The relationship between fear of birth and prenatal attachment in pregnancy

Objective: It is to determine the relationship between fear of childbirth and prenatal attachment in pregnant women and the factors affecting it. Material and Methods: This analytical and cross-sectional research was conducted between 15.04.2021 and 15.09.2021 with 398 pregnant women at least 28 weeks of age who applied to the Obstetrics and Gynecology Department of Ege University Faculty of Medicine Hospital between 15.04.2021 and 15.09.2021. The data were collected using the Pregnant Identification ForM, the Wijma Birth Expectation/Experience Scale (W-DEQ) A Version and the Prenatal Attachment Inventory (PBE). Descriptive statistics, Mann-Whitney U test, Kruskal Wallis Variance Analysis, Spearman test, linear regression analysis were used in the evaluation of the data. Results: The median age of the pregnant women participating in the study was found to be 28.0 (18.0–45.0) and the median age of their spouses was 32.0 (20.0-51.0). It was found that 37.9% of pregnant women graduated from high school, 67.3% did not work in any job, 78.1% of their income was equivalent to their expenses, 88.9% were in the nuclear family type structure, 77.9% were supported by their spouse. 62.6% of pregnant women are 35-38. it was determined that 66.3% of the pregnancies were planned, 37.2% had a total pregnancy, 23.9% had a miscarriage, 6.3% had an abortion, 3.3% had a stillbirth, 48.5% did not have any children, 66.3% had a planned pregnancy. It was found that 72.8% of pregnant women received information about birth methods, 37.5% preferred vaginal delivery and 37.5% preferred cesarean delivery. It has been found that 70.4% of pregnant women are positively affected by their birth experience, while 64.8% are afraid of experiencing labor pain. A statistically significant relationship was found between the sociodemographic characteristics of pregnant women (spouse's age, educational status, spouse's educational status, work status, family income status, spouse's support status) and obstetric characteristics (attending birth preparation classes, going to check-ups and follow-ups, getting information about birth methods, being affected by childbirth experiences, fear of childbirth pain) and W-DEQ-A scale scores. A statistically significant relationship was found between the sociodemographic characteristics of pregnant women (age, spouse's age, educational status, spouse's educational status, work status, spouse's work status, family income status, longest-lived place, marriage duration, family type, spouse's support status) and obstetric characteristics (total number of pregnancies, miscarriage, number of children alive, planned pregnancy status, attending childbirth preparation classes, going to check-ups and follow-ups, getting information about childbirth methods, talking and listening to childbirth experiences, being affected by childbirth experiences) and PBE scores. A statistically significant negative relationship was found between the W-DEQ-A scale score and the PBE score of pregnant women (p=0.000). It was found that the PBE score decreased as the W-DEQ-A scale score of the participants increased. The ability of pregnant women's PBE score to predict W-DEQ-A scale score was evaluated by linear regression analysis. After excluding the confounding effect of the variables of educational status, work status, family income status, spousal support status, participation in childbirth preparation classes, going to controls, getting information about birth methods, and being affected by childbirth experiences, a statistically significant relationship was found between the W-DEQ-A scale score and the PBE score. It was found that an increase of one unit in the PBE score of pregnant women decreased the W-DEQ-A scale score by 0.698 units. Conclusion: The findings obtained from the research have shown that fear of childbirth decreases as prenatal attachment increases in pregnant women, and there are some socio-demographic and obstetric characteristics that affect prenatal attachment and fear of childbirth. In this direction, it is recommended that nurses and midwives carefully evaluate prenatal attachment situations, the way they perceive childbirth, their readiness for childbirth, the presence of fear of childbirth, which may affect the birth and postpartum processes of pregnant women during prenatal care follow-ups. Keywords: Mother-fetus Relationship, Attachment, Fear of Childbirth, Pregnant