Background: Around 20% of birthing women report high levels of childbirth fear. Fear potentially impacts women’s emotional health, preparation for birth, and birth outcomes. Evidence suggests that personal and extern...Background: Around 20% of birthing women report high levels of childbirth fear. Fear potentially impacts women’s emotional health, preparation for birth, and birth outcomes. Evidence suggests that personal and external factors contribute to childbirth fear, however results vary. Aim: To identify pyscho-social factors associated with childbirth fear and possible antenatal predictors of childbirth fear according to women’s parity. Method: 1410 women in second trimester and attending one of three public hospitals in south-east Queensland were screened for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Other measures included the Edinburgh Depression Scale (EPDS), Decisional Conflict Scale (DCS) and items from the EuroQol (EQ-5D) targeting Anxiety/Depression and Pain/Discomfort. In addition items measuring a previous mental health condition, social support and knowledge were used. Preferred mode of birth was also collected. Psycho-social factors were analysed to determine associations with childbirth fear. Multivariate analysis was used to determine predictors of fear. Results: Thirty-one percent (n = 190/604) of nulliparous and 18% (n = 143/782) of multiparous women reported high fear levels. Having a mental health history, desiring a caesarean section, reporting moderate to high pain during pregnancy, having a non-supportive partner and perceiving less childbirth knowledge than peers, were associated with childbirth fear. Standard multiple regression analyses by parity determined that depression, decisional conflict, low social support and less perceived knowledge predicted levels of childbirth fear. The model explained 32.4% of variance in childbirth fear for nulliparous and 29.4% for multiparous women. Conclusion: Psychosocial factors are significantly associated with childbirth fear. The identification of predictive psychosocial factors for childbirth fear indicates the importance of observing, assessing, and developing support strategies for women. Such strategies are required to decrease anxiety and depression for women during pregnancy, promote normal birth, and build social support to improve women’s feelings and positive expectations of birth.展开更多
BACKGROUND Fear of childbirth(FoC)is a widespread issue that impacts the health and well-being of mothers and newborns.However,there is inconsistency regarding the prevalence of FoC in the and there is limited researc...BACKGROUND Fear of childbirth(FoC)is a widespread issue that impacts the health and well-being of mothers and newborns.However,there is inconsistency regarding the prevalence of FoC in the and there is limited research on the prevalence of FoC among Australian pregnant women.AIM To investigate the prevalence of FoC,its risk factors and birth outcomes in Aust-ralian multiparous women.METHODS In this prospective cohort quantitative study,212 multiparous women were re-cruited from antenatal clinics at Westmead Hospital in western Sydney from 2019 to 2022.Pregnant women who attended antenatal visits and met the inclusion criteria signed the consent forms and completed several online questionnaires at baseline.After they gave birth,their birth outcomes were collected from the hospital’s medical record database.The data were analyzed using SPSS software and descriptive statistics,χ^(2)test,independent samples t-test,and multivariable logistic regression analysis.RESULTS Out of 212 participants,24%experienced a high level of FoC and 7%experienced severe FoC.Theχ^(2)test results revealed that a family income of≤$100000,no alcohol intake during pregnancy,pre-existing health problems,previous caesarean section(emergency or planned),and previous neutral/traumatic childbirth experiences were significantly associated with higher levels of FoC(P<0.05).Other risk factors included being moderately to very worried and fearful about the upcoming birth,having severe to extremely severe anxiety throughout pregnancy,and expressing low relationship satisfaction.According to multivariable logistic regression,the odds of a high level of FoC were higher in women with anxiety,a history of traumatic childbirth experience,a history of sexual assault during childhood,pre-existing health problems,and lower relationship satisfaction(P<0.05).CONCLUSION High-severe levels of FoC are experienced by pregnant multiparous women and are affected by several demo-graphic factors.However,due to the small sample size in the present study,further studies with larger sample sizes are required to draw a firm conclusion on the prevalence of severe FoC among multiparous women and its associated risk factors and birth outcomes.展开更多
The study aimed to determine whether antenatal fear of childbirth (expectation) could predict postnatal fear of childbirth (experience) by taking account of other antenatal psychological variables (anxiety and depress...The study aimed to determine whether antenatal fear of childbirth (expectation) could predict postnatal fear of childbirth (experience) by taking account of other antenatal psychological variables (anxiety and depression) as well as birth outcomes in Japanese women. A longitudinal observational study was conducted at a clinic in Tokyo, Japan, in 2011. Self-report questionnaires were distributed to 240 Japanese women at 37 gestational weeks (Time 1) and on the second day after delivery (Time 2). Regression analyses by means of structural equation modelling were conducted in both the primiparous and the multiparous group. The models exhibited good fit (chisquare value/degree of freedom = 1.10 - 1.62, comparative fit index = 0.92 - 0.99 and root mean square error of approximation = 0.03 - 0.07). Antenatal fear of childbirth was the most predictive variable of postnatal fear of childbirth in both the primiparous (β = 0.58, p = 0.002) and the multiparous group (β = 0.62, p < 0.001). In conclusion, antenatal fear of childbirth was a significant predictor of postnatal fear of childbirth when other antenatal psychological variables and birth outcomes were taken into account. Pregnant women who are strongly afraid of childbirth need special attention before and after delivery.展开更多
Background: To improve negative birth experiences among women who experience intense labor pain during labor, it is important to examine the relationship between fear of childbirth immediately after vaginal delivery a...Background: To improve negative birth experiences among women who experience intense labor pain during labor, it is important to examine the relationship between fear of childbirth immediately after vaginal delivery and the actual intensity of labor pain. However, previous studies have generally evaluated labor pain in a retrospective setting. Purpose: This study examined the relationship between fear of childbirth immediately after vaginal delivery and the actual labor pain intensity and accumulated labor pain intensity without pharmacological pain relief during labor in Japan. Methods: A prospective observational study was conducted between July 2015 and April 2016. Forty-seven pregnant Japanese women were available for analysis. Fear of childbirth was measured by the Japanese version of the Wijma Delivery Expectancy/Experience Questionnaire (JW-DEQ) version B on the third day after vaginal delivery. Participants with scores of 85 or higher were categorized in the high JW-DEQ group, having severe fear of childbirth. Labor pain intensity was examined chronologically in real time with stepwise usage of two types of Numeric Rating Scale (NRS). Accumulated labor pain intensity was calculated using the area under the curve (AUC). Results: Nine participants were in the high JW-DEQ group and eight of the nine were primiparae. Primiparae in the high JW-DEQ group experienced significantly longer duration and larger accumulated labor pain intensity between the onset of labor and 4 to 6 cm of cervical dilatation than those in the low JW-DEQ group (P = 0.024 and P = 0.021, respectively). Conclusions/Implications for Practice: The latent phase of labor was a key stage to improve fear of childbirth immediately after vaginal delivery without pharmacological pain relief among Japanese primiparae. Midwives should give assistance in the latent phase of labor by focusing on progressing labor smoothly and relieving labor pain to improve negative birth experiences.展开更多
文摘Background: Around 20% of birthing women report high levels of childbirth fear. Fear potentially impacts women’s emotional health, preparation for birth, and birth outcomes. Evidence suggests that personal and external factors contribute to childbirth fear, however results vary. Aim: To identify pyscho-social factors associated with childbirth fear and possible antenatal predictors of childbirth fear according to women’s parity. Method: 1410 women in second trimester and attending one of three public hospitals in south-east Queensland were screened for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Other measures included the Edinburgh Depression Scale (EPDS), Decisional Conflict Scale (DCS) and items from the EuroQol (EQ-5D) targeting Anxiety/Depression and Pain/Discomfort. In addition items measuring a previous mental health condition, social support and knowledge were used. Preferred mode of birth was also collected. Psycho-social factors were analysed to determine associations with childbirth fear. Multivariate analysis was used to determine predictors of fear. Results: Thirty-one percent (n = 190/604) of nulliparous and 18% (n = 143/782) of multiparous women reported high fear levels. Having a mental health history, desiring a caesarean section, reporting moderate to high pain during pregnancy, having a non-supportive partner and perceiving less childbirth knowledge than peers, were associated with childbirth fear. Standard multiple regression analyses by parity determined that depression, decisional conflict, low social support and less perceived knowledge predicted levels of childbirth fear. The model explained 32.4% of variance in childbirth fear for nulliparous and 29.4% for multiparous women. Conclusion: Psychosocial factors are significantly associated with childbirth fear. The identification of predictive psychosocial factors for childbirth fear indicates the importance of observing, assessing, and developing support strategies for women. Such strategies are required to decrease anxiety and depression for women during pregnancy, promote normal birth, and build social support to improve women’s feelings and positive expectations of birth.
文摘BACKGROUND Fear of childbirth(FoC)is a widespread issue that impacts the health and well-being of mothers and newborns.However,there is inconsistency regarding the prevalence of FoC in the and there is limited research on the prevalence of FoC among Australian pregnant women.AIM To investigate the prevalence of FoC,its risk factors and birth outcomes in Aust-ralian multiparous women.METHODS In this prospective cohort quantitative study,212 multiparous women were re-cruited from antenatal clinics at Westmead Hospital in western Sydney from 2019 to 2022.Pregnant women who attended antenatal visits and met the inclusion criteria signed the consent forms and completed several online questionnaires at baseline.After they gave birth,their birth outcomes were collected from the hospital’s medical record database.The data were analyzed using SPSS software and descriptive statistics,χ^(2)test,independent samples t-test,and multivariable logistic regression analysis.RESULTS Out of 212 participants,24%experienced a high level of FoC and 7%experienced severe FoC.Theχ^(2)test results revealed that a family income of≤$100000,no alcohol intake during pregnancy,pre-existing health problems,previous caesarean section(emergency or planned),and previous neutral/traumatic childbirth experiences were significantly associated with higher levels of FoC(P<0.05).Other risk factors included being moderately to very worried and fearful about the upcoming birth,having severe to extremely severe anxiety throughout pregnancy,and expressing low relationship satisfaction.According to multivariable logistic regression,the odds of a high level of FoC were higher in women with anxiety,a history of traumatic childbirth experience,a history of sexual assault during childhood,pre-existing health problems,and lower relationship satisfaction(P<0.05).CONCLUSION High-severe levels of FoC are experienced by pregnant multiparous women and are affected by several demo-graphic factors.However,due to the small sample size in the present study,further studies with larger sample sizes are required to draw a firm conclusion on the prevalence of severe FoC among multiparous women and its associated risk factors and birth outcomes.
文摘The study aimed to determine whether antenatal fear of childbirth (expectation) could predict postnatal fear of childbirth (experience) by taking account of other antenatal psychological variables (anxiety and depression) as well as birth outcomes in Japanese women. A longitudinal observational study was conducted at a clinic in Tokyo, Japan, in 2011. Self-report questionnaires were distributed to 240 Japanese women at 37 gestational weeks (Time 1) and on the second day after delivery (Time 2). Regression analyses by means of structural equation modelling were conducted in both the primiparous and the multiparous group. The models exhibited good fit (chisquare value/degree of freedom = 1.10 - 1.62, comparative fit index = 0.92 - 0.99 and root mean square error of approximation = 0.03 - 0.07). Antenatal fear of childbirth was the most predictive variable of postnatal fear of childbirth in both the primiparous (β = 0.58, p = 0.002) and the multiparous group (β = 0.62, p < 0.001). In conclusion, antenatal fear of childbirth was a significant predictor of postnatal fear of childbirth when other antenatal psychological variables and birth outcomes were taken into account. Pregnant women who are strongly afraid of childbirth need special attention before and after delivery.
文摘Background: To improve negative birth experiences among women who experience intense labor pain during labor, it is important to examine the relationship between fear of childbirth immediately after vaginal delivery and the actual intensity of labor pain. However, previous studies have generally evaluated labor pain in a retrospective setting. Purpose: This study examined the relationship between fear of childbirth immediately after vaginal delivery and the actual labor pain intensity and accumulated labor pain intensity without pharmacological pain relief during labor in Japan. Methods: A prospective observational study was conducted between July 2015 and April 2016. Forty-seven pregnant Japanese women were available for analysis. Fear of childbirth was measured by the Japanese version of the Wijma Delivery Expectancy/Experience Questionnaire (JW-DEQ) version B on the third day after vaginal delivery. Participants with scores of 85 or higher were categorized in the high JW-DEQ group, having severe fear of childbirth. Labor pain intensity was examined chronologically in real time with stepwise usage of two types of Numeric Rating Scale (NRS). Accumulated labor pain intensity was calculated using the area under the curve (AUC). Results: Nine participants were in the high JW-DEQ group and eight of the nine were primiparae. Primiparae in the high JW-DEQ group experienced significantly longer duration and larger accumulated labor pain intensity between the onset of labor and 4 to 6 cm of cervical dilatation than those in the low JW-DEQ group (P = 0.024 and P = 0.021, respectively). Conclusions/Implications for Practice: The latent phase of labor was a key stage to improve fear of childbirth immediately after vaginal delivery without pharmacological pain relief among Japanese primiparae. Midwives should give assistance in the latent phase of labor by focusing on progressing labor smoothly and relieving labor pain to improve negative birth experiences.
