The Relationship between Fear of Childbirth and Attachment Style, and Associated Factors among Pregnant Women Registered at Comprehensive Health Service Centers: A Cross-sectional Study in Iran.

BACKGROUND

Fear of childbirth (FOC) during pregnancy is associated with adverse effects on mothers' and children's health. Factors related to FOC include physical, psychological, and social aspects. The purpose of the study is to investigate the relationship between FOC and attachment styles and to examine the factors associated with FOC.

MATERIALS AND

METHODS

This analytical cross-sectional study was carried out using cluster sampling of comprehensive health centers and convenience sampling of individuals from November 21, 2023, to March 20, 2024. The participants were 330 pregnant Iranian women across different trimesters. The questionnaire included Collins and Read's Revised Adult Attachment Scale and the Wijma Delivery Expectancy/Experience Questionnaire, which was completed online. A t-test and one-way analysis of variance were used to compare the means of variables. Tukey's post hoc test examined pairwise comparisons. All analyses were conducted using SPSS version 23. p < 0.05 was considered significant.

RESULTS

The mean (SD) FOC of participants was 56.37 (27.78). The results showed that the average FOC of people with a dismissive-avoidant attachment style was 10 units higher than that of people with a fearful-avoidant attachment style (Mean difference: 10.72, 95% confidence interval [CI]: 0.96-20.49, p = 0.025). Also, FOC was significantly related to income satisfaction (F = 5.16, p = 0.006), unwanted pregnancy (t = 5.88, p = 0.013), others' role in creating FOC (F = 11.83, p < 0.001), and the supporting person (t = -2.44, p < 0.015).

CONCLUSIONS

Attachment style and psychosocial factors play an important role in shaping FOC. Early identification of these patterns can help healthcare providers support women and promote a positive pregnancy and birth experience.