Psychological Mechanisms in Fear of Childbirth: Intolerance of Uncertainty in Nulliparous and Multiparous Women.

INTRODUCTION

To gain more insight into psychological mechanisms associated with fear of childbirth (FoC), this study examined the relationship between intolerance of uncertainty (IU) and FoC in nulliparous and multiparous pregnant women, as well as the moderating role of maternal parity in this relationship, and the role of inhibitory IU and prospective IU in relation to FoC.

METHODS

Validated Dutch versions of the Wijma Delivery Expectations Questionnaire version A (W-DEQ-A) and the Intolerance of Uncertainty scale (IUS-12) were filled out by 410 nulliparous and multiparous pregnant women. Statistical analyses in this cross-sectional study included correlation analyses and (multivariate) linear regression analyses.

RESULTS

A significant, positive correlation was found between IU and FoC (ρ = 0.425, p < 0.001; b = 1.533, p < 0.001). Multivariate linear regression identified multiple variables contributing significantly to the level of FoC, with IU remaining the strongest predictor, both for the total group and for nulliparous and multiparous women separately. Maternal parity was not found to moderate the relationship between IU and FoC. Both inhibitory IU and prospective IU were significantly, positively associated with FoC.

CONCLUSION

Higher levels of IU are positively associated with higher levels of FoC in both nulliparous and multiparous women. Psychological treatment targeting FoC may benefit from focusing on managing uncertainty and increasing psychological flexibility. Future research is needed to better understand the role of IU in FoC during pregnancy, in order to increase maternal mental health and improve (post-partum) mother-child relationships.