Mapping fear of childbirth and the role of family support in pregnant women: A network approach.

BACKGROUND

Fear of childbirth (FOC) is a common psychological concern among pregnant women and is associated with adverse maternal and neonatal outcomes.

AIM: To identify central dimensions of FOC and to explore their associations with family support within the same network in pregnant women, using network analysis.

METHODS

A cross-sectional study was conducted. Pregnant women were recruited in China from June to December 2023. They completed the Chinese version of the Childbirth Fear Questionnaire (C-CFQ) and the Family APGAR Index. Network analysis was conducted to identify central dimensions FOC and family support components through node centrality metrics, examine their structural interrelationships, and compare network structures between women with and without prior adverse pregnancy outcomes.

FINDINGS: A total of 740 pregnant women were included. Fear of enjoying sexual intercourse less, vagina looking less attractive, and baby being hurt emerged as the nodes with the highest strength centrality. Family support was negatively correlated with FOC dimensions, with the strongest associations observed for fear of medical procedures and labor pain. Women with prior adverse pregnancy outcomes showed a denser FOC-family support network.

DISCUSSION: Our findings highlight the value of adopting dimension-specific intervention strategies. Addressing FOC through these targeted approaches, along with enhancing family involvement, may help break the cycle of fear and improve maternal mental health.

CONCLUSION

Network analysis provides valuable guidance for midwives, suggesting that tailored interventions targeting central dimensions of fear and leveraging family resources can enhance prenatal care, especially for women with a history of adverse pregnancy outcomes.