Women's fear of childbirth during pregnancy: A concept analysis

Purpose

To map and analyze the concept of women's fear of childbirth (FOC) during pregnancy and to develop a new nursing diagnosis (ND).

Methods

Concept analysis based on Walker and Avant's methodology. An integrative literature search was conducted in Scopus, Web of Science, and CINAHL Complete databases, including peer-reviewed articles published in English from January 1981 to October 2022.

Findings

Thirty-one studies were included in the review. Women's FOC during pregnancy comprises three central categories: attributes, antecedents, and consequences. Nine main characteristics (attributes) are related to one or more of eight prior conditions (antecedents) that have the potential to exert negative or favorable impacts (consequences), depending on whether coping strategies have been a part of a fearful woman's pregnancy. These elements and relationships among them should be viewed as dynamic.

Conclusions

Women's FOC during pregnancy is a subjective, multidimensional, and dynamic concept that benefits prenatal care responses. A conceptual matrix on prenatal care will consider the factors underlying women's FOC and their potential mechanisms, how fearful pregnant women respond, the aspects that shape FOC, and how it influences outcomes when supporting pregnant women with FOC. Therefore, the study findings can be used to inform ways of identifying fearful women or as a basis for interventions to manage fears and enhance the confidence of pregnant women for childbirth.

Implications for nursing practice

The results of this study help nurses, OB nursing practitioners, nurse–midwives, and midwives to identify the condition of women's FOC during pregnancy and guide nursing therapeutic interventions to decrease the negative effects on women's health and well-being. Therefore, there are valuable reasons to propose using “fear of childbirth” as a ND in the class “coping responses” within domain coping/stress tolerance, contributing to refining the NANDA-I taxonomy.