Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional study

Abstract Introduction Fear of childbirth is a well‐known problem during pregnancy and can have implications for childbirth, including prolonged labor, use of epidural analgesia, obstetric complications, presence of traumatic stress symptoms, or request for an elective cesarean section. The coronavir...

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Main Authors: Sanne J. M. Zilver, Yvette M. G. A. Hendrix, Birit F. P. Broekman, Robert A. deLeeuw, Christianne J. M. deGroot, Maria G. vanPampus
Format: Article
Language:English
Published: Wiley 2022-10-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14409
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author Sanne J. M. Zilver
Yvette M. G. A. Hendrix
Birit F. P. Broekman
Robert A. deLeeuw
Christianne J. M. deGroot
Maria G. vanPampus
author_facet Sanne J. M. Zilver
Yvette M. G. A. Hendrix
Birit F. P. Broekman
Robert A. deLeeuw
Christianne J. M. deGroot
Maria G. vanPampus
author_sort Sanne J. M. Zilver
collection DOAJ
description Abstract Introduction Fear of childbirth is a well‐known problem during pregnancy and can have implications for childbirth, including prolonged labor, use of epidural analgesia, obstetric complications, presence of traumatic stress symptoms, or request for an elective cesarean section. The coronavirus disease 2019 (COVID‐19) pandemic has affected mental health and therefore could have increased fear of childbirth during the pandemic. The aim of this study was to investigate fear of childbirth during the pandemic in the Netherlands compared with a reference group from before the pandemic. Material and methods We conducted a cross‐sectional study to evaluate pregnant women during the first and second waves of COVID‐19 compared with both each other and with pregnant women from before the pandemic. Participants were recruited through social media platforms, hospitals, and midwifery practices. Pregnant women aged ≥18 years who had mastered the Dutch language were eligible to participate. Fear of childbirth was measured with the Wijma Delivery Expectancy Questionnaire online using a cut‐off score of ≥85 to indicate clinically relevant fear of childbirth. The primary outcome was the prevalence of fear of childbirth. We undertook additional analyses to specifically look at possible effect modification. Results In total, 1102 pregnant women completed the questionnaire during the first wave of the pandemic, 731 during the second wave, and 364 before the pandemic. Fear of childbirth was present in 10.6%, 11.4%, and 18.4%, respectively. We considered possible effect modification, which indicated that age and parity had a significant influence. In participants during the first wave of COVID‐19, nulliparous women had significantly lower odds (odds ratio [OR] 0.50; 95% confidence interval [CI] 0.34–0.73; p < 0.01) of having a fear of childbirth than did the reference group. Both younger participants in the first wave (OR 0.59; 95% CI 0.37–0.93; p < 0.05) and older participants in the first wave (OR 0.44; 95% CI 0.28–0.71; p < 0.01) and the second wave (OR 0.36; 95% CI 0.21–0.62; p < 0.01) of COVID‐19 had lower odds of fear of childbirth than the reference group. Conclusions Pregnant women during the first and second waves of COVID‐19 had lower fear of childbirth scores than pregnant women before the pandemic, indicating less fear of childbirth during the pandemic. This could be explained by an increased level of information, more time to consume information, and better work–life balance with more people working at home during the pandemic.
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spelling doaj-art-1f23d9f07a8e433b8db47cc13263af4d2025-08-20T03:31:00ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-10-01101101129113410.1111/aogs.14409Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional studySanne J. M. Zilver0Yvette M. G. A. Hendrix1Birit F. P. Broekman2Robert A. deLeeuw3Christianne J. M. deGroot4Maria G. vanPampus5Department of Obstetrics and Gynecology Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction & Development research institute Amsterdam the NetherlandsDepartment of Obstetrics and Gynecology, OLVG Amsterdam the NetherlandsDepartment of Psychiatry, OLVG and Amsterdam UMC Amsterdam the NetherlandsDepartment of Obstetrics and Gynecology Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction & Development research institute Amsterdam the NetherlandsDepartment of Obstetrics and Gynecology Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction & Development research institute Amsterdam the NetherlandsDepartment of Obstetrics and Gynecology, OLVG Amsterdam the NetherlandsAbstract Introduction Fear of childbirth is a well‐known problem during pregnancy and can have implications for childbirth, including prolonged labor, use of epidural analgesia, obstetric complications, presence of traumatic stress symptoms, or request for an elective cesarean section. The coronavirus disease 2019 (COVID‐19) pandemic has affected mental health and therefore could have increased fear of childbirth during the pandemic. The aim of this study was to investigate fear of childbirth during the pandemic in the Netherlands compared with a reference group from before the pandemic. Material and methods We conducted a cross‐sectional study to evaluate pregnant women during the first and second waves of COVID‐19 compared with both each other and with pregnant women from before the pandemic. Participants were recruited through social media platforms, hospitals, and midwifery practices. Pregnant women aged ≥18 years who had mastered the Dutch language were eligible to participate. Fear of childbirth was measured with the Wijma Delivery Expectancy Questionnaire online using a cut‐off score of ≥85 to indicate clinically relevant fear of childbirth. The primary outcome was the prevalence of fear of childbirth. We undertook additional analyses to specifically look at possible effect modification. Results In total, 1102 pregnant women completed the questionnaire during the first wave of the pandemic, 731 during the second wave, and 364 before the pandemic. Fear of childbirth was present in 10.6%, 11.4%, and 18.4%, respectively. We considered possible effect modification, which indicated that age and parity had a significant influence. In participants during the first wave of COVID‐19, nulliparous women had significantly lower odds (odds ratio [OR] 0.50; 95% confidence interval [CI] 0.34–0.73; p < 0.01) of having a fear of childbirth than did the reference group. Both younger participants in the first wave (OR 0.59; 95% CI 0.37–0.93; p < 0.05) and older participants in the first wave (OR 0.44; 95% CI 0.28–0.71; p < 0.01) and the second wave (OR 0.36; 95% CI 0.21–0.62; p < 0.01) of COVID‐19 had lower odds of fear of childbirth than the reference group. Conclusions Pregnant women during the first and second waves of COVID‐19 had lower fear of childbirth scores than pregnant women before the pandemic, indicating less fear of childbirth during the pandemic. This could be explained by an increased level of information, more time to consume information, and better work–life balance with more people working at home during the pandemic.https://doi.org/10.1111/aogs.14409anxietycoronavirusCOVID‐19fear of childbirthpregnancySars‐Cov‐2
spellingShingle Sanne J. M. Zilver
Yvette M. G. A. Hendrix
Birit F. P. Broekman
Robert A. deLeeuw
Christianne J. M. deGroot
Maria G. vanPampus
Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional study
Acta Obstetricia et Gynecologica Scandinavica
anxiety
coronavirus
COVID‐19
fear of childbirth
pregnancy
Sars‐Cov‐2
title Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional study
title_full Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional study
title_fullStr Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional study
title_full_unstemmed Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional study
title_short Fear of childbirth in pregnancy was not increased during the COVID‐19 pandemic in the Netherlands: a cross‐sectional study
title_sort fear of childbirth in pregnancy was not increased during the covid 19 pandemic in the netherlands a cross sectional study
topic anxiety
coronavirus
COVID‐19
fear of childbirth
pregnancy
Sars‐Cov‐2
url https://doi.org/10.1111/aogs.14409
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