The impact of fear and anxiety of childbirth on delivery method preference among pregnant women presenting to primary healthcare services

ABSTRACT The Impact of Fear and Anxiety of Childbirth on Delivery Method Preference Among Pregnant Women Presenting to Primary Healthcare Services Dr. Halim BAYRAKCI This study aimed to evaluate the impact of childbirth fear and pregnancy- related anxieties on delivery method preferences among pregnant women presenting to primary healthcare centers. This descriptive study was conducted with 216 pregnant women who applied to six different family health centers in the city center of Denizli between May 27 and June 27, 2025. Data were collected through face-to- face interviews using a questionnaire developed by the researcher based on literature review, which included questions about participants' sociodemographic and obstetric characteristics and anxiety status, as well as the validated Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ A). Data analysis was performed using SPSS 25.0 software, and both parametric and non-parametric tests were employed for statistical evaluation. The caesarean section rate among participants was 53.5%, consistent with national data (TDHS 2018). Obstetricians (67.1%) were identified as the most influential figures in delivery method decisions. Nearly half of the participants indicated that the delivery decision should be made jointly by the woman, her partner, and the physician, underscoring the importance of shared decision-making. The mean W-DEQ A score was 62.25±16.05, indicating a moderate level of childbirth fear. Additionally, 6.9% of participants experienced clinically significant fear of childbirth. No significant differences in fear levels were observed based on education level, obstetric history, or number of previous births. Pregnancy- and childbirth-related anxieties were strongly associated with childbirth fear. Economic status was a significant influencing factor; women whose expenses exceeded their income exhibited higher levels of fear. Women whose previous delivery method had been determined solely by the physician also had higher fear levels. Prenatal education did not significantly affect fear scores. Anxiety levels were higher among women with no prior birth experience, suggesting that 8 previous delivery experience may reduce anxiety. Although anxiety was high in both groups, it was not statistically associated with delivery method preference. Among women who preferred caesarean delivery, fear of pain emerged as a key determinant and was associated with the highest anxiety levels. The findings suggest that childbirth fear and anxiety influence delivery method preference. Therefore, early assessment of these psychological factors during pregnancy and the provision of appropriate information and support are essential. The results highlight the need for a multidisciplinary and holistic approach in managing childbirth-related fear. Keywords: Fear of childbirth, pregnancy anxiety, delivery preference, W-DEQ, caesarean section