Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
Department of Child Health, Norwegian Institute of Public Health, Oslo, Norway.
BMC Pregnancy Childbirth. 2018 Sep 5;18(1):362. doi: 10.1186/s12884-018-1997-5.
Fear of childbirth (FOC) could have significant impact on women's childbearing choices and experience. Culture affects the way women conceptualize childbirth, influencing the fears and expectations they may hold in relation to it. In the current study, we examined differences in childbirth preferences of cesarean section and use of epidural analgesia between Norwegian and Israeli pregnant women. Later, we used the Norwegian six-factor solution of the widely-used Wijma Delivery Expectancy Questionnaire (W-DEQ-A) to compare levels of the different FOC factors. Finally, we investigated differences in the associations between FOC and childbirth preferences between the two countries.
Secondary analysis of two large surveys. Women from Israel (n = 490) and Norway (n = 2918) were recruited during prenatal check-ups in community clinics and a university hospital. At around 32 weeks of gestation, all participants filled out questionnaires, including the W-DEQ-A. Statistical analysis included exploratory factor analysis, confirmatory factor analysis, M/ANOVA, Spearman's Rho and Fisher's Z tests for the significance of the difference between independent correlations.
The Norwegian six-factor solution of the W-DEQ fit well with the Israeli data. Norwegian women were more concerned about loneliness, feeling less self-efficacy, negatively appraising birth, and lacking positive anticipation. Israeli women were more concerned about negative outcomes for the child and experienced greater general fear and fear of pain. Norwegian women preferred more cesarean sections compared to Israeli women, who preferred more epidural use than Norwegians. FOC factors were more strongly related to childbirth preferences among Norwegians.
Cultural differences between Israel and Norway are reflected by the differences seen in the levels of fear reported across the six factors. In Israel, birth culture is very medicalized, motherhood is highly revered, and there is an emphasis on having "perfect babies". In contrast, Norwegian women have fewer children, and birth is considered more natural. This could explain why Israeli women were more concerned that their child might be harmed during birth, while Norwegian women were more concerned with the physical and emotional expectations of birth.
分娩恐惧（FOC）可能对女性的生育选择和体验产生重大影响。文化影响了女性对分娩的概念化方式，影响了她们可能与之相关的恐惧和期望。在本研究中，我们检查了挪威和以色列孕妇剖宫产偏好和硬膜外镇痛使用的差异。之后，我们使用广泛使用的 Wijma 分娩期望问卷（W-DEQ-A）的挪威六因素解决方案来比较不同 FOC 因素的水平。最后，我们调查了两国之间 FOC 与分娩偏好之间关联的差异。
两项大型调查的二次分析。以色列（n=490）和挪威（n=2918）的女性在社区诊所和大学医院的产前检查中招募。大约在 32 周妊娠时，所有参与者填写了问卷，包括 W-DEQ-A。统计分析包括探索性因素分析、验证性因素分析、M/ANOVA、Spearman's Rho 和 Fisher's Z 检验用于检验独立相关性之间差异的显著性。
W-DEQ-A 的挪威六因素解决方案与以色列数据拟合良好。挪威女性更担心孤独、自我效能感降低、对分娩的负面评价以及缺乏积极的预期。以色列女性更担心孩子的负面后果，并经历了更大的普遍恐惧和对疼痛的恐惧。与以色列女性相比，挪威女性更喜欢更多的剖宫产，而以色列女性比挪威女性更喜欢更多的硬膜外使用。FOC 因素与挪威女性的分娩偏好关系更密切。
以色列和挪威之间的文化差异反映在报告的六个因素的恐惧水平差异上。在以色列，分娩文化非常医学化，母亲身份备受推崇，并且强调要有“完美的婴儿”。相比之下，挪威女性生育的孩子较少，分娩被认为更自然。这可以解释为什么以色列女性更担心孩子在分娩过程中受到伤害，而挪威女性更关心分娩的身体和情感期望。
