Reasons for childbirth-related fear among pregnant women. A cross-sectional study in a teaching institution.

Background: Though both the woman and the fetus are healthy, fear and anxiety of childbirth have led to the cesarean section (CS) of many women in recent years. Aim: To investigate the level of antenatal fear of childbirth at various gestational ages and factors associated with intense fear among pregnant women. Methods: A cross-sectional study was conducted at King Abdulaziz University Hospital from February 2024 to April 2024, on women of reproductive age, who requested a CS without a medical reason, excluding women with medical indications for CS, high-risk pregnancy, or refusal to participate. A questionnaire was used, which included participants' demographics, obstetric history, the Childbirth Attitude Questionnaire (CAQ), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Results: There were 48.1% of the participants with ages 25-34 years, 97.2% were married, 74.1% had a university degree, 42.5% were housewives, and 27.4% had chronic conditions. Only 1.4% suffered from anxiety, and 0.5% had depression. 34.4% of respondents reported having 3-4 previous pregnancies, and 87.3% and 65.1% had never experienced fetal death and/or abortions, respectively. Of them, 24.1% had two spontaneous vaginal deliveries, 30.2% had delivery complications, 66.5% attended regular follow-up antenatal appointments, and 97.6% had husband's support during pregnancies. The primary fears included the fear of the baby being injured during delivery, fear of something being wrong with the baby, fear of needing a CS, and fear of experiencing tearing during birth (episiotomy). Older age, having an abortion, or having a vaginal birth were significantly associated with increased childbirth fears. Conclusion: In order to maximize the goals of pregnant moms, lessen anxiety, and ultimately enhance maternal wellbeing, prenatal healthcare providers should be equipped to handle these fears and provide comprehensive support and therapies. This will reduce anxiety, increase women's trust in their healthcare providers, and enhance their birth experience.