Cited by 399Maternal and Perinatal Health InterventionsMaternal Mental Health During Pregnancy and PostpartumMaternal and Neonatal Healthcare

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Experiences of Fears Associated with Pregnancy and Childbirth: A Study of 329 Pregnant Women

Hanna‐Leena Melender, RM·2002·Birth

DOI 10.1046/j.1523-536x.2002.00170.x

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Abstract

Background: Women may experience a variety of fears in association with pregnancy and childbirth. The purpose of this study was to describe their objects, causes, and manifestations, and to identify factors associated with the fears. Methods: The study sample comprised 481 pregnant women in western Finland, of whom 329 (response rate 69%) completed a questionnaire. It was developed on the basis of semi‐structured interviews and previous studies and had a 4‐point scale and a dichotomous scale. Data were subjected to rotated factor analysis, and sum variables were produced. The effects of various demographic variables were calculated using the Kruskal‐Wallis and Mann‐Whitney U tests. Results: Of the 329 respondents, 78 percent expressed fears relating to pregnancy, to childbirth, or to both. Specific fears concerned childbirth, the child's and mother's well‐being, health care staff, family life, and cesarean section. Causes of fears were negative mood, negative stories told by others, alarming information, diseases and child‐related problems, and, in multiparas, negative experiences of previous pregnancy, childbirth, and baby's health and care; causes were significantly related to occupation. Fears were manifested as symptoms of stress, effects on everyday life, and a wish to have a cesarean section or to avoid pregnancy and childbirth; employment situation and elective cesarean section were the most important factors related to manifestation of fears. Parity and antenatal training were the most important variables related to objects of fears. Conclusions: Women's fears that are associated with pregnancy and childbirth can be explained by different factors. It is important for perinatal health caregivers to ask pregnant women about their feelings related to the current pregnancy, childbirth, and future motherhood, and to give women who express fears an opportunity to discuss them, paying special attention to primiparas and to multiparas with negative experiences of earlier pregnancies. (BIRTH 29:2 June 2002)

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Stahl, K., & Hundley, V. A. (2003) · Midwifery · doi:10.1016/s0266-6138(03)00041-x · Cited by 67
Psychosocial Correlates of Depression Symptoms During the Third Trimester of Pregnancy
Records, K., & Rice, M. J. (2007) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/j.1552-6909.2007.00140.x · Cited by 67
Swedish midwives’ perceptions of fear of childbirth
Salomonsson, B., Wijma, K., & Alehagen, S. (2008) · Midwifery · doi:10.1016/j.midw.2008.07.003 · Cited by 67
“Several studies show that FOC also exists in nulliparous women (Ryding, 1993; Geissbuehler and Eberhard, 2002; Melender, 2002; Saisto and Halmesmäki, 2003; Waldenström et al., 2006), and that it is even more intense in nulliparous than multiparous women (Wijma et al.”
Background
Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial
Klabbers, G. A., Wijma, K., Paarlberg, K. M., Emons, W. H. M., & Vingerhoets, A. J. J. M. (2017) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2017.1398230 · Cited by 67
What Constitutes a Good Childbirth? A Qualitative Study of Pregnant Finnish Women
Melender, H. (2006) · Journal of Midwifery & Women s Health · doi:10.1016/j.jmwh.2006.02.009 · Cited by 65
Fear of childbirth, women's preference for cesarean section and childhood abuse: a longitudinal study
LUKASSE, M., VANGEN, S., ØIAN, P., & SCHEI, B. (2011) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2010.01024.x · Cited by 61
The initial development of the Pregnancy-related Anxiety Scale
Brunton, R. J., Dryer, R., Saliba, A., & Kohlhoff, J. (2019) · Women and Birth · doi:10.1016/j.wombi.2018.05.004 · Cited by 73
Pregnant women's thoughts when assessing fear of birth on the Fear of Birth Scale
Ternström, E., Hildingsson, I., Haines, H., & Rubertsson, C. (2016) · Women and Birth · doi:10.1016/j.wombi.2015.11.009 · Cited by 60
“Lack of trust in staff has earlier been described as a prevalent source of fear of birth.(19,21) In the present study, women stated that having trust in the staff was a strategy that helped them to cope with their own worries and fears.”
Background
Fear of Childbirth and Associated Risk Factors in Healthy Pregnant Women in Northwest of China: A Cross-Sectional Study
Zhou, X., Liu, H., Li, X., & Zhang, S. (2021) · Psychology Research and Behavior Management · doi:10.2147/prbm.s309889 · Cited by 66
What do midwives fear?
Dahlen, H. G., & Caplice, S. (2014) · Women and Birth · doi:10.1016/j.wombi.2014.06.008 · Cited by 60
Women's experiences of interventions for fear of childbirth in the perinatal period: A meta-synthesis of qualitative research evidence
O’Connell, M. A., Khashan, A. S., & Leahy‐Warren, P. (2020) · Women and Birth · doi:10.1016/j.wombi.2020.05.008 · Cited by 58
“Studies included in this meta-analysis [4] were all undertaken in first world countries, however, there has since been a prevalence study performed in Kenya which indicates a similar prevalence of 14% in primigradas in this developing country, while FOC prevalence was lower in multigravidas (8%) [8].”
BackgroundMethodInfluential
Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research
Jomeen, J., Martin, C., Jones, C., Marshall, C. A., Ayers, S., Burt, K., Frodsham, L., Horsch, A., Midwinter, D., O’Connell, M. A., et al. (2020) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2020.1843908 · Cited by 58
“Melender (2002) reported that almost a fifth of women will experience some degree of pregnancy-and childbirth-related fear or both.”
A Birth Education Program for Expectant Fathers in Taiwan: Effects on Their Anxiety
Li, H., Lin, K., Chang, S., Kao, C., Liu, C., & Kuo, S. (2009) · Birth · doi:10.1111/j.1523-536x.2009.00356.x · Cited by 58
Adult attachment at the transition to motherhood: predicting worry, health care utility and relationship functioning
Trillingsgaard, T., Elklit, A., Shevlin, M. E., & Maimburg, R. D. (2011) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2011.611937 · Cited by 57
“Transition to motherhood begins with pregnancy, a phase of profound physical, biological and neuro-endocrinological changes that have been associated with increases in fear and anxiety (Melender, 2002).”
Background
Severe fear of childbirth: Its features, assesment, prevalence, determinants, consequences and possible treatments
Klabbers, G. A., van Bakel, H. J. A., van den Heuvel, M. M. A., & Vingerhoets, A. J. J. M. (2016) · Research portal (Tilburg University) · Cited by 56
Interventions to treat fear of childbirth in pregnancy: a systematic review and meta-analysis
Webb, R., Bond, R., Romero‐Gonzalez, B., Mycroft, R. H., & Ayers, S. (2021) · Psychological Medicine · doi:10.1017/s0033291721002324 · Cited by 67
“Research also suggests that vicarious experiences such as viewing a live birth is associated with a reduction in fear (Stoll & Hall, 2013) and research also suggests that the transmission of information such as negative childbirth stories (Melender, 2002; Tsui et al., 2007) and public discourses of birth (Fenwick, Hau…”
BackgroundInfluential
Effect of Training Preparation for Childbirth on Fear of Normal Vaginal Delivery and Choosing the Type of Delivery Among Pregnant Women in Hamadan, Iran: A Randomized Controlled Trial.
Masoumi, S. Z., Kazemi, F., Oshvandi, K., Jalali, M., Vardanjani, A. E., & Rafiei, H. (2016) · PubMed Central · Cited by 55
Aromatherapy and massage for antenatal anxiety: Its effect on the fetus
Bastard, J., & Tiran, D. (2005) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2005.07.001 · Cited by 52
The Successes and Challenges of Implementing Telehealth for Diverse Patient Populations Requiring Prenatal Care During COVID-19: Qualitative Study
Farrell, R. M., Collart, C., Craighead, C., Pierce, M., Chien, E. K., Frankel, R., Edmonds, B. T., Perni, U. C., Coleridge, M. B., Ranzini, A. C., et al. (2021) · JMIR Formative Research · doi:10.2196/32791 · Cited by 198
Factors influencing maternal distress among Dutch women with a healthy pregnancy
Kuipers, Y., Ausems, M., Budé, L. M., van Limbeek, E. B. M., Vries, R. G. D., & Nieuwenhuijze, M. J. (2015) · Women and Birth · doi:10.1016/j.wombi.2015.02.002 · Cited by 55
“It's All the Rage These Days”: University Students' Attitudes Toward Vaginal and Cesarean Birth
Stoll, K., Fairbrother, N., Carty, E., Jordan, N., Miceli, C., Vostrcil, Y., & Willihnganz, L. (2009) · Birth · doi:10.1111/j.1523-536x.2009.00310.x · Cited by 62
Translation and validation of the J apanese version of the W ijma D elivery E xpectancy/ E xperience Q uestionnaire version A
Takegata, M., Haruna, M., Matsuzaki, M., Shiraishi, M., Murayama, R., Okano, T., & Severinsson, E. (2013) · Nursing and Health Sciences · doi:10.1111/nhs.12036 · Cited by 49
Maternal Fear Associated with Pregnancy and Childbirth in Hong Kong Chinese Women
Tsui, M. H. Y., Pang, M. W., Melender, H., Xu, L., Lau, T. K., & Leung, T. N. (2007) · Women & Health · doi:10.1300/j013v44n04_05 · Cited by 49
“The causes of fear in our population were also similar to those identified in the Finnish population (Melender 2002), although “negative stories from others” featured more strongly in our population than “negative attitude or mood.””
BackgroundMethodResultInfluential
Reconceiving Pregnancy and Childcare
Mullin, A. (2005) · Cambridge University Press eBooks · doi:10.1017/cbo9780511814280 · Cited by 96
SARS: pregnant women's fears and perceptions
Ng, J. W. Y., Sham, A., Tang, P. L., & Fung, S. Y. (2004) · British Journal of Midwifery · doi:10.12968/bjom.2004.12.11.16710 · Cited by 48
Effects of extended childbirth education by midwives on the childbirth fear of first‐time mothers: an RCT
Haapio, S., Kaunonen, M., Arffman, M., & Åstedt-Kurki, P. M. (2016) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.12346 · Cited by 48
Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial
Rondung, E., Ternström, E., Hildingsson, I., Haines, H. M., Sundin, Ö., Ekdahl, J., Karlström, A., Larsson, B., Segeblad, B., Baylis, R., et al. (2018) · JMIR Mental Health · doi:10.2196/10420 · Cited by 47
Tokophobia: A dread of pregnancy
Bhatia, M., & Jhanjee, A. (2012) · Industrial Psychiatry Journal · doi:10.4103/0972-6748.119649 · Cited by 47
“[4,5] However, 13% of non‑gravid women report fear of childbirth sufficient to postpone or avoid pregnancy.”
Pregnancy related risk perception in pregnant women, midwives & doctors: a cross-sectional survey
Lee, S., Holden, D., Webb, R., & Ayers, S. (2019) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-019-2467-4 · Cited by 47
Women's needs from antenatal care in three European countries
Luyben, A. G., & Fleming, V. E. M. (2005) · Midwifery · doi:10.1016/j.midw.2004.11.001 · Cited by 45
Predictors of women's positive childbirth pain experience: Findings from an Icelandic national study.
Karlsdóttir, S. I., Sveinsdóttir, H., Kristjánsdóttir, H., Aspelund, T., & Olafsdottir, O. (2017) · Women and Birth · doi:10.1016/j.wombi.2017.09.007 · Cited by 37
Fear of childbirth in nulliparous women: A cross-sectional multicentre study in China
Qiu, L., Sun, N., Shi, X., Zhao, Y., Feng, L., Gong, Y., & Yin, X. (2019) · Women and Birth · doi:10.1016/j.wombi.2019.04.005 · Cited by 45

Authors: Hanna‐Leena Melender, R.
Venue: Birth
Publisher: Wiley
Published: 2002-05-16
Volume: 29
Issue: 2
Pages: 101-111
ISSN: 0730-7659 (ISSN-L)
1523-536X
DOI: 10.1046/j.1523-536x.2002.00170.x
OpenAlex: W2153268917
Cited by: 399
References: 28
Citations by year: 2026: 13 · 2025: 12 · 2024: 17 · 2023: 18 · 2022: 20 · 2021: 31 · 2020: 27 · 2019: 17 · 2018: 21 · 2017: 18 · 2016: 18 · 2015: 15 · 2014: 15 · 2013: 22 · 2012: 18
FWCI: 9.80
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Birth (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Keywords: fear of childbirth, pregnant women, causes of fear, cesarean section, parity, primiparous women, multiparous women, maternal stress, perinatal care, working conditions
MeSH terms: Adolescent, Adult, Family, Fear, Female, Finland, Humans, Interpersonal Relations, Labor, Obstetric, Negativism, Pain, Pregnancy, Pregnancy Complications, Surveys and Questionnaires, Stress, Physiological, Delivery, Obstetric

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Experiences of Fears Associated with Pregnancy and Childbirth: A Study of 329 Pregnant Women

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