A comparison of childbirth self-efficacy, fear of childbirth, and labor pain intensity between primiparas and multiparas during the latent phase of labor: a cross-sectional study.
A cross-sectional study
Childbirth self-efficacy
Fear of childbirth
Labor pain
Multipara
Primipara
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
31 May 2024
31 May 2024
Historique:
received:
03
01
2023
accepted:
09
05
2024
medline:
1
6
2024
pubmed:
1
6
2024
entrez:
31
5
2024
Statut:
epublish
Résumé
Childbirth is a long-lasting physiological stress. As one of the main stressors, labor pain exists throughout the whole process. Childbirth self-efficacy is the confidence, or belief that they can manage pain during childbirth. This sense of self-efficacy determines how pregnant women deal with labor pain and enables them to regulate their behavior and actively deal with childbirth. However, the difference in pain sensitivity between single births (primiparas) and multiple births (multiparas) has rarely been investigated. This study is aimed at investigating self-efficacy, fear of childbirth, labor pain of primiparas and multiparas and exploring factors related to the perceived labor pain intensity of pregnant women. Prospective cross-sectional study. Labour and delivery in a large academic specialized hospital in Guangzhou, China. A total of 347 women, (182 primiparas and 165 multiparas) were enrolled in the data analysis. Pain was assessed before cervical dilatation (cervical dilatation ≤ 3 cm for the first delivery and ≤ 2 cm for the second delivery). The general information of participants was obtained by questionnaire and obstetrical records of the subjects were obtained from the electronic medical records extracted from the electronic medical record system (EMRS). Childbirth self-efficacy, fear of childbirth (FOC) and labor pain were compared between primiparas and multiparas. Paired t-test, chi-square test, Mann-Whitney test, univariate and multivariate regression analysis were used to analyze labor pain between the two groups and investigate factors related perceived labor pain intensity. The total scores related to fear of childbirth, fetal health, self-control, and labor pain injury of multiparas were notably reduced compared with primiparas (all P < 0.05). The perceived labor pain intensity and duration of the first stage of labor was reduced in the multipara group compared with the primipara group. The childbirth control sense of the multipara was better than that of the primipara. The perceived labor pain intensity was negatively correlated with advanced age (age ≥ 35 years), self-efficacy score, family support, and education (all P < 0.05). In contrast, the perceived labor pain intensity was positively correlated with tension, severe fear of childbirth, and anxiety (P < 0.05). Self-efficacy, gravidity, delivery cognition, and fear of childbirth were independent risk factors for the perceived labor pain intensity in the latent period (all P < 0.05). Fear of childbirth is a predictor of perceived labor pain intensity. The extent of labor pain (minimum and maximum) can be predicted by the level of fear the expectant mother has. During the latent phase of labor, self-efficacy, fear of childbirth and labor pain are different between primiparas and multiparas.
Sections du résumé
BACKGROUND
BACKGROUND
Childbirth is a long-lasting physiological stress. As one of the main stressors, labor pain exists throughout the whole process. Childbirth self-efficacy is the confidence, or belief that they can manage pain during childbirth. This sense of self-efficacy determines how pregnant women deal with labor pain and enables them to regulate their behavior and actively deal with childbirth. However, the difference in pain sensitivity between single births (primiparas) and multiple births (multiparas) has rarely been investigated.
OBJECTIVES
OBJECTIVE
This study is aimed at investigating self-efficacy, fear of childbirth, labor pain of primiparas and multiparas and exploring factors related to the perceived labor pain intensity of pregnant women.
DESIGN
METHODS
Prospective cross-sectional study.
SETTING(S)
METHODS
Labour and delivery in a large academic specialized hospital in Guangzhou, China.
PARTICIPANTS
METHODS
A total of 347 women, (182 primiparas and 165 multiparas) were enrolled in the data analysis. Pain was assessed before cervical dilatation (cervical dilatation ≤ 3 cm for the first delivery and ≤ 2 cm for the second delivery).
METHOD
METHODS
The general information of participants was obtained by questionnaire and obstetrical records of the subjects were obtained from the electronic medical records extracted from the electronic medical record system (EMRS). Childbirth self-efficacy, fear of childbirth (FOC) and labor pain were compared between primiparas and multiparas. Paired t-test, chi-square test, Mann-Whitney test, univariate and multivariate regression analysis were used to analyze labor pain between the two groups and investigate factors related perceived labor pain intensity.
RESULTS
RESULTS
The total scores related to fear of childbirth, fetal health, self-control, and labor pain injury of multiparas were notably reduced compared with primiparas (all P < 0.05). The perceived labor pain intensity and duration of the first stage of labor was reduced in the multipara group compared with the primipara group. The childbirth control sense of the multipara was better than that of the primipara. The perceived labor pain intensity was negatively correlated with advanced age (age ≥ 35 years), self-efficacy score, family support, and education (all P < 0.05). In contrast, the perceived labor pain intensity was positively correlated with tension, severe fear of childbirth, and anxiety (P < 0.05). Self-efficacy, gravidity, delivery cognition, and fear of childbirth were independent risk factors for the perceived labor pain intensity in the latent period (all P < 0.05).
CONCLUSIONS
CONCLUSIONS
Fear of childbirth is a predictor of perceived labor pain intensity. The extent of labor pain (minimum and maximum) can be predicted by the level of fear the expectant mother has. During the latent phase of labor, self-efficacy, fear of childbirth and labor pain are different between primiparas and multiparas.
Identifiants
pubmed: 38822235
doi: 10.1186/s12884-024-06571-3
pii: 10.1186/s12884-024-06571-3
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
400Subventions
Organisme : Research project of Guangdong Nurses Association
ID : gdshsxh2023ms66
Organisme : Research project of Guangdong Nurses Association
ID : gdshsxh2023ms66
Organisme : Research project of Guangdong Nurses Association
ID : gdshsxh2023ms66
Organisme : Guangzhou Health science and technology project
ID : 20241A011031
Organisme : Guangzhou Health science and technology project
ID : 20241A011031
Organisme : Guangzhou Health science and technology project
ID : 20241A011037
Informations de copyright
© 2024. The Author(s).
Références
Carlhäll S, Nelson M, Svenvik M, Axelsson D, Blomberg M. Maternal childbirth experience and time in labor: a population-based cohort study. Sci Rep. 2022;12(1):11930.
doi: 10.1038/s41598-022-14711-y
pubmed: 35831421
pmcid: 9279318
Hulsbosch LP, Nyklíček I, Potharst ES, Boekhorst MG, Pop VJ. Development of the Labor Pain Relief attitude questionnaire for pregnant women (LPRAQ-p). BMC Pregnancy Childbirth. 2020;20(1):718.
doi: 10.1186/s12884-020-03415-8
pubmed: 33228637
pmcid: 7686754
Gido R, Yadeta TA, Tura AK. Utilization of Obstetric Analgesia for Labor Pain Management and Associated Factors among Obstetric Care Providers in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study. Obstet Gynecol Int 2021, 2021:9973001.
Zha Y, Gong X, Yang C, Deng D, Feng L, Luo A, Wan L, Qiao F, Zeng W, Chen S, et al. Epidural analgesia during labor and its optimal initiation time-points: a real-world study on 400 Chinese nulliparas. Med (Baltim). 2021;100(9):e24923.
doi: 10.1097/MD.0000000000024923
Deepak D, Kumari A, Mohanty R, Prakash J, Kumar T, Priye S. Effects of Epidural Analgesia on Labor Pain and Course of Labor in Primigravid parturients: a prospective non-randomized comparative study. Cureus. 2022;14(6):e26090.
pubmed: 35875290
pmcid: 9295827
Veringa-Skiba IK, de Bruin EI, van Steensel FJA, Bögels SM. Fear of childbirth, nonurgent obstetric interventions, and newborn outcomes: a randomized controlled trial comparing mindfulness-based childbirth and parenting with enhanced care as usual. Birth. 2022;49(1):40–51.
doi: 10.1111/birt.12571
pubmed: 34250636
Fairbrother N, Albert A, Collardeau F, Keeney C. The Childbirth Fear Questionnaire and the Wijma Delivery Expectancy Questionnaire as Screening Tools for specific phobia, fear of Childbirth. Int J Environ Res Public Health 2022, 19(8).
Massae AF, Larsson M, Leshabari S, Mbekenga C, Pembe AB, Svanberg AS. Predictors of fear of childbirth and depressive symptoms among pregnant women: a cross-sectional survey in Pwani region, Tanzania. BMC Pregnancy Childbirth. 2021;21(1):704.
doi: 10.1186/s12884-021-04169-7
pubmed: 34666696
pmcid: 8524824
Stjernholm YV, Charvalho PDS, Bergdahl O, Vladic T, Petersson M. Continuous support promotes Obstetric Labor Progress and Vaginal Delivery in Primiparous Women - A Randomized Controlled Study. Front Psychol. 2021;12:582823.
doi: 10.3389/fpsyg.2021.582823
pubmed: 33679510
pmcid: 7928421
Logtenberg SLM, Verhoeven CJ, Oude Rengerink K, Sluijs AM, Freeman LM, Schellevis FG, Mol BW. Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study. BMC Pregnancy Childbirth. 2018;18(1):347.
doi: 10.1186/s12884-018-1986-8
pubmed: 30144796
pmcid: 6109320
Ankaya S, Imek B. Effects of Antenatal Education on Fear of Birth, Depression, anxiety, Childbirth Self-Efficacy, and Mode of Delivery in Primiparous pregnant women: a prospective randomized controlled study. Clin Nurs Res 2021, 30.
Shakarami A, Mirghafourvand M, Abdolalipour S, Jafarabadi MA, Iravani M. Comparison of fear, anxiety and self-efficacy of childbirth among primiparous and multiparous women. BMC Pregnancy Childbirth. 2021;21(1):642.
doi: 10.1186/s12884-021-04114-8
pubmed: 34548055
pmcid: 8456545
Munkhondya BMJ, Munkhondya TE, Chirwa E, Wang H. Efficacy of companion-integrated childbirth preparation for childbirth fear, self-efficacy, and maternal support in primigravid women in Malawi. BMC Pregnancy Childbirth. 2020;20(1):48.
doi: 10.1186/s12884-019-2717-5
pubmed: 31964346
pmcid: 6975021
Smith A, Laflamme E, Komanecky C. Pain Management in Labor. Am Family Phys. 2021;103(6):355–64.
Saiman L, Acker KP, Dumitru D, Messina M, Goffman D. Infection prevention and control for labor and delivery, well baby nurseries, and neonatal intensive care units. Semin Perinatol. 2020;44(7):151320.
doi: 10.1016/j.semperi.2020.151320
pubmed: 33071033
pmcid: 7550181
Guo H, Que M, Shen J, Nie Q, Chen Y, Huang Q, Jin A. Effect of Music Therapy Combined with Free Position Delivery on Labor Pain and Birth Outcomes. Appl Bionics Biomech 2022, 2022:8963656.
Huang J, Huang J, Li Y, Liao B. The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis. BMC Pregnancy Childbirth. 2021;21(1):643.
doi: 10.1186/s12884-021-04123-7
pubmed: 34551755
pmcid: 8456556
Akköz Çevik S, Karaduman S. The effect of sacral massage on labor pain and anxiety: a randomized controlled trial. Jpn J Nurs Sci. 2020;17(1):e12272.
doi: 10.1111/jjns.12272
pubmed: 31298494
Hou Y, Zhou X, Yao M, Liu S. Fear of childbirth and its predictors in re-pregnant women after cesarean section: a cross-sectional multicenter study in China. BMC Pregnancy Childbirth. 2022;22(1):393.
doi: 10.1186/s12884-022-04721-z
pubmed: 35525927
pmcid: 9080153
Deng Y, Lin Y, Yang L, Liang Q, Fu B, Li H, Zhang H, Liu Y. A comparison of maternal fear of childbirth, labor pain intensity and intrapartum analgesic consumption between primiparas and multiparas: a cross-sectional study. Int J Nurs Sci. 2021;8(4):380–7.
pubmed: 34631987
pmcid: 8488849
Weil J, Liu JY. Correlation analysis between fear of childbirth and self-efficacy in pregnant women. Chin Nurs Res. 2017;31(6):3.
Wei J, Liu J, Zhang L, Wu Y, Fu C, Department N. Reliability and validity of the Chinese version of Childbirth attitudes Questionnaire. J Nurs ence.
Koyuncu SB, Bülbül M. The impact of yoga on fear of childbirth and childbirth self-efficacy among third trimester pregnants. Complement Ther Clin Pract. 2021;44:101438.
doi: 10.1016/j.ctcp.2021.101438
pubmed: 34252859
Liang Q, Wang X, Deng Y, Lu L, Fu B. Effect of an evidence-based activity management program on delivery outcomes in pregnant women after intraspinal labor analgesia. Am J Translational Res. 2021;13(4):3054–63.
Adams SS, Eberhard-Gran M, Eskild A. Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. BJOG. 2012;119(10):1238–46.
doi: 10.1111/j.1471-0528.2012.03433.x
pubmed: 22734617
Körükcü Ö, Fırat MZ, Kukulu K. Relationship between fear of childbirth and anxiety among Turkish pregnant women. Procedia - Social Behav Sci 2010.
Kaplan E, Çevik S. The effect of guided imagery and reflexology on pain intensity, duration of labor and birth satisfaction in primiparas: randomized controlled trial. Health Care Women Int. 2021;42(4–6):691–709.
doi: 10.1080/07399332.2021.1880411
pubmed: 34156906
Liao CC, Lan SH, Yen YY, Hsieh YP, Lan SJ. Aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: a systematic review and meta-analysis. J Obstet Gynaecol. 2021;41(1):21–31.
doi: 10.1080/01443615.2019.1673707
pubmed: 32666866
Saisto T, Ylikorkala O, Halmesmäki E. Factors associated with fear of delivery in second pregnancies. Obstet Gynecol. 1999;94(5 Pt 1):679–82.
pubmed: 10546709
Størksen HT, Garthus-Niegel S, Vangen S, Eberhard-Gran M. The impact of previous birth experiences on maternal fear of childbirth. Acta Obstet Gynecol Scand. 2013;92(3):318–24.
doi: 10.1111/aogs.12072
pubmed: 23278249
Qi WH, Miao WJ, Ji YZ, Li C, Wang JH. The analgesic effect of Transcutaneous Electrical Acupoint Stimulation on Labor: a Randomized Control Study. Int J Gen Med. 2021;14:559–69.
doi: 10.2147/IJGM.S291699
pubmed: 33654423
pmcid: 7910100
Zhao Y, Wu J, Yang H, Yin X, Li D, Qiu L, Sun N, Gong Y. Factors associated with childbirth self-efficacy: a multicenter cross-sectional study in China. Midwifery. 2021;93:102883.
doi: 10.1016/j.midw.2020.102883
pubmed: 33246143
Çankaya S, Şimşek B. Effects of Antenatal Education on Fear of Birth, Depression, anxiety, Childbirth Self-Efficacy, and Mode of Delivery in Primiparous pregnant women: a prospective randomized controlled study. Clin Nurs Res. 2021;30(6):818–29.
doi: 10.1177/1054773820916984
pubmed: 32281410
Zhang HX, Zhao YY, Wang YQ. Analysis of the characteristics of pregnancy and delivery before and after implementation of the two-child policy. Chin Med J (Engl). 2018;131(1):37–42.
doi: 10.4103/0366-6999.221268
pubmed: 29271378
Kamalimanesh B, Moradi M, Fathi M, Afiat M, Rezazadeh MB, Shakeri MT. Effect of self-hypnosis on the experience of delivery fear and duration of labor in primiparity: A randomized clinical trial. Birjand University of Medical Sciences and Health Services 2021(1).
Bülez A, Soukpnar N, Sayner FD. A quasi-experimental study to assess Hypnobirthing Educational intervention on Labor Pain and Fear of Childbirth—the case of Eskisehir/Turkey. Int J Childbirth. 2020;10(3):167–78.
doi: 10.1891/IJCBIRTH-D-19-00008
Carolin J. Tilmann, von, Soest, Kerstin, Weidner, Andreas, Seidler, Malin: Labor pain in women with and without severe fear of childbirth: A population-based, longitudinal study. Birth (Berkeley, Calif) 2018.
Fenwick J, Toohill J, Gamble J, Creedy DK, Buist A, Turkstra E, Sneddon A, Scuffham PA, Ryding EL. Effects of a midwife psycho-education intervention to reduce childbirth fear on women’s birth outcomes and postpartum psychological wellbeing. BMC Pregnancy Childbirth. 2015;15:284.
doi: 10.1186/s12884-015-0721-y
pubmed: 26518597
pmcid: 4628230