is a common health concern for women during pregnancy. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is widely used to measure childbirth fear during pregnancy. However, this instrument is yet to be validated in Malawi, Africa. Our study aimed to assess the psychometric properties of the W-DEQ questionnaire in Malawi.MethodsHealthy pregnant women in the third trimester (N = 476) at a district hospital in Malawi were included. Fear of childbirth, depressive symptoms, and quality of life were assessed using the W-DEQ, the Edinburg Postnatal Depression Scale, and the World Health Organization Quality of Life scale, respectively. The construct validity, reliability, and convergent validity of the W-DEQ were examined using exploratory and confirmatory factor analyses, Cronbach’s alpha, and Pearson correlations.ResultsThe mean age of participants was 28.2 (standard deviation = 6.8) years. Exploratory and confirmatory factor analysis of the Malawian version of the W-DEQ indicated a multidimensional structure with three factors: fear, negative appraisal, and a lack of self-efficacy, with acceptable goodness of model fit. The Malawian version of the W-DEQ showed a satisfactory internal consistency (α = 0.84) and was significantly correlated with depressive symptoms (r = 0.23, p < 0.001) and quality of life (r = − 0.17 ~ -0.26, ps < 0.05).ConclusionsOur findings support the Malawian W-DEQ version being a reliable and valid instrument for measuring childbirth fear in African women.

Effects of Dance and Music on Pain and Fear During Childbirth

ObjectiveTo test the effects of dance and music and music alone on pain and fear during the active phase of labor among nulliparous women. DesignSingle-blind, randomized, controlled study. SettingA maternity and children’s hospital in Konya Province, Turkey. ParticipantsA total of 93 nulliparous, pregnant women who were in the active phase of labor at term gestation with single fetuses in cephalic presentation. MethodsWe randomly assigned participants to one of three groups: dance and music, music alone, and usual care (control). We collected data four times during labor using a personal information form, labor monitoring form, visual analog scale (VAS), and Version A of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQA) to measure fear. ResultsBased on multivariate analysis of variance, the effect of time and study group interaction on VAS and W-DEQA scores was statistically significant (p < .05), and the effect of study groups and time on VAS scores was statistically significant (p < .05). The effect of the study groups on W-DEQA scores was statistically significant (p < .05), but there was no statistically significant effect of time on W-DEQA scores (p > .05). ConclusionDance and music and music alone significantly reduced pain and fear in nulliparous women during the active phase of labor. These interventions are easy for nurses and midwives to use, affordable, and effective, and they enable a woman and her partner to be actively engaged in the woman’s care.

Preferred and actual mode of delivery in relation to fear of childbirth

Purpose This prospective cohort study aimed to investigate the interrelation between preferred/actual mode of delivery and pre- and postpartum fear of childbirth (FOC). Material and methods Participants from 13 midwifery practices and four hospitals in Southwest Netherlands filled out questionnaires at 30 weeks’ gestation (n = 561) and two months postpartum (n = 463), including questions on preferred mode of delivery, the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Hospital Anxiety Depression Scale (HADS). Results were related to obstetric data. Results Both severe FOC (OR 7.0, p < .001) and previous Cesarean section (CS) (OR 16.6, p < .001) predicted preference for CS. Severe prepartum FOC also predicted actual CS. Preferring a vaginal delivery (VD) and actually having a CS predicted higher postpartum W-DEQ scores (partial r = 0.107, p < .05). Other significant predictors for high postpartum W-DEQ scores were high prepartum W-DEQ (partial r = 0.357) and HADS anxiety scores (partial r = 0.143) and the newborn in need of medical assistance (partial r = −0.169). Conclusions Women preferring a VD but ending up with a CS are at risk for severe FOC postpartum, while the same risk was not demonstrated for women who preferred a CS but had a VD. Prepartum FOC is strongly associated with postpartum FOC, regardless of congruence between preferred and actual mode of delivery.

Doğum Sürecinde Gebelere Verilen Fiziksel Desteğin Doğum Sonuçlarına Etkisinin Değerlendirilmesi

Objectives: This study was aimed to examine the effects of physical support during the childbirth period on the birth process. Methods: Research is an experimental randomized controlled study. In the study group, each pregnant woman was directly assisted by using non-pharmacological methods without leaving the woman during her birth. Simultaneous evaluations were made to the control group with routine hospital procedures. Wijma Delivery Expectancy/ Experience Questionnaire (W-DEQ)-A was applied to all pregnant women before delivery. Wijma Delivery Expectancy/ Experience Questionnaire (W-DEQ)-B version and The Scale for Measuring Maternal Satisfaction at Normal and Cesarean Birth were completed to all pregnant women after delivery. Results: The need for induction at birth decreased for women who were offered physical support (p = 0.033). The duration of labor for the study group was 657,93 ± 283.69 min. while the control group had 1062,43 ± 673.11 min. (p = 0.004) and the difference between them is statistically significant were determined (p=0,004). It was determined that the rate of episiotomy (p=0,000), fundal press (p=0,000) and fear of birth (p=0,001) decreased after birth. Also, women were found to have higher birth satisfaction (p = 0.001). Conclusion: It was determined that the physical support applied during the active phase of birth affects the birth process positively.

Is fear of childbirth related to the woman's preferred location for giving birth? A Dutch low-risk cohort study.

BackgroundIn The Netherlands, women with low‐risk pregnancy are routinely given the option of home birth, providing a unique opportunity to study the relationship between fear of childbirth (FOC) and preference for childbirth location, and whether women experience higher FOC when the actual location differs from their preference.MethodsIn this prospective cohort study, 331 nulliparous and parous women completed a questionnaire at gestational week 30 (T1) and two months postpartum (T2). FOC was assessed using versions A (T1) and B (T2) of the Wijma Delivery Expectancy/Experience Questionnaire (W‐DEQ).ResultsAt T1, women who preferred home birth had significantly lower FOC compared with women who preferred a hospital birth (mean ± SD W‐DEQ scores: 55 ± 19.8 and 64 ± 18.3, respectively, P < .01). About 28% of women who responded at T2 gave birth at home. Congruence between the preferred and actual childbirth location was not predictive of FOC assessed at T2 when adjusted for obstetric and psychological variables. In an extended analysis, we found that except for prepartum FOC, the following variables also correlated with postpartum FOC: being referred because of complications and poor neonatal condition.ConclusionsCompared to women who prefer hospital birth, women who prefer home birth have lower prepartum and postpartum FOC. Giving birth at a location other than the preferred location does not appear to affect postpartum FOC. Whether giving birth at home or in the hospital, caregivers should pay extra attention to women with high FOC because they are vulnerable to postpartum FOC, especially after a complicated birth and referral.

Fear and Anxiety Disorders Related to Childbirth: Epidemiological and Therapeutic Issues.

This paper seeks to identify the risk factors of fear of childbirth (FOC) and posttraumatic stress disorder (PTSD) related to birth and reviews the efficacy of their respective screening tools and therapeutic interventions. Biofeedback, hypnosis, internet-based cognitive behavioral therapy, and antenatal education are promising treatments for FOC. Training midwives to address traumatic birth experiences could help in preventing PTSD. A shorter more pragmatic screening tool for FOC than the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ) is needed. Women with PTSD attributed a mismatch between the expected mode of delivery (MOD) and the actual MOD as the cause of their trauma. A history of mental health disorders, lack of social support, previous negative birth experiences, and MOD are correlated to FOC and postpartum PTSD. Psycho-education and CBT-based treatments have been found to reduce levels of FOC and PTSD.

Predictors of prenatal distress and fear of childbirth among nulliparous and parous women.

Prenatal distress and fear of childbirth negatively affect the health of the mother and the fetus. Sociodemographic and pregnancy related characteristics may influence prenatal distress and fear of childbirth. This study aimed to explore the relationship between fear of childbirth and prenatal distress levels with accompanying factors. The study was designed as a cross-sectional survey study and conducted in the outpatient clinic of Obstetrics and Gynecology Department of Pamukkale University Hospital, Denizli, Turkey, between April 2017 and January 2018. Survey data were collected from 103 third-trimester pregnant women who had admitted to the hospital for routine prenatal examination. Sociodemographic Information Form, the Revised Prenatal Distress Questionnaire (NUPDQ), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) were used to collect data. Sociodemographics, obstetrics, and other variables were summarized by descriptive statistics. Mann-Whitney U-test, Chi-squared test, and Fisher's exact test were used for comparison of data between groups. The mean score of NUPDQ was 7.58 (SD 4.09) in the nulliparous group and 8.17 (SD 5.16) in the multiparous group (P = 0.68). The mean W-DEQ score was 40.46 (SD 21.80) in nulliparous women and 45.55 (SD 26.72) in multiparous women (P = 0.38). The W-DEQ and NUPDQ scores were moderately correlated with a Spearman correlation co-efficient of 0.58 (P < 0.001). The results of this study revealed that fear of childbirth and prenatal distress were moderately and positively correlated. NUPDQ and W-DEQ can be used during pregnancy to understand if pregnant women have fear or distress. This could help to give a better support to pregnant women.

Childbirth fear and related factors among pregnant and postpartum women in Malawi

BackgroundChildbirth fear is a health concern in women living in high-income countries; however, little is known about childbirth fear among women living in low-income countries like Malawi. In this study, we explored childbirth fear and associated factors among pregnant and postpartum women in Malawi.MethodsA cross-sectional study of 152 pregnant and 153 postpartum women was conducted at a district hospital in Malawi. Participants were assessed for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ). Demographic and obstetric variables were collected using a structured questionnaire. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Using a multinomial logistic regression, factors related to childbirth fears were examined, namely demographic and obstetric characteristics, and social support.ResultsThe mean age of participants was 26 (standard deviation: 6.4) years. During pregnancy, 39% women reported a low level of fear, 41% reported moderate fear, and 20% reported high fear; while after birth, 49, 41, and 10% women reported low, moderate, and high fear, respectively. Pregnant women who were illiterate (odds ratio (OR): 5.0, p < 0.01) or unemployed (OR: 12.6, p < 0.01) were more likely to report moderate and high fear. Postpartum mothers who were illiterate (OR: 4.2, p < 0.01) or unemployed (OR: 11.8, p < 0.01) were more likely to have moderate and high fear. Furthermore, postpartum women who sustained perineal tears had significantly higher odds of experiencing moderate (OR: 5.3, p < 0.01) or high (OR: 19.9, p < 0.01) fear than their counterparts.ConclusionsChildbirth fear is common in Malawi, and pregnant women are more likely to experience high levels of fear than postpartum women. This study highlighted the connection between childbirth fear with mother’s education, employment, and perineal tears during delivery. Identifying and developing interventions for women with these associated characteristics is of clinical importance for the reduction of childbirth fear before and after childbirth in Malawi.

Does haptotherapy benefit mother-child bonding in women with high fear of childbirth?

Objective: To evaluate the effect of haptotherapy during pregnancy on mother-child bonding (MCB). Population or Sample: Primigravida and multigravida (N = 73). Methods: Data were obtained from a randomized controlled trial study on treatment for severe fear of childbirth with haptotherapy. Fear of Childbirth (FOC) was evaluated using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and mother-child bonding (MCB) by an online version of the Pictorial Representation of Attachment Measure (PRAM). Screen-positive women for severe FOC were randomly assigned either to a haptotherapy (HT) arm or a no-haptotherapy (No-HT) arm (psycho-education via internet or care as usual). In this group, a median split was carried out on the PRAM to allow focusing on the women with the 50% poorest MCB levels. Measurements were on four occasions: (T1) 20-24 weeks of gestation, (T2) 36 weeks of gestation, (T3) 6 weeks postpartum, and (T4) 6 months postpartum. Repeated measurements ANOVA was carried out on the basis of the as-treated principle. Main Outcome Measures: MCB measured with the PRAM across two measurement occasions T1 and T4. Results: In the group of women with high MCB, we found no statistically significant difference in the mean PRAM change scores between the HT arm and the no HT-arm, F(3, 69) = 2.009, p = .121. However, in the group of women with low MCB, women in the HT arm showed a statistically significant greater improvement of mother-child bonding than in the no-HT, F(3, 69) = 2.877, p = .042. Conclusion: Haptotherapy during pregnancy can statistically significantly increase mother-child bonding in women with a high fear of childbirth and a poor MCB as compared with psycho-education via internet or care as usual.

Fear of birth in clinical practice: A structured review of current measurement tools

To identify measurement tools which screen for the presence of fear of birth (FOB) and to determine the most effective tool/s for use in clinical practice.Fear or birth (FOB) is internationally recognised as a cause for increasing concern, despite a lack of consensus on a definition or optimal measure of assessment. There is a wide array of FOB measurement tools, however little clarity on which tool should be used to screen for FOB in clinical practice. This review explores the use of tools that are used to screen for FOB and discusses the perceived effectiveness of such tools.A structured literature review was undertaken. Electronic databases were searched in July 2017 and manuscripts reviewed for quality.The review included 46 papers. The majority of studies were undertaken in Scandinavia (n = 29) and a range of tools were used to measure FOB. The most widely used tool was the Wijma Delivery Expectancy Experience Questionnaire’ (W-DEQ). Inconsistencies were found in the way this tool was used, including variations in assessment cut-off points, implementation and use across a range of cultural settings and women of varying gestations. Moreover, the tool may be too lengthy to use in clinical practice. The Fear of Birth Scale (FOBS) has been shown to be as effective as W-DEQ but has the advantage of being short and easy to administer.The inconsistencies in tools reflect the difficulties in defining FOB. A clear consensus definition of FOB would aid comparisons across practice and research. The W-DEQ is not used in clinical practice; this may be due to its length and complexity. The FOBS is likely to be a more versatile tool that can be used in clinical practice.

The Relationship between Perceived Social Support in the First Pregnancy and Fear of Childbirth.

Background:Numerous empirical evidences have shown that social and environmental circumstances and social relations have an important impact on pregnancy outcomes, women's ability to cope with stressful situations, and childbirth pain management. The present study was conducted to determine the relationship between perceived social support and fear of childbirth.Materials and Methods:The present descriptive correlational study was conducted on 270 nulliparous pregnant women who referred for pregnancy care in 2016. The subjects were selected through convenience sampling method. The data collection tools were a demographic characteristics form, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). The collected data were analyzed using descriptive and inferential statistics tests.Results:The mean perceived social support score of the participants was 77.90 and a significant correlation was observed between the perceived social support score and fear of childbirth score (β = −0.18, p = 0.004). The participants' mean score of fear of childbirth was 36.8. The results of study after the evaluation of the effect of predictive variables on the fear of childbirth are as follows: pregnancy preparation classes: (β = 3.50, p = 0.220); observation of natural childbirth videos: (β = 5.26, p = 0.040); and use of educational software: (β =5.82, p = 0.080).Conclusions:In order to reduce the fear of childbirth, women's social support structure during pregnancy should be assessed. Moreover, demographic characteristics form the structure and determine the extent of individuals' social network and, through the evaluation of these characteristics during pregnancy, the rate of effective support can be predicted in individuals.

Investigation of the relationship between fear of childbirth and social supports of pregnant women in the third trimester in Turkey

Purpose: To investigate the relationship between fear of childbirth and social supports of pregnant women in the third trimester. Materials and Methods: The sample of this cross-sectional study comprised 302 pregnant women who were admitted to the gynecology and obstetrics clinic of a state hospital in Turkey. Data were collected with the Personal Information Form, Wijma Delivery Expect ancy/Experience Questionnaire (W-DEQ-A), and Multidimensional Scale of Perceived Social Support (MSPSS). Results: While no relationship was determined between the mean total scores obtained from the W-DEQ-A and MSPSS scales (p > 0.05), statistically significant positive correlations were determined between family and friends (r = 0.206, p = 0.000), family, and significant others (r = 0.193, p = 0.001), and friends and significant others (r = 0.156, p = 0.006) subscales of the MSPSS (p Conclusion: As the social support received from the family increased so did the support from friends and significant others, and as the support received from significant others increased so did the support from friends.

Effect of a Childbirth Psychoeducation Program on the Level of Fear of Childbirth in Primigravid Women

Background: Severe fear of childbirth (FOC) is the most important cause of elective and emergency cesarean section and results in an unpleasant experience among women. Implementing a psychoeducational program can promote mothers’ knowledge and reduce the FOC. Aim: the aim of this study was to determine the effect of childbirth psychoeducational program on the FOC intensity in primigravid women. Method: This randomized clinical trial was conducted on 122 primigravid women with a gestational age of 14 to 28 weeks referred to healthcare centers of Mashhad, Iran, during 2015-2016. The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), versions A and B, was used for the data collection. The subjects had the FOC scores of 66 or higher based on the W-DEQ, version A. The women in the intervention group received the psychoeducational program for three weeks (one 90-minute session per week) by a clinical psychologist; however, the control group underwent the routine prenatal care. The FOC intensity was reassessed using W-DEQ, version B, six weeks postpartum in both groups. Data analysis was performed in SPSS, version 20, using Mann-Whitney U and Wilcoxon tests. Results: The mean age of the subjects was 23.2±3.6 and 24.2±4.4 years in the intervention and control groups, respectively. After the intervention, the Mann-Whitney U test demonstrated a significant difference between the intervention (83.5±21.7) and control (92.6±18.4) groups regarding the mean FOC score (P=0.001). Implications for Practice: The childbirth psychoeducational program could diminish the FOC in primigravid women with severe FOC. We recommend midwives and expert psychologists to incorporate psychoeducational programs in childbirth classes.

Validity and reliability of the Farsi version of Wijma delivery expectancy questionnaire: an exploratory and confirmatory factor analysis.

BackgroundFear of childbirth may cause complications such as experiencing severe labour pain, postpartum depression, and impaired mother–fetus attachment.ObjectiveTo validate the Farsi version of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) (versions A & B) in a sample of Iranian women.MethodsThe WDE-Q (versions A & B) was translated into Farsi, and the content validity of the scales was confirmed. In a cross-sectional study conducted in 2015, 405 pregnant women in the third trimester of pregnancy and 320 postpartum women completed the Farsi W-DEQ versions A & B, respectively. The construct validity and reliability of the scales were examined using exploratory and confirmatory factor analyses (EFA and CFA) and Cronbach’s alpha coefficient, respectively. SPSS version 18 and Lisrel version 8.80 were used for statistical analyses.ResultsResults of the CFA on 33 items could not confirm the one-factor structure proposed by Wijma (RMSEA= 0.14, SRMR=0.11, Chi-square/df=8.95, p<0.05, CFI=0.86, IFI=0.86) or other structures suggested by previous studies. We conducted an EFA on 33-item version A and found six factors with eigenvalue > 1. One item was not loaded on any factor. A CFA on 32 items of the W-DEQ (version B) yielded acceptable fit for the factorial structure found on version A (RMSEA= 0.075 (CI [0.071, 0.08]), SRMR=0.078, Chi-square/df=2.93, p<0.05, CFI=0.95, IFI=0.95). Cronbach’s Alpha coefficients for the 32-item Farsi W-DEQ (versions A & B) were 0.914 and 0.919, respectively.ConclusionsBoth Farsi W-DEQ are reliable and valid instruments to assess fear of childbirth in Iranian pregnant and postpartum women. Further research should be designed to examine the validity of the W-DEQ (A) in pregnant women regardless of gestational age.

Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child.

The objective of this study was to calculate costs associated with severe fear of childbirth (FOC) during pregnancy and peripartum by comparing two groups of women expecting their first child and attending an ordinary antenatal program; one with low FOC and one with severe FOC. In a prospective case-control cohort study one group with low FOC [Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) sum score ≤60, n = 107] and one with severe FOC (W-DEQ ≥85, n = 43) were followed up till 3 months postpartum and included in the analysis. Medical records were assessed and medical parameters were mapped. Mean costs for healthcare consumption and sick leave during pregnancy were calculated and compared. When means were compared between the groups, the group with severe FOC had more visits for psychosocial reasons (p = 0.001) and more hours on sick leave (p = 0.03) during pregnancy, and stayed longer at the maternity ward (p = 0.04). They also more seldom had normal spontaneous deliveries (p = 0.03), and more often had an elective cesarean section on maternal request (p = 0.02). Postpartum, they more often than the group with low FOC paid visits to the maternity clinic because of complications (p = 0.001) and to the antenatal unit because of adverse childbirth experiences (p = 0.001). The costs for handling women with severe FOC was 38% higher than those for women with low FOC. Women with severe FOC generate considerably higher perinatal costs than women with low FOC when handled in care as usual.

Psychometric Evaluation of the Japanese Wijma Delivery Expectancy/Experience Questionnaire Version B

The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) is a widely accepted approach to measuring fear of childbirth and is available in two versions: antenatal (version A) and postnatal (version B). The aim of this study was to develop the Japanese W-DEQ version B and confirm its validity and reliability among Japanese women. A self-administered questionnaire incorporating the translated Japanese W-DEQ (JW-DEQ) version B and the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS) was distributed to Japanese mothers at two days postpartum. Of the 246 women recruited, 231 who completed the questionnaire at two days postpartum were analyzed. An exploratory factor analysis of the JW-DEQ version B revealed four factors: fear, lack of positive anticipation, isolation and riskiness. The JW-DEQ version B exhibited a positive correlation with the HADS anxiety subscale (r = 0.34, p α value derived from the total 33 items was 0.95. This study provides evidence of the factorial, concurrent validity and the internal consistency of the JW-DEQ version B. However, a further study involving participants from different demographic groups will be required.

Fear of childbirth in urban and rural regions of Turkey: Comparison of two resident populations.

OBJECTIVE:Childbirth is a natural physiological event experienced by many women; however, it is frequently also a source of fear in women. Rates of cesarean sections in Turkey are higher in the urban areas than in the rural areas. We hypothesized that lower fear of childbirth (FOC) rates would be observed in the city having the lowest cesarean section rates in Turkey. This study aimed to compare FOC in women in two resident populations: one in a rural area and the other in an urban area.METHODS:This study was conducted on 253 pregnant women in Istanbul, a large urban municipality, and Siirt, a city in rural Turkey. A descriptive information form and the A version of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) were used.RESULTS:Severe FOC levels were recorded in women in the Istanbul sample; moreover, these levels were higher than those recorded in women in the Siirt sample. In addition, women in the Istanbul sample preferred vaginal birth to cesarean section and had greater FOC, a finding which demonstrates that women prefer vaginal birth even though they have a higher FOC level and live in a city with high cesarean section rates. Where women live (rural versus urban areas) affects their perception of birth and consequently, their FOC levels.CONCLUSION:The results of this study suggest that further cross-cultural and regional research is needed for better understanding FOC and factors associated with elevated FOC levels within each cultural setting.

Childbirth Fear Influence On Delivery Process And The Choice Of Analgesia Method

Labor, as a life event, is characterized by tremendous physiological and psychological changes that require major behavioral adjustments in a short period of time. These changes may negatively impact the state of the pregnant woman and the fetus and may even complicate pregnancy and childbirth. Clinically significant fear of childbirth is estimated to affect 20-25% of pregnant women and the prevalence of pathological fear is thought to be 6-10%. Objective. To examine the influence of fear of childbirth on the process of delivery and the choice of analgesia. Methods. The study composed of two stages was carried. During the first stage of this study 245 lowrisk pregnant women in their 3rd trimester of pregnancy completed A version of The Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and the fear of childbirth was evaluated. During the second stage of the study medical records (including information about the exact time of labor, the beginning of labor, duration of labor, labor progress, mode of delivery, the medicinal pain relief used during delivery) of 189 respondents were examined. Statistical analysis was carried out using SPSS 17.0. Results. Study showed that the majority of respondents (47,8 %) experienced moderate fear, 34,7% respondents suffered from severe fear, 16,3% respondents experienced mild fear, while 1,2% respondents suffered from pathological fear. Severe fear was more common in unemployed, single women and women with lower education. The fear of childbirth intensifies closer to the birth. Statistically significant links between the fear of childbirth and the beginning of spontaneous labor, premature rupture of membranes, induced labor and the use medicinal pain relief have been found. The study could not show an important connection between the mode of delivery and the fear of childbirth. However, respondents who had vacuum delivery were experiencing higher level of fear of childbirth than those respondents who had spontaneous delivery or caesarean section. Conclusions. Pregnant women experience moderate or severe fear of childbirth closer to the birth. Greater fear of childbirth increased the risk of protracted and inducted labor and using medicinal pain relief during the labor. The fear of childbirth is not connected with the mode of delivery.

The Validity and Reliability of Persian Version of Wijma Delivery Expectancy/Experience Questionnaire (Version A) among Iranian Nulliparous Women

&lt;p&gt;Extreme fear of childbirth may interfere with normal process of labor and increase the rate of cesarean section.&lt;strong&gt; &lt;/strong&gt;The aim of this study was to evaluate validity and reliability of a Persian version of Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) among nulliparous women. In this cross-sectional study, 200 nulliparous women of reproductive age were recruited. The original form of the W-DEQ was received from corresponding author (Garthus-Niegel). This questionnaire was translated into Persian language and back-translated to English by three experts in reproductive health and psychiatry who were fluent in Persian and English. Two questionnaires namely the Beck Anxiety Inventory (BAI) and the Depression Anxiety Stress Scale (DASS) were used to check the convergent and divergent validity. Confirmatory factor analysis was used to assess the construct validity, while the Pearson correlation coefficient was used to assess the convergent and divergent validity of the W-DEQ. Reliability was measured using Cronbach’s coefficient alpha. Factor analysis yielded nine factors that explained 70.06% of the total variation. Cronbach’s alpha was 0.64 and the convergent validity with the BAI questionnaire was (r=0.402) and the divergent validity of W-DEQ with the DASS questionnaire was (r=0.349). The Persian W-DEQ has a good validity and reliability for measuring the fear of delivery in Iranian women of reproductive age. Using this questionnaire for nulliparous women is recommended.&lt;/p&gt;