Fear of childbirth among pregnant women in hospital for delivery and its impact on birth outcomes and lactation initiation: a prospective longitudinal study in Wuhan

BackgroundFear of childbirth (FOC) has been shown to adversely affect the physical and mental health of pregnant women. However, most of the previous studies have explored only certain factors influencing FOC and have not consistently followed birth outcomes and lactation initiation. This study aimed to understand the incidence of FOC antenatally among pregnant women, analyse the factors influencing this fear, investigate the relationship between generalised anxiety disorder (GAD) and FOC, and explore the influence of this fear on birth outcomes and lactation initiation.MethodsBetween August and November 2018, 237 pregnant women hospitalised for delivery in Wuhan were selected. The Chinese version of the Childbirth Attitudes Questionnaire (CAQ) was used to measure the level of FOC before delivery, A self-administered questionnaire was used to collect general demographic and obstetric information, while the Generalised Anxiety Disorder Scale-7 (GAD-7) was utilised to assess anxiety status. Additionally, information on birth outcomes, including the length of each stage of labour, and lactation initiation, was collected by consulting the electronic medical record system and through telephonic follow-up on postpartum days 5-7.ResultsThe incidence of FOC was 73.8%, and 4.2% of women were diagnosed with severe FOC. GAD is positively associated with FOC. Maternal age, maternity insurance, expected labour pain score, sensitivity to pain, and GAD were the main factors influencing FOC (R-2=0.314). A significant difference was found in the length of the second stage of labour in primiparas with different levels of FOC (F = 2.815, P < 0.05); the higher the level of FOC, the greater the length of the second stage of labour. No significant differences were noted between the different levels of FOC and delayed initiation of lactation, gestational age and birth weight, or the Apgar scores at 1 and 5 min after birth (P > 0.05).ConclusionsFOC is highly prevalent among pregnant women hospitalised for delivery, influenced by multiple factors, and has a negative impact on birth outcomes and lactation initiation. To enhance the childbirth experience and reduce FOC, it is recommended to introduce standardised screening and interventions for FOC.