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Cluster analysis of fear of childbirth, anxiety, depression, and childbirth self-efficacy
Umeå University, Faculty of Medicine, Department of Nursing. Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden.
Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden; Women’s Mental Health During the Reproductive Lifespan (WOMHER), Uppsala University, Uppsala, Sweden.
Women’s and Children’s Health, Karolinska Institutet, Solna, Sweden.
Department of Women’s and Children’s HEALTH, Uppsala University, Uppsala, Sweden.
2024 (English)In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 53, no 5, p. 522-533Article in journal (Refereed) Published
Abstract [en]

Objective: To identify clusters of women based on anxiety, depression, fear of birth, and childbirth self-efficacy and factors associated with the clusters.

Design: Cross-sectional survey.

Setting: Online in Sweden. Participants: Pregnant women (N = 1,419).

Methods: We collected data through online questionnaires. We included scales to measure anxiety, depression, worries about and fear of birth, and self-efficacy in a kappa-means cluster analysis. We calculated odds ratios with 95% confidence intervals between clusters and background variables.

Results: We identified 4 clusters based on severity: Resourceful-Robust, Resourceful-Fearful, Vulnerable-Fearful, and Fragile-Fearful. Participants in the Resourceful-Fearful and Vulnerable-Fearful clusters were more likely to report mental health problems than those in the Resourceful-Robust cluster. Participants in the Vulnerable-Fearful and Fragile-Fearful clusters were more likely to report mental health problems than those in the Resourceful-Robust cluster. Participants in the Fragile-Fearful cluster were more likely to be multiparous, report that their pregnancy was not normal, and prefer cesarean birth than those in the Resourceful-Robust cluster.

Conclusions: Women with childbirth fear may be vulnerable to anxiety and depression during the perinatal period, although the severity might vary. Self-efficacy might be a mediator against mental health problems. Findings demonstrated levels of severity, and the one-size-fits-all approach in Swedish health care may benefit from a more targeted approach for women with fear of childbirth.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 53, no 5, p. 522-533
Keywords [en]
anxiety, childbirth fear, cluster analysis, depression, self-efficacy, women
National Category
Nursing Gynaecology, Obstetrics and Reproductive Medicine
Identifiers
URN: urn:nbn:se:umu:diva-232517DOI: 10.1016/j.jogn.2024.04.004ISI: 001315494200001PubMedID: 38782047Scopus ID: 2-s2.0-85201270727OAI: oai:DiVA.org:umu-232517DiVA, id: diva2:1917400
Available from: 2024-12-02 Created: 2024-12-02 Last updated: 2025-02-11Bibliographically approved

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Hildingsson, Ingegerd

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CiteExportLink to record
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Citation style
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