Beyond Fear: Unveiling the Relationship Between Fear of Childbirth and Pharmacological Pain Relief*

Background: Pharmacological analgesia is the dominant method for pain relief in labor. Fear of childbirth (FOC) may significantly affect women's preferences for and usage of pharmacological analgesia. Aim: This study aimed to investigate the relationship between FOC in late pregnancy and preferences for, as well as actual use of, pharmacological analgesia among nulliparous and multiparous women, accounting for confounding factors.Methods: A total of 1,300 women participated in the study, completing questionnaires assessing preferences for pharmacological analgesia, FOC, perception of labor pain, social support, coping styles, and demographic variables. The actual use of pharmacological analgesia was followed up. The data were analyzed using univariate and multivariate regression analyses.Results: Univariate analysis revealed that women with moderate to severe FOC had a stronger preference for pharmacological analgesia compared to those with none to mild FOC. However, multivariate analysis showed no direct association between FOC and actual usage of pharmacological analgesia. Instead, a stronger preference for pharmacological analgesia increased the likelihood of its actual usage during labor.Conclusions: Our study underscores the effect of FOC on preferences for pharmacological analgesia and its potential influence on actual usage during labor. Healthcare providers should consider women's FOC and preferences when evaluating pain management options. Targeted interventions focusing on promoting non-pharmacological techniques should be implemented to optimize labor pain management for women, particularly nulliparous women. (c) 2023 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.