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Ibrahim HA, Alshahrani MS, Elgzar WTI. Determinants of Prenatal Childbirth Fear during the Third Trimester among Low-Risk Expectant Mothers: A Cross-Sectional Study. Healthcare (Basel) 2023; 12:50. [PMID: 38200956 PMCID: PMC10778686 DOI: 10.3390/healthcare12010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/14/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Fear of Childbirth (FOC) can significantly impact women's physical and psychological health; therefore, healthcare providers must provide proactive care, which means they have to intervene before FOC becomes tokophobia. This study's purpose is to evaluate the determinants of prenatal childbirth fear during the third trimester among low-risk expectant mothers. METHODS A cross-sectional comparative study was conducted at the Maternal and Children Hospital's outpatient clinics in Najran City, Saudi Arabia, from April to July 2023. The study involved 377 nulliparous and multiparous women, using a systemic random sampling technique. The data were collected using an interview schedule composed of questions related to demographic and obstetrics characteristics, the FOC questionnaire, and a multidimensional scale of perceived social support. Significant FOC predictors were examined using a binary logistic regression model. RESULTS There was a statistically significant difference between nulliparous and multiparous participants concerning FOC; 80.0% of nulliparous participants had significant FOC compared to 67.8% of multiparous participants (p = 0.011). A binary logistic regression clarified that regular antenatal care and family and spousal support were significantly negatively correlated with significant FOC among multiparous and nulliparous women (p < 0.05). For multiparas, FOC was associated with pregnancy planning and previous labor-related complications. In addition, friends' support was an important predictor of significantly lower FOC among nulliparous women (p < 0.05). CONCLUSIONS Significant FOC was higher in nulliparous women when compared to multiparous women. Numerous obstetric variables and different types of social support play important roles in significant FOC. Special attention and support should be provided to high-risk women for proper FOC management during prenatal classes to improve their childbirth experiences.
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Affiliation(s)
- Heba A. Ibrahim
- Nursing College, Najran University, Najran 66261, Saudi Arabia
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Clemons JH, Payne D, Garrett N, Couper JM, Farrya A, Swift EM, Stoll K. Gaining insight from future mothers: A survey of attitudes and perspectives of childbirth. Midwifery 2022. [DOI: 10.1016/j.midw.2022.103499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/02/2022] [Accepted: 09/25/2022] [Indexed: 11/24/2022]
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Ataman H, Dişsiz M. Premenstrual Syndrome and Childbirth Fear Prior to Pregnancy in Young Women: An Association and Cross-Sectional Study. Rev Assoc Med Bras (1992) 2022; 68:898-903. [PMID: 35946765 DOI: 10.1590/1806-9282.20211211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of the study was to determine the association between premenstrual syndrome and the childbirth fear prior to pregnancy. METHODS This was an association and cross-sectional study conducted on 327 university students. Data were collected using "Participant Information Form," "Premenstrual Syndrome Scale," and "Childbirth Fear-Prior to Pregnancy Scale." RESULTS It was found that the childbirth fear had increased in students with premenstrual syndrome. The Women Childbirth Fear-Prior to Pregnancy Scale score was statistically significantly higher among students who preferred caesarean section than those who preferred vaginal delivery. There was a weak, positive, and statistically significant correlation between the students' depressive sensation, anxiety, fatigue, nervousness, depressive thoughts, pain, appetite changes, sleep pattern changes, and bloating subscales of Premenstrual Syndrome Scale and Women Childbirth Fear-Prior to Pregnancy Scale. CONCLUSION The score of the Women Childbirth Fear-Prior to Pregnancy Scale increases with an increase in the score of the Premenstrual Syndrome subscale. It should be evaluated whether or not women experiencing premenstrual syndrome have the childbirth fear prior to pregnancy.
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Affiliation(s)
- Hacer Ataman
- Istanbul Medeniyet University, Faculty of Health Sciences - Istanbul, Turkey
| | - Melike Dişsiz
- University of Health Sciences, Hamidiye Faculty of Nursing - Istanbul, Turkey
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Rublein L, Muschalla B. Childbirth fear, birth-related mindset and knowledge in non-pregnant women without birth experience. BMC Pregnancy Childbirth 2022; 22:249. [PMID: 35331176 DOI: 10.1186/s12884-022-04582-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 03/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background Childbirth fear and interventions during childbirth might be related to the mindset and knowledge non-pregnant women have regarding childbirth. Non-pregnant women before their first birth experience may be particularly at risk for childbirth fear. Methods The present study examined the expressions and associations of birth-related mindset, knowledge, and fear among 316 young, non-pregnant women without birth experience. They participated in a cross-sectional online study and completed the Childbirth Fear Prior to Pregnancy, the Mindset and Birth Questionnaire, and a birth knowledge test. Results Most women (44%) had a natural mindset and low fear, 29% had a medical mindset and low fear, 8% natural mindset and higher fear, and 19% medical mindset and higher fear. There were no differences in knowledge between the four groups. Some gaps in knowledge appeared concerning signs of beginning birth, and non-medical approaches to pain relief. From women with natural mindset and low childbirth fear, a higher percentage (13%) has already watched a birth, as compared to the other groups. Natural mindset was associated with lower childbirth fear, whereas knowledge was independent from childbirth fear. Higher knowledge was low associated with natural mindset. Mindset and childbirth fear were independent from age and education degree. Conclusions Gynecologists, midwifes and other health professionals may develop an awareness for birth as a natural event in their non-pregnant patients, and take birth-related fear into account in their counseling, with focus on women’s self-efficacy and non-medical approaches to pain relief.
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Rousseau S, Polachek IS, Frenkel TI. A machine learning approach to identifying pregnant women's risk for persistent post-traumatic stress following childbirth. J Affect Disord 2022; 296:136-149. [PMID: 34601301 DOI: 10.1016/j.jad.2021.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/11/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
INTRO Recent literature identifies childbirth as a potentially traumatic event, following which mothers may develop symptoms of Post-Traumatic-Stress-Following-Childbirth (PTS-FC). Especially when persistent, PTS-FC may interfere with mothers' caregiving and associated infant development, underscoring the need for accurate predictive screening of risk. Drawing on recent developments in advanced statistical modeling, the aim of the current study was to identify a set of prenatal indicators and prediction rules that may accurately identify pregnant women's risk for developing symptoms of PTS-FC which persist throughout the early postpartum period. METHODS 182 women from the general population completed a comprehensive set of approximately 200 potentially predictive questions during pregnancy, and subsequently reported on their acute stress and PTS-FC at three days, one month, and three months postpartum (self-report and clinician-administered interview). Based on the postpartum acute stress and PTS-FC data, women were classified into profiles of "Stable-High-PTS-FC" and "Stable-Low-PTS-FC" by means of Latent-Class Analyses. Prenatal data were modeled to identify women at risk for "Stable-High PTS-FC". RESULTS Employing machine-learning decision-tree analyses, a total of 36 questions and 7 prediction-rules were selected. Based on a cost-rate of 15 versus 100 for false-negative "Stable-Low-PTS-FC" versus false-negative "Stable-High-PTS-FC", the final model showed 80.6% accuracy for "Stable-High-PTS-FC" prediction. DISCUSSION This study identifies a short set of questions and prediction rules that may be included in future large-scale validation studies aimed at developing and validating a brief PTS-FC screening instrument that could be implemented in general population prenatal healthcare practice. Accurate screening would allow for selective administering of preventive interventions towards women at risk.
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Affiliation(s)
- Sofie Rousseau
- Ziama Arkin Infancy Institute, Interdisciplinary Center (IDC) Herzliya, Hanadiv 71, 1st floor, Herzliya 46485, Israel; Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, HaUniversity 8, Herzliya 4610101, Israel
| | - Inbal Shlomi Polachek
- Be'er Ya'akov Medical Center, Israel; Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel
| | - Tahl I Frenkel
- Ziama Arkin Infancy Institute, Interdisciplinary Center (IDC) Herzliya, Hanadiv 71, 1st floor, Herzliya 46485, Israel; Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, HaUniversity 8, Herzliya 4610101, Israel.
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Nguyen LD, Nguyen LH, Ninh LT, Nguyen HTT, Nguyen AD, Vu LG, Nguyen CT, Vu GT, Doan LP, Latkin CA, Ho CSH, Ho RCM. Fear of Childbirth and Preferences for Prevention Services among Urban Pregnant Women in a Developing Country: A Multicenter, Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:5382. [PMID: 34070085 PMCID: PMC8158107 DOI: 10.3390/ijerph18105382] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 12/28/2022]
Abstract
This study aimed to examine fear of childbirth and willingness to pay for fear-prevention services in pregnant women. A multicenter, cross-sectional study was conducted on pregnant women in two obstetric hospitals in Vietnam. The Fear of Birth Scale was utilized to evaluate fear of childbirth. Multivariable, generalized linear regression and logistic regression models were performed to identify associated factors with fear of childbirth, demand, and willingness to pay for prevention services. Of 900 pregnant women, fear of childbirth was moderately high with a mean score of 18.1 (SD = 2.3). Age of partner; ever having complications of pregnancy; attitudes toward different aspects of childbirth delivery; satisfactions with friends, parents, and siblings' care; and information support were associated with fear of childbirth. Only 33.8% participants had a demand for the prevention service, and 43.7% were willing to pay for this service with an average amount of $US 10.0 per month (SD = 72.0). Our study suggested that individualized psychological counseling and information-seeking guidance should be provided appropriately and differently for multiparous and nulliparous women for reducing fear and improving the acceptability of the prevention services.
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Affiliation(s)
- Lam Duc Nguyen
- Department of Anaesthesiology, Hanoi Medical University, Hanoi 100000, Vietnam;
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden;
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau 98000, Vietnam;
| | - Ha Thu Thi Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi 100000, Vietnam; (H.T.T.N.); (A.D.N.)
| | - Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi 100000, Vietnam; (H.T.T.N.); (A.D.N.)
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (C.T.N.); (L.P.D.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (C.T.N.); (L.P.D.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam;
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (C.T.N.); (L.P.D.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; (C.S.H.H.); (R.C.M.H.)
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; (C.S.H.H.); (R.C.M.H.)
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
- Institute of Health Economics and Technology, Hanoi 100000, Vietnam
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Moore MF. Birth Observation Among African American Women Prior to Pregnancy. J Perinat Educ 2020; 29:181-187. [PMID: 33223791 PMCID: PMC7662164 DOI: 10.1891/j-pe-d-19-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A focused ethnography among African American college students who had observed a live birth prior to their own pregnancy was pursued. Women described two reasons to attend births: curiosity about birth, or a desire to support the birth mother. Women attended the births of friends, family members, or saw their mother give birth to a younger sibling. Themes included pain, operative or traumatic birth, and surprise at the length and/or stages of labor. Some language suggested lingering trauma. Future expectations included painful labor, operative birth or damage, or traumatic labor and birth. Other women felt closer to the infant, or felt more prepared for their own births after observing birth. Prior personal experiences at birth should be explored prenatally.
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Stoll KH, Downe S, Edmonds J, Gross MM, Malott A, McAra-Couper J, Sadler M, Thomson G. A Survey of University Students' Preferences for Midwifery Care and Community Birth Options in 8 High-Income Countries. J Midwifery Womens Health 2020; 65:131-141. [PMID: 31957228 DOI: 10.1111/jmwh.13069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 08/20/2019] [Accepted: 08/26/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Midwifery care is associated with positive birth outcomes, access to community birth options, and judicious use of interventions. The aim of this study was to characterize and compare maternity care preferences of university students across a range of maternity care systems and to explore whether preferences align with evidence-based recommendations and options available. METHODS A cross-sectional, web-based survey was completed in 2014 and 2015 by a convenience sample of university students in 8 high-income countries across 4 continents (N = 4569). In addition to describing preferences for midwifery care and community birth options across countries, this study examined sociodemographic characteristics, psychological factors, knowledge about pregnancy and birth, and sources of information that shaped students' attitudes toward birth in relation to preferences for midwifery care and community birth options. RESULTS Approximately half of the student respondents (48.2%) preferred midwifery-led care for a healthy pregnancy; 9.5% would choose to give birth in a birthing center, and 4.5% preferred a home birth. Preference for midwifery care varied from 10.3% among women in the United States to 78.6% among women in the United Kingdom. Preferences for home birth varied from 0.3% among US women to 18.3% among Canadian women. Women, health science students, those with low childbirth fear, those who learned about pregnancy and birth from friends (compared with other sources, eg, the media), and those who responded from Europe were significantly more likely to prefer midwifery care and community birth. High confidence in knowledge of pregnancy and birth was linked to significantly higher odds of community birth preferences and midwifery care preferences. DISCUSSION It would be beneficial to integrate childbirth education into high school curricula to promote knowledge of midwifery care, pregnancy, and childbirth and to reduce fear among prospective parents. Community birth options need to be expanded to meet demand among the next generation of maternity service users.
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Affiliation(s)
- Kathrin H Stoll
- Division of Midwifery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Soo Downe
- School of Community Health and Midwifery, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Joyce Edmonds
- Connell School of Nursing, Boston College, Boston, Massachusetts
| | - Mechthild M Gross
- Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany
| | - Anne Malott
- Midwifery Education Program, McMaster University, Hamilton, Ontario, Canada
| | - Judith McAra-Couper
- Centre for Midwifery & Women's Health Research, Faculty of Health & Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Michelle Sadler
- Department of History and Social Sciences, Faculty of Liberal Arts, Universidad Adolfo Ibáñez, Santiago, Chile
| | - Gill Thomson
- School of Community Health and Midwifery, University of Central Lancashire, Preston, Lancashire, United Kingdom
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- International Childbirth Attitudes-Prior to Pregnancy (ICAPP) Study Team (see list of names in Acknowledgments)
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Vitek K, Ward LM. Risky, Dramatic, and Unrealistic: Reality Television Portrayals of Pregnancy and Childbirth and their Effects on Women's Fear and Self-Efficacy. Health Commun 2019; 34:1289-1295. [PMID: 29869897 DOI: 10.1080/10410236.2018.1481708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Because portrayals of pregnancy and childbirth on reality television (TV) often highlight risk, drama, and the use of medical interventions, it is possible that exposure to this content could influence women's fear of childbirth and childbirth self-efficacy. To test this question, we conducted an experiment among 213 undergraduate women who were assigned to view a video clip of either medicalized births from reality TV, midwife-attended births from reality TV, or a neutral childbirth education clip. Findings indicated that childbirth attitudes did vary across conditions, with participants in the medicalized condition reporting the highest fear of childbirth and lowest childbirth self-efficacy. Participants' feelings about potential pregnancy also varied depending on the clip viewed. Because the likelihood of witnessing a birth in person before becoming pregnant is lower than in previous years, these findings have significant implications for how women form their understandings of pregnancy and childbirth.
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Affiliation(s)
- Kali Vitek
- Department of Psychology, University of Michigan
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Namujju J, Muhindo R, Mselle LT, Waiswa P, Nankumbi J, Muwanguzi P. Childbirth experiences and their derived meaning: a qualitative study among postnatal mothers in Mbale regional referral hospital, Uganda. Reprod Health 2018; 15:183. [PMID: 30390685 PMCID: PMC6215682 DOI: 10.1186/s12978-018-0628-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/15/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Evidence shows that negative childbirth experiences may lead to undesirable effects including failure to breastfeed, reduced love for the baby, emotional upsets, post-traumatic disorders and depression among mothers. Understanding childbirth experiences and their meaning could be important in planning individualized care for mothers. The purpose of this study was to explore childbirth experiences and their meaning among postnatal mothers. METHODS A phenomenological qualitative study was conducted at Mbale Regional Referral Hospital among 25 postnatal mothers within two months after birth using semi-structured interviews and focus group discussions and data was thematically analyzed. RESULTS The severity, duration and patterns of labour pains were a major concern by almost all women. Women had divergent feelings of yes and no need of biomedical pain relief administration during childbirth. Mothers were socially orientated to regard labour pains as a normal phenomenon regardless of their nature. The health providers' attitudes, care and support gave positive and negative birth experiences. The Physical and psychosocial support provided comfort, consolation and encouragement to the mothers while inappropriate care, poor communication and compromised privacy contributed to the mothers' negative childbirth experiences. The type of birth affected the interpretations of the birth experiences. Women who gave birth vaginally, thought they were strong and brave, determined and self-confident; and were respected by members of their communities. On the contrary, the women who gave birth by operation were culturally considered bewitched, weak and failures. CONCLUSION Childbirth experiences were unique; elicited unique feelings, responses and challenges to individual mothers. The findings may be useful in designing interventions that focus on individualized care to meet individual needs and expectations of mothers during childbirth.
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Affiliation(s)
- Josephine Namujju
- Department of Nursing, Makerere University, College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Richard Muhindo
- Department of Nursing, Makerere University, College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Lilian T. Mselle
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Nursing and Midwifery Services Muhimbili Academic Medical Centre, P.O. Box 65427, Dar es Salaam, Tanzania
| | - Peter Waiswa
- Department of Health, Policy, Planning and Management, Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda
- Global Health Division Karolinska Institutet, Sweden and Leader Makerere University Maternal and Newborn Centre of Excellence and the INDEPTH Network Maternal and Newborn Health Research, Stockholm, Sweden
| | - Joyce Nankumbi
- Department of Nursing, Makerere University, College of Health Sciences, P.O Box 7072, Kampala, Uganda
| | - Patience Muwanguzi
- Department of Nursing, Makerere University, College of Health Sciences, P.O Box 7072, Kampala, Uganda
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Hildingsson I, Rubertsson C, Karlström A, Haines H. Exploring the Fear of Birth Scale in a mixed population of women of childbearing age—A Swedish pilot study. Women Birth 2018; 31:407-413. [DOI: 10.1016/j.wombi.2017.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 11/23/2017] [Accepted: 12/04/2017] [Indexed: 01/24/2023]
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Stoll K, Edmonds J, Sadler M, Thomson G, McAra-Couper J, Swift EM, Malott A, Streffing J, Gross MM, Downe S. A cross-country survey of attitudes toward childbirth technologies and interventions among university students. Women Birth 2018; 32:231-239. [PMID: 30150150 DOI: 10.1016/j.wombi.2018.07.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
Abstract
PROBLEM & AIM Cultural beliefs that equate birth technology with progress, safety and convenience contribute to widespread acceptance of childbirth technology and interventions. Little is known about attitudes towards childbirth technology and interventions among the next generation of maternity care users and whether attitudes vary by country, age, gender, childbirth fear, and other factors. METHODS Data were collected via online survey in eight countries. Students who had never had children, and who planned to have at least one child were eligible to participate. FINDINGS The majority of participants (n=4569) were women (79.3%), and the median age was 22 years. More than half of students agreed that birth technology makes birth easier (55.8%), protects babies from harm (49.1%) and that women have a right to choose a medically non-indicated cesarean (50.8%). Respondents who had greater acceptance of childbirth technology and interventions were from countries with higher national caesarean birth rates, reported higher levels of childbirth fear, and were more likely to report that visual media or school-based education shaped their attitudes toward birth. Positive attitudes toward childbirth technology and interventions were also associated with less confidence in knowledge of birth, and more common among younger and male respondents. DISCUSSION/CONCLUSION Educational strategies to teach university students about pregnancy and birth in ways that does not frighten them and promotes critical reflection about childbirth technology are needed. This is especially true in countries with high rates of interventions that reciprocally shape culture norms, attitudes, and expectations.
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Affiliation(s)
- Kathrin Stoll
- Birth Place Lab, University of British Columbia, BC Women's Hospital Shaughnessy Building E418 4500 Oak Street, Vancouver, BC V6H 3N1, Canada.
| | - Joyce Edmonds
- Connell School of Nursing, Boston College, Maloney Hall, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA.
| | - Michelle Sadler
- Department of History and Social Sciences, Faculty of Liberal Arts, Adolfo Ibáñez University, Diagonal Las Torres 2640, Peñalolén, Santiago, Chile.
| | - Gill Thomson
- School of Community Health and Midwifery, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
| | - Judith McAra-Couper
- Centre for Midwifery & Women's Health Research, Faculty of Health & Environmental Sciences, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
| | - Emma M Swift
- Department of Midwifery, Faculty of Nursing-University of Iceland, Iceland.
| | - Anne Malott
- Midwifery Education Program, McMaster University, 1280 Main St. West, MDCL 2nd Floor, Hamilton, Ontario, Canada.
| | - Joana Streffing
- Midwifery Research and Education Unit, Hannover Medical School Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Mechthild M Gross
- Midwifery Research and Education Unit, Hannover Medical School Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Soo Downe
- School of Community Health and Midwifery, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
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13
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Neerland CE. Maternal Confidence for Physiologic Childbirth: A Concept Analysis. J Midwifery Womens Health 2018; 63:425-435. [DOI: 10.1111/jmwh.12719] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 11/30/2022]
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Cappell J, Pukall CF. Perceptions of the effects of childbirth on sexuality among nulliparous individuals. Birth 2018; 45:55-63. [PMID: 29164677 DOI: 10.1111/birt.12321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/12/2017] [Accepted: 10/12/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Media representations of sexuality after childbirth depict vaginal birth as harmful and cesarean delivery as protective, although research does not support these depictions. The objective of the current study was to investigate perceptions of the effects of mode of delivery on sexuality. METHODS Nulliparous participants who were able to and interested in giving birth (N = 1428) completed an online survey about their preferences for mode of delivery and their perceptions of childbirth as they specifically relate to sexuality. Participants provided demographic information, rated how influential different sources of information about childbirth were, and completed the Attitudes Toward Women's Genitals Scale. RESULTS Up to half (16-48%), the participants agreed with different statements about vaginal birth as harmful to, and cesarean delivery as protective of, future sexuality. Participant characteristics that were independently predictive of endorsing these beliefs were: self-identifying as heterosexual, holding negative attitudes toward women's genitals, and reporting that reality media, nonreality media, and online media sources are influential sources of childbirth information. Participants who rated health care professionals as an influential source of information were less likely to endorse these beliefs. CONCLUSION Given that there is no clear evidence in the empirical literature to support the claim that vaginal births are harmful and cesarean delivery is protective to one's future sexual life, it is important to dispel the existing misconceptions. Various media sources likely play a role in the perpetuation of this misinformation.
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Affiliation(s)
- Jaclyn Cappell
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Caroline F Pukall
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
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15
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Abstract
Learning about potential threats is critical for survival. Learned fear responses are acquired either through direct experiences or indirectly through social transmission. Social fear learning (SFL), also known as vicarious fear learning, is a paradigm successfully used for studying the transmission of threat information between individuals. Animal and human studies have begun to elucidate the behavioral, neural and molecular mechanisms of SFL. Recent research suggests that social learning mechanisms underlie a wide range of adaptive and maladaptive phenomena, from supporting flexible avoidance in dynamic environments to intergenerational transmission of trauma and anxiety disorders. This review discusses recent advances in SFL studies and their implications for basic, social and clinical sciences.
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Affiliation(s)
- Jacek Debiec
- Molecular & Behavioral Neuroscience Institute and Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Andreas Olsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
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16
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Abstract
BACKGROUND Sociocultural childbirth representations can influence the perceptions of childbirth negatively. In this paper we report on a survey study to explore the factors associated with negative impressions of childbirth in a North-West England University student sample. We also explored whether different sources and perceptions of childbirth information were linked to fear of childbirth. METHODS All students received a survey link via an online messaging board and/or direct e-mail. Female students who were 18-40 years of age and childless (but planned to have children in the future) were invited to participate. Demographics, birth preferences, a fear of birth and general anxiety measures were included as well as questions about what sources of information shaped students' attitudes toward pregnancy and birth (i.e. visual/written media, experiences of friends/family members, school-based education and other) and impressions of birth from these sources (i.e. positive, negative, both positive and negative and not applicable). RESULTS Eligible students (n = 276) completed the online questionnaire. The majority were Caucasian (87%) with a mean age of 22.6 years. Ninety-two students (33.3%) reported negative childbirth impressions through direct or vicarious sources. Students with negative birth impressions were significantly more likely to report higher fear of birth scores. Negatively perceived birth stories of friends/family members, and mixed perceptions of visual media representations of birth were associated with higher fear of birth scores. Having witnessed a birth first-hand and describing the experience as amazing was linked to lower fear scores. CONCLUSION First-hand observations of birth, especially positive experiences, had implications for salutary outcomes. Negative or conflicting perceptions of vicarious experiences were associated with increased levels of childbirth fear. While further research is needed, these insights suggest a need for positive birth stories and messages to be disseminated to mitigate any negative effects of indirect accounts.
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Affiliation(s)
- Gill Thomson
- a Maternal and Infant Nutrition and Nurture Unit (MAINN) , University of Central Lancashire , Preston , Lancashire , England
| | - Kathrin Stoll
- b Faculty of Medicine , School of Population and Public Health, University of British Columbia , Vancouver , BC , Canada
| | - Soo Downe
- c Research in Childbirth and Health Unit (ReaCH) , University of Central Lancashire , Preston , Lancashire , England
| | - Wendy A Hall
- d School of Nursing , University of British Columbia , Vancouver , BC , Canada
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17
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Swift EM, Gottfredsdottir H, Zoega H, Gross MM, Stoll K. Opting for natural birth: A survey of birth intentions among young Icelandic women. Sexual & Reproductive Healthcare 2017; 11:41-46. [DOI: 10.1016/j.srhc.2016.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 09/09/2016] [Accepted: 09/14/2016] [Indexed: 10/21/2022]
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18
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Abstract
The objective of this narrative review was to examine the literature on fear of childbirth from a psychological perspective, addressing the specificity of childbirth fear, the pathways of fear acquisition, and the physiological, cognitive and behavioral aspects of fear. Systematic procedures for literature search, inclusion and exclusion left 86 original research papers for analysis. Findings summarize the body of knowledge for each area of interest, as well as the number of studies addressing each theme. Overall, few studies adopt a clear-cut psychological perspective, leaving the psychological mechanisms of childbirth fear largely unexplored. Although methodological limitations make conclusions difficult, results give a hint of etiological diversity and possible psychological mechanisms commonly described as transdiagnostic features in anxiety. Systematic investigations of psychological mechanisms, longitudinal studies exploring possible vicious circles of fear, and studies comparing psychological characteristics within the group of women fearing childbirth are identified as research areas of high priority.
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Affiliation(s)
- Elisabet Rondung
- Department of Psychology, Mid Sweden University, 831 40 Östersund, Sweden.
| | - Johanna Thomtén
- Department of Psychology, Mid Sweden University, 831 40 Östersund, Sweden.
| | - Örjan Sundin
- Department of Psychology, Mid Sweden University, 831 40 Östersund, Sweden.
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19
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Stoll K, Hauck Y, Downe S, Edmonds J, Gross MM, Malott A, McNiven P, Swift E, Thomson G, Hall WA. Cross-cultural development and psychometric evaluation of a measure to assess fear of childbirth prior to pregnancy. Sexual & Reproductive Healthcare 2016; 8:49-54. [DOI: 10.1016/j.srhc.2016.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 02/13/2016] [Accepted: 02/15/2016] [Indexed: 01/04/2023]
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20
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Hauck YL, Stoll KH, Hall WA, Downie J. Association between childbirth attitudes and fear on birth preferences of a future generation of Australian parents. Women Birth 2016; 29:511-517. [PMID: 27233945 DOI: 10.1016/j.wombi.2016.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Revised: 04/20/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The reality of childbirth fear is recognised for expectant parents but we lack knowledge about the childbirth attitudes of the next generation of Australian parents. AIM Examination of adults' attitudes toward childbirth including influencing contributing factors, fear scores, birth preferences and reasons for this preference. METHODS A cross-sectional online study was conducted with 654 Western Australian students attending one tertiary institution. Students (male and female) were eligible to participate if they were less than 40 years of age and did not currently have children but confirmed their intention to become parents. To assess associations or comparison of means, bi-variable analyses (Chi square test, Fisher's Exact test, Independent Student's t-test or one way ANOVA) were used. Factors associated with childbirth fear and birth preferences were assessed with binary logistic regression analysis. FINDINGS Childbirth attitudes were shaped by family members' (82.0%) and friends' experiences (64.4%) plus media (TV, YouTube, and movies) (63.5%). Furthermore, 15.6% of adults indicated a preference for a caesarean birth, even without obstetric complications. Likewise, 26.1% reported elevated fear; students with elevated fear scores had 2.6 times greater odds of wanting a caesarean birth. Only 23.4% of students felt confident about their childbirth knowledge. CONCLUSION Adults reported fear levels that warrant attention prior to a future pregnancy. Although the majority would choose a vaginal birth, they require awareness of benefits and risks for both vaginal and caesarean births to ensure their decisions reflect informed choice rather than influences of inadequate knowledge or fear.
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Affiliation(s)
- Yvonne L Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA 6845 Australia; Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Bagot Rd, Subiaco, WA 6008, Australia.
| | - Kathrin H Stoll
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, East Mall, Vancouver, BC V6T-1Z3, Canada.
| | - Wendy A Hall
- School of Nursing, University of British Columbia, Westbrook Mall, Vancouver, BC V6T 2B5, Canada.
| | - Jill Downie
- Office of the Deputy Vice-Chancellor, Academic, Curtin University, Perth, WA 6845, Australia.
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21
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Luce A, Cash M, Hundley V, Cheyne H, van Teijlingen E, Angell C. "Is it realistic?" the portrayal of pregnancy and childbirth in the media. BMC Pregnancy Childbirth 2016; 16:40. [PMID: 26928660 PMCID: PMC4770672 DOI: 10.1186/s12884-016-0827-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 02/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Considerable debate surrounds the influence media have on first-time pregnant women. Much of the academic literature discusses the influence of (reality) television, which often portrays birth as risky, dramatic and painful and there is evidence that this has a negative effect on childbirth in society, through the increasing anticipation of negative outcomes. It is suggested that women seek out such programmes to help understand what could happen during the birth because there is a cultural void. However the impact that has on normal birth has not been explored. METHODS A scoping review relating to the representation of childbirth in the mass media, particularly on television. RESULTS Three key themes emerged: (a) medicalisation of childbirth; (b) women using media to learn about childbirth; and (c) birth as a missing everyday life event. CONCLUSION Media appear to influence how women engage with childbirth. The dramatic television portrayal of birth may perpetuate the medicalisation of childbirth, and last, but not least, portrayals of normal birth are often missing in the popular media. Hence midwives need to engage with television producers to improve the representation of midwifery and maternity in the media.
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Affiliation(s)
- Ann Luce
- Faculty of Media & Communication, Bournemouth University, Weymouth House W333, Talbot Campus, Poole, BH12 5BB, England, UK
| | - Marilyn Cash
- Health & Wellbeing Community, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Vanora Hundley
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Helen Cheyne
- NMAHP Research Unit, School of Health Science, University of Stirling, Stirling, Scotland, UK
| | - Edwin van Teijlingen
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK.
| | - Catherine Angell
- Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
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22
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Stoll K, Edmonds JK, Hall WA. Fear of Childbirth and Preference for Cesarean Delivery Among Young American Women Before Childbirth: A Survey Study. Birth 2015; 42:270-6. [PMID: 26104997 DOI: 10.1111/birt.12178] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/22/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fear of birth and mode of delivery preferences are similar among pregnant and nonpregnant women, suggesting that attitudes toward birth are formed in young adulthood or earlier. Understanding why some young women fear birth and prefer obstetric interventions can inform public health initiatives aimed at reducing fear and promoting birth as a normal life event. METHODS We conducted an online survey with 752 American nulliparous young women to assess their preferences and attitudes toward childbirth. We identified explanatory variables associated with reported fear of childbirth and cesarean delivery (CD) preferences. RESULTS A preference for CD was reported by 14 percent of young women and 27 percent had scores indicating elevated fear of birth. Fear of birth increased the likelihood of cesarean preference (adjusted relative risk (ARR) 3.84 [95% CI 2.49-5.95]) as did a family history of CD (ARR 1.65 [95% CI 1.13-2.42]). The likelihood of reporting elevated childbirth fear was increased among young women who reported concerns about the physical changes pregnancy and birth have on women's bodies (ARR 2.04 [95% CI 1.50-2.78]). Young women who reported a high degree of confidence in their knowledge about childbirth were significantly less likely to report childbirth fear (ARR 0.61 [95% CI 0.42-0.87]). Access to childbirth information was also associated with a decreased likelihood of fear of birth (ARR 0.75 [95% CI 0.59-0.95]). CONCLUSIONS Young women reporting high levels of childbirth fear are nearly four times more likely to prefer a CD. Specific fears, such as worries over the influence of pregnancy and birth on the female body, need to be addressed before pregnancy.
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Affiliation(s)
- Kathrin Stoll
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Wendy A Hall
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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Stoll K, Hall W, Janssen P, Carty E. Why are young Canadians afraid of birth? A survey study of childbirth fear and birth preferences among Canadian University students. Midwifery 2013; 30:220-6. [PMID: 23968778 DOI: 10.1016/j.midw.2013.07.017] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/09/2013] [Accepted: 07/15/2013] [Indexed: 12/19/2022]
Abstract
OBJECTIVE to examine attitudes towards birth that may be common among young adults who have been socialised into a medicalised birth culture. Specifically, we were interested in examining factors that might be associated with fear of birth and preferences for elective obstetric interventions among the next generation of maternity care consumers. DESIGN secondary analysis of an online survey of university students. SETTING British Columbia, Canada. PARTICIPANTS students from the University of British Columbia (n=3680). A quarter of the sample comprised Asian students, which allowed for analysis of cultural differences in attitudes towards birth. Both male and female students participated in the study; results are reported for the full sample, and by gender. MEASUREMENTS a six item fear of childbirth scale was developed, as well as a 4 item index that measures students' concerns over physical changes following pregnancy and birth and a 2 item scale that assesses students' attitudes towards obstetric technology. FINDINGS as we hypothesised, students who were more fearful of birth preferred epidural anaesthesia and birth by CS. Worries over physical changes following pregnancy and birth, favourable attitudes towards obstetric technology, and exposure to pregnancy and birth information via the media were also significantly associated with a preference for CS. Fear of birth scores were highest among students who reported that the media had shaped their attitudes towards pregnancy and birth. Asian students had significantly higher fear of birth scores and were more likely to prefer CS, compared to Caucasian students. IMPLICATIONS FOR PRACTICE young adults are contemplating pregnancy and birth in an increasingly technology-dependent society. Educational programmes aimed at reducing fear of childbirth and concerns over physical changes following pregnancy and childbirth might contribute to vaginal birth intentions among young adults. Midwives may use the findings to identify and counsel nulliparas who exhibit fear of birth and other childbirth attitudes that may predispose them to choose elective obstetric interventions.
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Affiliation(s)
- Kathrin Stoll
- Division of Midwifery, University of British Columbia, B54-2194 Health Sciences Mall, Vancouver, British Columbia, Canada V6T 1Z3.
| | - Wendy Hall
- School of Nursing, University of British Columbia, T201 2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5.
| | - Patricia Janssen
- School of Population & Public Health, University of British Columbia, Rm 103, 2206 East Mall, Vancouver, British Columbia, Canada V6T 1Z3.
| | - Elaine Carty
- Division of Midwifery, University of British Columbia, B54-2194 Health Sciences Mall, Vancouver, British Columbia, Canada V6T 1Z3
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