Self-efficacy beliefs and fear of childbirth in nulliparous women

Abstract

Objective: To explore how childbirth self-efficacy, i.e. outcome expectancy and efficacy expectancy, was associated with fear of childbirth (FOC) and how efficacy expectancy and FOC, respectively were related to socio-demographic characteristics, mental problems and preference for a caesarean section.

Methods: In this cross-sectional study, a consecutive sample of 1000 pregnant nulliparous women was sent the Wijma Delivery Expectancy Questionnaire and Childbirth Self-Efficacy Inventory. Statistical analyses were performed on data from 423 women.

Results: Outcome expectancy and efficacy expectancy correlated significantly and positively, FOC correlated significantly and negatively with both outcome expectancy and efficacy expectancy. Women with severe FOC (20.8%) had a significantly lower level of education (p = 0.001), and had more often sought help because of mental problems (p = 0.004). They were more likely to have low-efficacy expectancy (p < 0.001) and to prefer a caesarean section instead of a vaginal birth (p < 0.001).

Conclusions: Lower efficacy expectancy was associated with higher FOC while preference for a caesarean section was not. Improvement of self-efficacy could be a part of care for women with FOC during pregnancy; however, it would not be enough for fearful women who wish to have a caesarean section.

• Caesarean section
• CBSEI
• fear of childbirth
• pregnancy
• self-Efficacy
• W-DEQ

Acknowledgements

The authors thank all the women who participated in the study.

Current knowledge on this subject

• Substantial FOC is rather common and for about 6–15% of pregnant women the fear is so severe that daily life activities are negatively influenced.

• Severe FOC is documented as a reason for requesting elective caesarean section.

• Self-efficacy has been identified as a factor that influences satisfaction with childbirth.

What this study adds

• Low-efficacy expectancy is associated with a higher level of FOC.

• Preference for caesarean section instead of vaginal birth is related to severe FOC, not to efficacy expectancy beliefs.

• Outcome expectancy was higher than efficacy expectancy, irrespective of the level of FOC.