Department of Psychological Sciences, Institute of Psychology, Health& Society, University of Liverpool, Liverpool, UK.
Clinical Psychology, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK.
J Clin Nurs. 2018 Jul;27(13-14):2523-2535. doi: 10.1111/jocn.14219. Epub 2018 Jan 30.
This meta-synthesis aimed to identify key elements contributing to FOC derived from women's own reports.
Fear of childbirth (FOC) encompasses fear or anxiety about giving birth, which can resemble a phobic response. FOC holds implications for women's antenatal and postnatal well-being, and decisions made about the birth but a clear definition of the construct does not exist.
A meta-synthesis was conducted by searching databases (Web of Knowledge, CINAHL, EBSCO, MEDLINE, PsychInfo and PsychArticles) for qualitative studies describing women's perspectives with respect to fear, anxiety, concerns, phobia or stress about birth. A total of 25 papers, reporting findings from 24 studies, fulfilled eligibility criteria and were included in the synthesis.
Six key elements of FOC were identified; fears of the unknown, potential for injury, pain, capacity to give birth, losing control and adequacy of support from care providers. A single overarching theme linking all elements was "the unpredictability of childbirth." Three moderators of FOC were also identified; awareness of negative birthing experiences, information received about birth and support received from care providers.
Findings highlight the role of uncertainty in the birthing process as an overarching theme underpinning women's fears. Enhancing tolerance of uncertainty may be a way to reduce women's FOC.
Identification of the elements and moderators of FOC provide an insight into the potential mechanisms that contribute to women's fears, which can be used to inform methods of identifying women with FOC or a basis upon which to base supportive strategies to reduce women's fears for giving birth.
本元分析旨在从女性自身报告中确定导致生育恐惧的关键因素。
生育恐惧（FOC）包括对分娩的恐惧或焦虑，这类似于恐惧症反应。FOC 对女性的产前和产后健康以及分娩决策有影响，但该构念没有明确的定义。
通过搜索数据库（Web of Knowledge、CINAHL、EBSCO、MEDLINE、PsychInfo 和 PsychArticles），查找描述女性对分娩恐惧、焦虑、担忧、恐惧症或压力的观点的定性研究，进行元分析。共有 25 篇论文，来自 24 项研究，符合纳入标准并纳入综合分析。
确定了 FOC 的六个关键要素；对未知的恐惧、受伤的可能性、疼痛、分娩能力、失去控制和来自护理提供者的支持的充分性。一个将所有要素联系在一起的单一总体主题是“分娩的不可预测性”。还确定了 FOC 的三个调节因素；对负面分娩经历的认识、关于分娩的信息以及来自护理提供者的支持。
研究结果强调了不确定性在分娩过程中的作用，这是女性恐惧的一个总体主题。提高对不确定性的容忍度可能是减少女性 FOC 的一种方法。
确定 FOC 的要素和调节因素提供了对导致女性恐惧的潜在机制的深入了解，可以用于识别具有 FOC 或基于该基础的女性的方法支持策略，以减少女性对分娩的恐惧。
