Investigating the Direct and Indirect Effects of Corona-Related Fear on Childbirth Experience: The Mediating Role of COVID-19 Anxiety
Authors
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Zohreh Shahhosseini
Professor, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
https://orcid.org/0000-0003-1288-2277
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Leila Hajipour
Department of Midwifery, To.C., Islamic Azad University, Tonekabon, Iran.
https://orcid.org/0000-0001-9183-397X
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Roya Nikbakht
Assistant Professor of Biostatistics, Department of Biostatistics and Epidemiology, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
https://orcid.org/0000-0002-9684-8529
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Monirolsadate Hosseini Tabaghdehi
Associate Professor, Department of Midwifery, Sar.C., Islamic Azad University, Sari, Iran.
https://orcid.org/0000-0002-9485-3789
DOI:
https://doi.org/10.22100/ijhs.v12i4.1266Keywords:
Fear, Anxiety, , COVID-19, , ChildbirthAbstract
Background: During the Coronavirus pandemic, there is an increased risk of psychological disorders. Coronavirus causes fear and anxiety in pregnant women, leading to poor pregnancy outcomes. This study aimed to investigate the direct and indirect effect of corona-related fear on childbirth experiences: the mediating role of COVID-19 anxiety.
Methods: This study used the data from an analytical descriptive study conducted in 2021 in northern Iran. 278 samples were selected based on a multi-stage sampling method among women referring to the healthcare centers of Mazandaran University of Medical Sciences. Data were collected through the Fear of COVID-19 Scale (FCV-19S), the Corona Disease Anxiety Scale (CDAS), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). The structural equation model (SEM) in AMOS software version 24 was used for data analysis.
Results: The childbirth experience, fear of COVID-19, and corona-related anxiety mean scores were 78.99, 22.16, and 18.82, respectively. The direct effects of corona-related fear on corona-related anxiety and corona-related anxiety on childbirth experience were significant (P-value<0.05). Although the direct impact of corona-related fear on childbirth experience was not significant (P-value>0.05), its indirect effect was significant (P-value<0.05).
Conclusion: During the pandemic, people faced a critical situation that caused fear and anxiety in pregnant women, leading to negative childbirth experiences. Therefore, it is necessary for health care providers to provide support and practical advice, and use appropriate interventions to reduce fear and anxiety and promote positive childbirth experiences.
References
Organization WH. WHO recommendations on intrapartum care for a positive childbirth experience: World Health Organization; 2018.
Henriksen L, Grimsrud E, Schei B, Lukasse M, Group BS. Factors related to a negative birth experience-a mixed methods study. Midwifery 2017; 51:33-9. doi:10.1016/j.midw.2017.05.004
Elvander C, Cnattingius S, Kjerulff KH. Birth experience in women with low, intermediate or high levels of fear: findings from the first baby study. Birth 2013;40(4):289-96. doi:10.1111/birt.12065
Hildingsson I, Nilsson J, Merio E, Larsson B. Anxiety and depressive symptoms in women with fear of birth: A longitudinal cohort study. European Journal of Midwifery 2021;5. doi:10.18332/ejm/138941
Douglas PK, Douglas DB, Harrigan DC, Douglas KM. Preparing for pandemic influenza and its aftermath: mental health issues considered. International Journal of Emergency Mental Health 2009;11(3):137.
Corbett GA, Milne SJ, Hehir MP, Lindow SW, O'connell MP. Health anxiety and behavioural changes of pregnant women during the COVID-19 pandemic. European Journal of Obstetrics, Gynecology, and Reproductive Biology 2020;249:96. doi:10.1016/j.ejogrb.2020.04.022
Ballinger CB. Emotional disturbance during pregnancy and following delivery. Journal of Psychosomatic Research 1982;26(6):629-34. doi:10.1016/0022-3999(82)90079-4
Saccone G, Florio A, Aiello F, Venturella R, De Angelis MC, Locci M, et al. Psychological impact of coronavirus disease 2019 in pregnant women. American Journal of Obstetrics and Gynecology 2020;223(2):293-5. doi:10.1016/j.ajog.2020.05.003
Aydin E, Glasgow KA, Weiss SM, Khan Z, Austin T, Johnson MH, et al. Giving birth in a pandemic: women's birth experiences in England during COVID-19. BMC Pregnancy and Childbirth 2022;22(1):1-11. doi:10.1186/s12884-022-04637-8
Adamson B, Letourneau N, Lebel C. Prenatal maternal anxiety and children's brain structure and function: A systematic review of neuroimaging studies. Journal of Affective Disorders 2018; 241:117-26. doi:10.1016/j.jad.2018.08.029
Van den Bergh BR, Dahnke R, Mennes M. Prenatal stress and the developing brain: Risks for neurodevelopmental disorders. Development and Psychopathology 2018;30(3):743-62. doi:10.1017/S0954579418000342
Liepinaitienė A, Čirbaitė G, Stepanova J, Jotautis V, Dėdelė A. Women's experiences of childbirth during the COVID-19 pandemic in Lithuania. European Journal of Midwifery. 2024; 8:10-8332. doi:10.18332/ejm/185750
Su T-P, Lien T-C, Yang C-Y, Su YL, Wang J-H, Tsai S-L, et al. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan. Journal of Psychiatric Research 2007;41(1-2):119-30. doi:10.1016/j.jpsychires.2005.12.006
Cappon G, Vettoretti M, Sparacino G, Facchinetti A, Kim MK, Ko S-H, et al. 2019 Clinical practice guidelines for type 2 diabetes mellitus in Korea. Diabetes and Metabolism Journal 2019;43(4):398406. doi:10.4093/dmj.2019.0121
Yeşilçinar İ, Güvenç G, Kinci MF, Bektaş Pardes B, Kök G, Sivaslioğlu AA. Knowledge, fear, and anxiety levels among pregnant women during the COVID-19 pandemic: a cross-sectional study. Clinical Nursing Research 2022;31(4):758-65. doi:10.1177/10547738221085662
Muñoz-Vela FJ, Rodríguez-Díaz L, Gómez-Salgado J, Fernández-Carrasco FJ, Allande-Cussó R, Vázquez-Lara JM, Fagundo-Rivera J. Fear and anxiety in pregnant women during the COVID-19 pandemic: a systematic review. International Journal of Public Health 2023; 68:1605587. doi:10.3389/ijph.2023.1605587
Beebe KR, Lee KA, Carrieri‐Kohlman V, Humphreys J. The effects of childbirth self‐efficacy and anxiety during pregnancy on prehospitalization labor. Journal of Obstetric, Gynecologic and Neonatal 36(5):410-8. doi:10.1111/j.1552-6909.2007.00170.x
Dikmen-Yildiz P, Ayers S, Phillips L. Factors associated with post-traumatic stress symptoms (PTSS) 4-6 weeks and 6 months after birth: A longitudinal population-based study. Journal of Affective Disorders 2017; 221:238-45. doi:10.1016/j.jad.2017.06.049
Rúger-Navarrete A, Vázquez-Lara JM, Antúnez-Calvente I, Rodríguez-Díaz L, Riesco-González FJ, Palomo-Gómez R, Gómez-Salgado J, Fernández-Carrasco FJ. Antenatal fear of childbirth as a risk factor for a bad childbirth experience. Healthcare (Basel). 2023;11(3):297. doi:10.3390/healthcare11030297
Effati-Daryani F, Zarei S, Mohammadi A, Hemmati E, Ghasemi Yngyknd S, Mirghafourvand M. Depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. BMC Psychology 2020; 8:1-10. doi:10.1186/s40359-020-00464-8
Waldenström U. Why do some women change their opinion about childbirth over time? Birth 2004;31(2):102-7. doi:10.1111/j.0730-7659.2004.00287.x
Ahorsu DK, Lin C-Y, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scales: development and initial validation. International Journal of Mental Health and Addiction 2020:1-9. doi:10.1037/t78404-000
Alipour A, Ghadami A, Farsham A, Dorri N. A new self-reported assessment measure for COVID-19 anxiety scale (CDAS) in Iran: A Web-Based Study. Iranian Journal of Public Health 2020;49(7):1316-1323 doi:10.18502/ijph.v49i7.3585
Khorrami M, Pordelan N, Vakili S, Taghian F. Prediction of Coronavirus anxiety based on attachment styles, resilience, and life expectancy in drug users. Modern Care Journal. 2022;19(1):e121174. doi:10.5812/modernc-121174
Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. Journal of Psychosomatic Obstetrics and Gynecology 1998;19(2):84-97. doi:10.3109/01674829809048501
Mortazavi F. Validity and reliability of the Farsi version of Wijma delivery expectancy questionnaire: an exploratory and confirmatory factor analysis. Electronic Physician. 2017;9(6):4606-4615. doi:10.19082/4606
Waltz, C.F., Strickland, O.L., Lenz, E.R., 2010. Measurement in Nursing and Health Research, 4th ed. Springer Publishing Company, New York, USA.
Huynh T, Boise C, Kihntopf ME, Schaefer AA, Schafer M. "Fear and anxiety is what I recall the best.": A phenomenological examination of mothers' pregnancy experiences during COVID-19 in the United States. Midwifery 2023; 122:103700. doi:10.1016/j.midw.2023.103700
Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. Journal of Affective Disorders 2020; 277:5-13. doi:10.1016/j.jad.2020.07.126
Steimer T. The biology of fear-and anxiety-related behaviors. Dialogues in Clinical Neuroscience 2002;4(3):231-49. doi:10.31887/DCNS.2002.4.3/tsteimer
Salehi L, Rahimzadeh M, Molaei E, Zaheri H, Esmaelzadeh‐Saeieh S. The relationship among fear and anxiety of COVID‐19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model. Brain and Behavior 2020;10(11):e01835. doi:10.1002/brb3.1835
Giesbrecht G, Rojas L, Patel S, Kuret V, MacKinnon A, Tomfohr-Madsen L, et al. Fear of COVID-19, mental health, and pregnancy outcomes in the pregnancy during the COVID-19 pandemic study: Fear of COVID-19 and pregnancy outcomes. Journal of Affective Disorders 2022; 299:483-91. doi:10.1016/j.jad.2021.12.057
Tuma AH, Maser JD. Anxiety and the anxiety disorders: Routledge; 2019. doi:10.4324/9780203728215
Bayrampour H, Ali E, McNeil DA, Benzies K, MacQueen G, Tough S. Pregnancy-related anxiety: A concept analysis. International Journal of Nursing Studies 2016; 55:115-30. doi:10.1016/j.ijnurstu.2015.10.023
Nechita D, Nechita F, Motorga R. A review of the influence the anxiety exerts on human life. Romanian Journal of Morphology and Embryology 2018;59(4):1045-51.
Fan S, Guan J, Cao L, Wang M, Zhao H, Chen L, et al. Psychological effects caused by COVID-19 pandemic on pregnant women: A systematic review with meta-analysis. Asian Journal of Psychiatry 2021; 56:102533. doi:10.1016/j.ajp.2020.102533
Uludağ E, Serçekuş P, Vardar O, Özkan S, Alataş SE. Effects of online antenatal education on worries about labour, fear of childbirth, preparedness for labour and fear of COVID-19 during the COVID-19 pandemic: A single-blind randomised controlled study. Midwifery 2022; 115:103484. doi:10.1016/j.midw.2022.103484
Waldenström U, Hildingsson I, Rubertsson C, Rådestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth 2004;31(1):17-27. doi:10.1111/j.0730-7659.2004.0270.x
Schwartz H, McCusker J, Law S, Zelkowitz P, Somera J, Singh S. Perinatal mental healthcare needs among women at a community hospital. Journal of Obstetrics and Gynaecology Canada 2021;43(3):322-8. e1. doi:10.1016/j.jogc.2020.08.015
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