Fear of Childbirth and Associated Risk Factors in Healthy Pregnant Women in Northwest of China: A Cross-Sectional Study

Figures & data

Table 1 Socio-Demographic and Obstetric Characteristics of Study Participants (N=922)

Maternal Characteristics	n (%)	Maternal Characteristics	n (%)
Ethnic group		Support of husband for pregnancy
Han	895 (97.1)	Very supportive	848 (92.0)
Other	27 (2.9)	Unsupportive	74 (8.0)
Age		Relationship with partner
≤25	222 (24.1)	Close	471 (51.1)
26–30	478 (51.8)	Good	391 (42.4)
31–35	179 (19.4)	General	25 (2.7)
≥36	43 (4.7)	Occasional conflicts	35 (3.8)
Education level		Relationship with mother-in-law
Middle school and below	197 (21.4)	Good	709 (76.9)
High school/Vocational school	249 (27.0)	Fair	201 (21.8)
University or above	476 (51.6)	Poor	12 (1.3)
Occupation		Parity
Civil servant/Employee of institutions	123 (13.3)	Nullipara	567 (61.5)
Employee of enterprises	257 (27.9)	Multipara	355 (38.5)
Farmer	160 (17.4)	Gestational age
Freelancer	382 (41.4)	< 28 w	67 (7.3)
Residence		28–36 w	244 (26.4)
Rural area	370 (40.1)	≥37 w	611 (66.3)
Town/County	174 (18.9)	Preferred route of delivery
City	378 (41.0)	Vaginal delivery	751 (81.5)
Marital status		Caesarean delivery	171 (18.5)
Married	891 (96.6)	Social support
Unmarried	31 (3.4)	Lower (12–36)	4 (0.4)
Monthly household income		Middle (37–60)	121 (13.1)
< ¥2000	110 (11.9)	Higher (61–84)	797 (86.5)
¥2000–4500	594 (64.4)	Pregnancy stress
>¥4500	218 (23.7)	Mild (0–35)	651 (70.6)
Route prenatal care		Moderate (36–72)	260 (28.2)
Yes	789 (85.57)	Severe (>72)	11 (1.2)
No	133 (14.43)	EPDS score
Housing satisfaction		≤9	480 (52.1)
Satisfactory	212 (23.0)	10–12	193 (20.9)
Fair	657 (71.3)	≥13	249 (27.0)
Not satisfied	53 (5.7)

Table 2 Maternal Characteristics by Level of Fear of Childbirth (N = 922)

Maternal Characteristics	CAQ Score Mean (SD)	Level of Fear of Childbirth				F
		Low n = 274 No (%)	Mild n = 398 No (%)	Moderate n = 199 No (%)	Severe n = 51 No (%)
Age						3.629*
≤25 years	35.41 (10.75)	56 (20.5)	95 (23.9)	54 (27.1)	17 (33.3)
26–30 years	33.96 (10.05)	134 (48.9)	212 (53.3)	106 (53.3)	26 (51.0)
31–35 years	32.62 (9.97)	70 (25.5)	67 (16.8)	35 (17.6)	7 (13.7)
≥36 years	31.18 (8.16)	14 (5.1)	24 (6.0)	4 (2.0)	1 (2.0)
Education level						4.270*
Middle school and below	34.70 (11.02)	57 (20.8)	80 (20.1)	47 (23.7)	13 (25.5)
High school/technical school	35.09 (10.69)	65 (23.7)	108 (27.1)	55 (27.6)	21 (41.2)
University or above	32.98 (9.44)	152 (55.5)	210 (52.8)	97 (48.7)	17 (33.3)
Occupation						2.933*
Civil servant/Employee of institutions	32.68 (10.13)	44 (16.1)	49 (12.3)	25 (12.6)	5 (9.8)
Employee of enterprises	32.76 (9.08)	87 (31.8)	111 (27.9)	48 (24.1)	11 (21.6)
Farmer	34.86 (10.57)	46 (16.7)	62 (15.6)	42 (21.1)	10 (19.6)
Freelancer	34.70 (10.18)	97 (35.4)	176 (44.2)	84 (42.2)	25 (49.0)
Residence						6.570**
Rural area	33.92 (10.21)	107 (39.1)	167 (42.0)	75 (37.7)	21 (41.2)
Town/County	36.22 (9.93)	31 (11.3)	88 (22.1)	43 (21.6)	12 (23.5)
City	32.87 (10.11)	136 (49.6)	143 (35.9)	81 (40.7)	18 (35.3)
Housing satisfaction						5.444**
Satisfactory	32.43 (9.65)	76 (27.7)	91 (22.9)	35 (17.6)	10 (19.6)
Neutral	33.96 (10.14)	191 (69.7)	286 (71.9)	145 (72.9)	35 (68.6)
Not satisfied	39.35 (10.95)	7 (2.6)	21 (5.2)	19 (9.5)	6 (11.8)
Relationship with mother-in-law						8.361**
Good	33.20 (9.88)	232 (84.7)	292 (73.4)	155 (77.9)	30 (58.8)
Fair	36.11 (10.42)	39 (14.2)	102 (25.6)	42 (21.1)	18 (35.3)
Poor	39.50 (15.79)	3 (1.1)	4 (1.0)	2 (1.0)	3 (5.9)
Parity						17.071**
Nullipara	35.01 (10.43)	150 (54.7)	243 (61.1)	133 (66.8)	41 (80.4)
Multipara	32.18 (9.50)	124 (45.3)	155 (38.9)	66 (33.2)	10 (19.6)
Gestational age						3.321*
< 28 w	32.49 (8.92)	23 (8.4)	29 (7.3)	14 (7.0)	1 (2.0)
28–36 w	32.77 (9.62)	72 (26.3)	126 (31.7)	34 (17.1)	12 (23.5)
>36 w	34.53 (10.47)	179 (65.3)	243 (61.0)	151 (75.9)	38 (74.5)
Route prenatal care						7.060**
Yes	33.55 (9.83)	237 (86.5)	346 (86.9)	170 (85.4)	36 (70.6)
No	36.08 (11.85)	37 (13.5)	52 (13.1)	29 (14.6)	15 (29.4)
Social support						9.950**
High (61–84)	33.37 (9.95)	250 (91.2)	348 (87.4)	160 (80.4)	39 (76.5)
Moderate (37–60)	37.13 (10.63)	23 (8.4)	50 (12.6)	38 (19.1)	10 (19.6)
Low (12–36)	45.50 (17.38)	1 (0.4)	0 (0.0)	1 (0.5)	2 (3.9)
Pregnancy Stress						123.882**
Mild	30.81 (8.58)	250 (91.2)	302 (75.9)	85 (42.7)	14 (27.5)
Moderate	41.02 (9.45)	23 (8.4)	93 (23.4)	114 (57.3)	30 (58.8)
Severe	49.91 (14.48)	1 (0.4)	3 (0.7)	0 (0.0)	7 (13.7)
EPDS score						71.174**
≤9	30.69 (9.09)	196 (71.5)	210 (52.8)	60 (30.2)	14 (27.5)
10–12	34.80 (9.54)	44 (16.1)	94 (23.6)	45 (22.6)	10 (19.6)
≥13	39.46 (10.15)	34 (12.4)	94 (23.6)	94 (47.2)	27 (52.9)

Notes: *p < 0.05. **p < 0.01.

Table 3 Childbirth Attitude Questionnaire Item Scores (N = 922)

Original Item No.	CAQ Item	Mean	SD
9	I have fear of having to have a caesarean section.	2.49	1.031
11	I have fear of the baby being injured during the childbirth.	2.49	0.956
2	I am really afraid of giving birth.	2.39	0.932
6	I have some fear of something being wrong with the baby.	2.38	0.951
10	I have fear of being torn with the birth of the baby.	2.25	0.944
12	I have fear of painful labor contractions.	2.19	0.937
5	I have fear I will not be able to help during the childbirth.	2.18	0.907
8	I have fear of being left alone during labor.	2.16	0.971
16	Overall, I would rate my anxiety about childbirth as 1 (no anxiety), 2 (low anxiety), 3 (moderate anxiety), 4 (high anxiety).	2.1	0.828
13	I have difficulty relaxing when thinking of the coming birth.	2.08	0.891
4	I have fear of bleeding too much during the childbirth.	2.04	0.922
1	I have fear of losing control of myself at the childbirth.	2.01	0.830
7	I have fear of painful injections.	1.98	0.925
15	I have fear of not getting the kind of care that I want.	1.85	0.850
14	I have fear of the hospital environment.	1.74	0.836
3	I have nightmares about the childbirth.	1.6	0.863
Total Childbirth Attitude Questionnaire score		33.92	10.17

Table 4 Variables Correlated with Scores on the Childbirth Attitude Questionnaire (N = 922)

Variables	R	p-value
Pregnancy stress	0.598	0.000
Stress from seeking identifying maternal role	0.395	0.000
Stress from seeking safe passage for herself and her child	0.600	0.000
Stress from altering body structure and body function	0.503	0.000
Social support	−0.246	0.000
From family	−0.232	0.000
From friends	−0.240	0.000
From significant others	−0.193	0.000
EPDS score	0.434	0.000
Anhedonia	0.328	0.000
Anxiety	0.379	0.000
Depression	0.373	0.000
Parity	−0.135	0.000

Table 5 Results from Linear Regression Analyses Predicting CAQ Scores

Variables	β	SE	F	p-value
Residence	−0.088	0.034	6.495	0.002
Marital status	−0.058	0.022	6.703	0.000
Parity	0.097	0.030	10.448	0.001
Gestational age	0.080	0.027	8.855	0.003
Relationship with partner	−0.059	0.032	3.453	0.032
Pregnancy stress	0.394	0.037	112.849	0.000
Social support	−0.091	0.046	3.955	0.019
Depressive symptoms	0.220	0.036	37.788	0.000