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Self-efficacy beliefs and fear of childbirth in nulliparous women
Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Medical Psychology. Linköping University, Faculty of Health Sciences.
2013 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 34, no 3, 116-121 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Informa Healthcare, 2013. Vol. 34, no 3, 116-121 p.
Keyword [en]
Caesarean section, CBSEI, Fear of childbirth, Self-Efficacy, W-DEQ
National Category
Nursing
Identifiers
URN: urn:nbn:se:liu:diva-85647DOI: 10.3109/0167482X.2013.824418ISI: 000323332400004OAI: oai:DiVA.org:liu-85647DiVA: diva2:572235
Available from: 2012-11-27 Created: 2012-11-27 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Fear is in the air: Midwives´ perspectives of fear of childbirth and childbirth self-efficacy and fear of childbirth in nulliparous pregnant women
Open this publication in new window or tab >>Fear is in the air: Midwives´ perspectives of fear of childbirth and childbirth self-efficacy and fear of childbirth in nulliparous pregnant women
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: In Western countries, about one pregnant woman in five experiences a considerable fear of childbirth (FOC). Consequently FOC is an important topic for midwives, being pregnant women’s main care givers. Also, although many aspects of FOC have been studied, almost no studies have into detail applied a theoretical frame of reference for studying pregnant women’s expectations for their upcoming labour and delivery. Therefore, the theory of self-efficacy, here regarding pregnant women’s belief in own capability to cope with labour and delivery, has been applied with the aim to better understand the phenomenon of FOC.

Aim: The overall aims of the thesis were to describe midwives´ perceptions and views on FOC and to expand the current knowledge about expectations for the forthcoming birth in nulliparous women in the context of FOC.

Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed.

Method: Study I had a descriptive design. In total 21 midwives, distributed over four focus-groups, participated. Data were analysed by the phenomenographic approach. Studies II and III had cross sectional designs. Study II comprised 726 midwives, randomly selected from a national sample that completed a questionnaire that addressed the findings from Study I. Study III included 423 pregnant nulliparous women. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), self-efficacy by the Childbirth Self-Efficacy Inventory (CBSEI). Study IV had a descriptive interpretative design. Seventeen women with severe FOC were conveniently selected from the sample of Study III and individually interviewed. Content analyses, both deductive and inductive, were performed.

Conclusions: Swedish midwives regard severe FOC as a serious problem that influences pregnant women’s view on the forthcoming labour and delivery. Midwives at antenatal care clinics, compared to colleagues working at labour wards, experience a greater need for training in care of pregnant women with severe FOC. Self-efficacy is a useful construct and the self-efficacy theory an applicable way of thinking in analysing fear of childbirth. The self-efficacy concept might be appropriate in midwives’ care for women with severe FOC.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 75 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1334
Keyword
Anxiety; Childbirth; Content analysis; Fear; Focus-group interview; Midwives; Self-efficacy; Phenomenography; W-DEQ; CBSEI
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-85650 (URN)978-91-7519-780-7 (ISBN)
Public defence
2012-12-14, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
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Supervisors
Available from: 2012-11-27 Created: 2012-11-27 Last updated: 2012-11-27Bibliographically approved

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Salomonsson, BirgittaGullberg, Mats TAlehagen, SiwWijma, Klaas

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