Prevalence of Fear of Childbirth among Nulliparous Women

Objective: To assess the prevalence and factors associated with fear of childbirth (FOC) among nulliparous Thai women and to explore the relationship between FOC and postpartum depression (PPD). Materials and Methods: A cross-sectional study was conducted at Thammasat University Hospital (TUH) among low-risk nulliparous women between March and August 2023. Sociodemographic data and obstetric history were gathered. FOC was assessed using the Wijma Delivery Expectancy/Experience Questionnaire-A (WDEQ-A) at between 32 and 37 weeks of gestation at the prenatal care clinic. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the risk of PPD within 72 hours after delivery at postpartum ward. Results: The study included 271 participants, with 240 delivered at TUH. The average gestational age was 34.7 weeks. The prevalence of high-tosevere FOC and the risk of PPD were 19.5% and 46.7%, respectively. Lack of family support and no information about delivery were significantly associated with the levels of FOC. No family support was the only significant predictor of high-to-severe FOC (AOR 5.62, 95% CI 1.34 to 23.51). Factors that were significantly associated with the risk of PPD included health coverage, occupation, family income, and level of FOC. Additionally, pregnant women with high-to-severe FOC were 2.68 times more likely to develop PPD (AOR 2.68, 95% CI 1.29 to 5.56), while those with high income of more than 1,600 USD per month had a 67% lower risk of PPD (AOR 0.33, 95% CI 0.11 to 0.95). Conclusion: The prevalence of high-to-severe FOC was 19.5%. Lack of family support and insufficient knowledge about delivery were associated with levels of FOC. FOC was a significant predictor of increased PPD risk. Screening for FOC during pregnancy should be performed to identify at-risk pregnant women and help prevent PPD. Moreover, providing knowledge and encouraging family involvement play a crucial role in reducing FOC.