Antenatal fear of childbirth and sense of coherence among healthy pregnant women in Japan: A cross-sectional study

Abstract

While antenatal fear of childbirth (FOC) has been associated with many psychosocial variables, few studies have focused on individual stress resiliency. Sense of coherence (SOC) is one of the essential components of individual stress resiliency. This study investigates the relationship between antenatal FOC and SOC in Japanese healthy pregnant women. Self-reported questionnaires were distributed to 240 women at 37 gestational weeks at an obstetric clinic in Tokyo, Japan. Structural regression modeling was conducted to identify the causal relationships between FOC and SOC. The non-recursive model showed significant acceptance of fit (chi-square value/degree of freedom = 1.72, comparative fit index = 0.97, and root mean square error of approximation = 0.05). The model identified SOC as a direct cause of FOC (β = -0.89, p < 0.001), not a reflection of FOC. We found that SOC was negatively linked with antenatal fear of childbirth. High SOC works as a resiliency factor that helps pregnant women cope with the stress of their upcoming childbirth and reduces FOC.

Worldwide prevalence of tocophobia in pregnant women: systematic review and meta‐analysis

“…Three studies did not include data that could be included in the meta‐analysis and two studies included the same population as a third study . A brief summary of the studies not included in the meta‐analysis is presented in Table .…”

“…Furthermore, many of the studies included in the systematic review were of a cross-sectional design that only capture FOC at one point in time during pregnancy (see Table 1). It is possible that questionnaires may not be applicable in different countries and in other cultural contexts (even in the same language) as psychometric aspects of the tool may be lost (14), hence tools should be specifically validated for use in each country (14,52). This is a limitation of our study as we included studies that used various questionnaires administered in different languages (52).…”

“…Study characteristics are presented in Table 1. One study was published in 1981 (30), one study in the late 1990s (31), 14 studies between 2000 and 2009 (15,18,19,21,(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) and 17 studies between 2010 and April 2016 (1,8,9,16,17,20,(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52). Study settings included the following: USA (32), Canada (37), Australia (36,46,49), Sweden (15,16,19,(29)(30)(31)33,38,40,41,47,49), Norway (20,35,…”

“…Sampling was done in different languages, and in the case of standardized instruments (W-DEQ A, FOBS, CAQ) the studies ensured correct translation of the questionnaires in the following ways, which varied according to study: the questionnaire was translated into the most commonly spoken languages of the study area (forward translation); the various language versions of the questionnaire were translated by both lay and professional translators (expert back translation); draft versions of the translated questionnaire were assessed for accuracy and validated by professionals who were fluent in one or more of the languages (pre-testing) (16,17,44,49). One study (52) was the first to use the W-DEQ A in the Japanese language and so needs to be validated in further studies. Of the 21 studies that used the W-DEQ Part A, two used ≥100 as a cut-off for tocophobia (21,35), one used ≥95 (35), one used ≥85.8 (41), 12 used ≥85 (8,19,20,33,37,41,42,46,47,53), one used ≥84 (31), one used ≥71 (36) and two used ≥66 (15,37).…”

Association between the sense of coherence 13-item version scale score of pregnant women in the second trimester of pregnancy and threatened premature birth

“…In previous studies, low SOC scale scores were related to higher anxiety [25] and depression [28], and it was reported that SOC scale score was negatively linked with antenatal fear of childbirth: A high SOC scale score works as a resiliency factor that helps pregnant women cope with the stress of their upcoming childbirth and reduces fear of childbirth [40]. Furthermore, it was shown that the stress status during early pregnancy affects the pregnancy course and the health of the fetus [41], and that maternal complications were related to low SOC scale scores [42].…”