Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women

Abstract

Objective: The demographic characteristics, maternal parity and personal traits of pregnant women have been frequently studied predictors of fear of childbirth (FOC). The aim of this study was to examine the role of demographic variables, expected pain level, trait anxiety and anxiety sensitivity in FOC among nulliparous and multiparous women in the last trimester of pregnancy.

Method: Two-hundred pregnant women completed a booklet with questionnaires including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), Anxiety Sensitivity Index (ASI), The State – Trait Anxiety Inventory (STAI) and questions on expected labor pain and demographics.

Results: Results showed that FOC was higher amongst nulliparous women, but FOC level was not associated with other demographic variables. Different predictors were established in nulliparous and multiparous women. While higher intensity of expected labor pain and anxiety sensitivity (dimension physical concern) were significant predictors in both groups, trait anxiety was significant for the first-time mothers only.

Conclusion: Amongst all women, anxiety sensitivity (physical concerns dimension) was identified as an important vulnerability factor for FOC. As such, the level of anxiety sensitivity, and any resulting fear or expectations of pain, should be assessed in expectant mothers by clinicians in prenatal settings. Furthermore, anxiety sensitivity should be an important target for psychological interventions aimed at managing FOC.

• Anxiety sensitivity
• fear of childbirth
• parity
• socioeconomic status
• trait anxiety

Current knowledge on the subject

• Nulliparous women report higher level of fear of childbirth (FOC) than parous women.

• Younger, unemployed and less educated women have higher levels of FOC.

• High trait anxiety (relatively stable disposition to be anxious) and anxiety sensitivity (tendency to fear anxiety-related symptoms) are linked to FOC.

What this study adds

• This is the first study that investigated the role of trait anxiety and anxiety sensitivity (AS) in FOC among nulliparous and multiparous women.

• In the nulliparous group, FOC was found to be greatest among women who expected a higher intensity of labor pain, who demonstrated greater trait anxiety and who scored higher on the physical dimension of anxiety sensitivity. In contrast, FOC amongst multiparous women was highest when intense pain was expected and when scores on the AS-physical dimension were higher.

• Finally, trait anxiety was demonstrated to be a contributing factor to FOC only amongst primiparous women.