Fear of childbirth: cross-validation and comparison between two cultures

Abstract

Background: Fear of childbirth (FoC) could have significant physical and emotional consequences. In a large Norwegian study, six different factors of the widely-used instrument to measure FoC, Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), were identified. In the current study, we wished to confirm those factors and compare levels of the different dimensions between expectant mothers from Israel and Norway. Methods: Women from Israel (n=490) and Norway (n=2918) were recruited during prenatal check-ups around 32 weeks of gestation. They were recruited in community clinics and a university hospital. All participants filled in self-administered questionnaires, including the 33-item W-DEQ. Findings: The Norwegian 6-factor solution of the W-DEQ fit well with the Israeli data. Overall, primiparae reported more FoC than multiparae. When comparing Israeli and Norwegian Primiparae, Israelis were more concerned about negative outcomes for the child while Norwegians were more concerned about loneliness, feeling less self-efficacy, negatively appraising birth, and lacking positive anticipation. Similar results were found among multiparae, except that Israelis had more general and pain fear, and Norwegians did not report more lack of positive anticipation. Discussion: Cultural differences between Israel and Norway are reflected in the levels of FoC subscales. Israeli birth culture is very medicalized, motherhood is highly revered and there is emphasis on having "perfect babies". In contrast, Norwegian women have fewer children and birth is less medicalized. This could explain why Israeli women are more concerned their child might be harmed during birth, while Norwegian women are more concerned with physical and emotional expectations during birth.