Fear of natural childbirth and its related factors among primigravid women: a mixed-methods study

Fear of natural childbirth is a common problem among pregnant women. The present study was performed with aim to explain fear of natural childbirth and its related factors among primigravid women.

This sequential-explanatory mixed-methods study with participant selection type was conducted in 2014-2015. At quantitative phase, using a multistage cluster sampling method, 400 primigravid women with 18-32 gestation weeks were selected. To collected data, Childbirth Attitude Questionnaire, demographic characteristics, and Northouse Social Support Questionnaire were used. Data analysis was performed using Chi-square, t-test, Mann-Whitney test, and multivariate logistic regression. At qualitative phase, semi-structured individual interviews using open-ended questions was performed on 15 primigravid women who were selected using purposive sampling method. The data were analyzed using conventional content analysis method.

Mean score of fear of natural childbirth was 37.86±9.44 and its prevalence (CAQ≥28) was 80.8%. According to the results of multivariate logistic regression analysis, a significant relationship was found between lack of sufficient income (p=0.020), not participating in childbirth preparation classes (p=0.040) and selection of delivery method (vaginal delivery) (p<0.001) with fear of childbirth. Analysis of data at the qualitative stage led to three themes including feeling of inability for natural childbirth, confusion in decision making and concerns about natural childbirth complications.

Fear of childbirth was influenced by personal, social and cultural factors. Therefore, it is suggested that health service providers use the results of this study to implement educational programs in order to encourage natural childbirth.