Mode of delivery preferences: the role of childbirth fear among nulliparous women

Abstract

IntroductionThe increasing Cesarean Section (CS) rates may be attributed to women’s increasing requests for elective CS. High Fear of Childbirth (FOC), especially among nulliparous women, may be significantly associated with CS preference without medical indications. The current study aims to investigate the impact of childbirth fear on the mode of delivery preference among nulliparous women.MethodsA cross-sectional correlational study was performed in the Maternal and Children Hospital (MCH) from the beginning of October 2022 to the end of February 2023 and incorporated a convenience sample of 342 nulliparous women. The data was collected using a self-reported questionnaire comprising participants’ demographic and obstetrics characteristics and the FOC questionnaire. A logistic regression model examined the relationship between CS preference and the other independent variables.ResultsThe results indicated that 74.3% of the nulliparous women preferred vaginal delivery, while 25.7% preferred Cesarean Section. Concerning childbirth-related fear, the highest mean scores were related to fear of clinical procedures, fear of harming or distressing the infant, and fear of pain 5.19 ± 1.13, 5.12 ± 1.27, and 5.09 ± 1.22, respectively. High FOC was present among 74.6%, moderate in 17.3%, and severe in 6.7% of the participants. Logistic regression analysis showed maternal age and monthly income were the significant sociodemographic determinants of choosing CS as the preferred delivery mode (p < 0.05). Moreover, the participants who had increased fear of harming or distressing the infant, fear from pain, fear from the body’s ability to give birth, fear from not being involved in decision-making, and overall FOC had a higher probability of choosing CS as the preferred delivery mode compared to the participants who had lower fear (p < 0.05).DiscussionHaving high FOC increases the CS preference among nulliparous women. Increased fear of harming or distressing the infant, fear from pain, fear from the body’s ability to give birth, and fear from not being involved in decision- making seem to be significant dimensions of childbirth fear associated with CS preference among nulliparous women.

Determinants of Prenatal Childbirth Fear during the Third Trimester among Low-Risk Expectant Mothers: A Cross-Sectional Study

“…Namely, the seven FOC components were fear of the unknown and not being able to plan for unpredictable events, fear of hurting or stressing the baby, fear of not being able to deal with pain, fear of harming oneself during labor and after birth, fear of being exposed, fear of not having a voice in decision making, and fear of abandonment and loneliness. Additionally, in the Saudi context, a very recent study conducted by Elgzar et al [ 12 ] explained the significant component of FOC associated with cesarean section preference. They elaborated that fear of harming or distressing the infant, fear of pain, fear of the body’s ability to give birth, and fear of not being involved in decision making were associated with cesarean section preference.…”

“…A recent study explored the role of childbirth in choosing the mode of delivery and concluded that a high level of FOC can be related to women’s unjustifiable requests for cesarean section. They further elaborated that increased fear of harming or distressing the infant, fear from pain, fear from the body’s ability to give birth, and fear of not being involved in decision making seem to be significant dimensions of childbirth fear associated with cesarean section preference [ 12 ].…”

Análise da incidência e indicações de cesáreas na Maternidade Escola de Valença/RJ

“…A decisão entre parto vaginal e cesáreo tem sido objeto de intenso debate na comunidade obstétrica, com um consenso emergente de que a preferência por cesáreas pode estar crescendo, apesar das recomendações para limitar cesáreas a indicações médicas claras (Elgzar, 2023;Brown, 2023;Comfort, 2023). A escolha obstétrica da via de parto impacta diretamente a frequência de partos vaginais futuros.…”

“…Além disso, o estudo visa compreender os motivos por trás das altas taxas de cesariana no Brasil, considerando aspectos como preferências pessoais, condições clínicas e práticas médicas (Pires et al, 2023;Angolile et al, 2023). A análise das tendências e práticas obstétricas em hospitais é vital para informar futuras políticas e intervenções de saúde (Comfort et al, 2023;Elgzar et al, 2023).…”