Socio demographic status of the study participants
A total of 387 pregnant women were interviewed yielding a 96.5% response rate. The age of the participants was ranged from 18 to 42 years with the mean age of 27±5 years. (Table 1).
Table 1 Socio-demographic status of pregnant women attended ANC at public health facilities in Arba Minch town, Southern Ethiopia, 2019 (n=387).
Variable
|
Category
|
Frequency
|
Percent
|
Age in years
|
18 – 19
|
14
|
3.6
|
20 – 24
|
121
|
31.3
|
25 – 29
|
127
|
32.8
|
30 – 34
|
97
|
25.1
|
35 – 39
|
21
|
5.4
|
40 – 45
|
7
|
1.8
|
Residence
|
Urban
|
288
|
74.4
|
Rural
|
99
|
25.6
|
Marital status
|
Single
|
21
|
5.4
|
Married
|
364
|
94.1
|
Divorced
|
2
|
0.5
|
Occupational status
|
Employed
|
124
|
32.0
|
House wife
|
180
|
46.5
|
Self-employed
|
54
|
14.0
|
Daily laborer
|
9
|
2.3
|
Student
|
12
|
3.1
|
Other*
|
8
|
2.1
|
Educational status
|
No formal education
|
28
|
7.2
|
Primary education
|
117
|
30.2
|
Secondary education
|
106
|
27.4
|
College and above
|
136
|
35.2
|
Religion
|
Orthodox Christian
|
175
|
45.2
|
Protestant Christian
|
168
|
43.4
|
Muslim
|
24
|
6.2
|
Catholic
|
17
|
4.4
|
Others **
|
3
|
0.8
|
Ethnicity
|
Gamo
|
190
|
49.1
|
Gofa
|
91
|
23.5
|
Wolayta
|
45
|
11.6
|
Amhara
|
25
|
6.5
|
Oromo
|
22
|
5.7
|
Other***
|
14
|
3.6
|
*-wood collecting, farmer, jobless, other**-Adventist, Jehovah,s witness, ***Konso, Gurage, Tigrie, Sidama, Zeyse
|
History of abuse and social support status
Twenty-three (5.9%) of the participants reported that they had a history of abuse in their lifetime and 191(49.3%) had a husband’s support during the current pregnancy. With regards to social support: 102(26.3%) had poor social support, 191(49.3%) had moderate social support and the rest 94(24.3%) had high social support.
Obstetrics characteristics of the participants
More than half (52.5%) of the study participants were in the third trimester of their pregnancy. The majority (87.2%) of the parous women had given birth to the preceding baby via spontaneous vaginal delivery (Table 2).
Table 2. Obstetrical characteristics of the study participants, Arba Minch town, Southern Ethiopia, 2019 (n=387).
Gravidity
|
Primigraviada
|
122
|
31.5
|
Multigravida
|
265
|
68.5
|
Parity
|
Nulliparous
|
129
|
33.3
|
Primiparous
|
142
|
36.7
|
Multiparous
|
116
|
30
|
Trimester
|
First trimester
|
03
|
0.8
|
Second trimester
|
181
|
46.7
|
Third trimester
|
203
|
52.5
|
Mode of delivery of the preceding pregnancy (n=258)
|
Vaginal birth with episiotomy
|
74
|
28.7
|
Vaginal birth without episiotomy
|
151
|
58.5
|
Instrument assisted vaginal birth
|
12
|
4.7
|
Caesarean delivery
|
21
|
8.1
|
Planned current pregnancy
|
Yes
|
348
|
89.9
|
No
|
39
|
10.1
|
Wanted current pregnancy
|
Yes
|
373
|
96.4
|
No
|
14
|
3.6
|
Problems during the current pregnancy
|
Yes
|
28
|
7.2
|
No
|
359
|
92.8
|
Had history of abortion
|
Yes
|
17
|
4.4
|
No
|
370
|
95.6
|
Obstetrical/medical problems during the previous pregnancy(n=265)
|
Yes
|
29
|
10.9
|
No
|
236
|
89.1
|
Had history of stillbirth
|
Yes
|
13
|
3.4
|
No
|
374
|
96.6
|
Had fear of medical intervention
|
Yes
|
270
|
69.8
|
No
|
117
|
30.2
|
Husband support present
|
Yes
|
355
|
91.7
|
No
|
32
|
8.3
|
Magnitude of fear of childbirth
Forty (24.3%) of the pregnant women had W-DEQ sum score <38(low degree fear), 154(39.8%) had W-DEQ score of 38 – 65.9 (moderate degree fear), 98(25.3%) had a W-DEQ score of 66-84 (high degree fear), and 95(24.5%) had severe degree fear of childbirth (W-DEQ >85).
Factors associated with severe degree fear of childbirth
As the health consequences of sever degree childbirth fear likely to be of significant importance, we have executed bivariate and multivariable analysis for severe degree fear of childbirth. Accordingly, the bivariate analysis showed educational status, parity, unplanned pregnancy, current pregnancy complications, no husband support for pregnancy and poor social support were factors associated with sever degree fear of childbirth. In multivariable logistic regression analysis, unplanned pregnancy, current pregnancy problems and poor social support were factors associated with severe degree fear of childbirth. Those women who had unplanned pregnancy were about 2 times more likely to have severe degree fear of childbirth compared with those with planned pregnancy (AOR=2.30, 95% CI: 1.12, 4.74). Women who had current pregnancy-related complications were about 6 times more likely to have severe degree fear of childbirth than those without current pregnancy-related problems (AOR=6.24, 95% CI: 2.72, 14.29). Moreover, participants who had poor social support were about 2 times more likely to report severe degree fear of childbirth (AOR=1.93, 95%CI: 1.01, 3.68) (Table 3).
Table 3 Multivariable logistic analyses for severe degree fear of childbirth and associated factors among pregnant women, Arba Minch town, southern Ethiopia, 2019
|
Variables
|
Severe degree Fear of childbirth
|
COR 95%CI
|
AOR 95%CI
|
Yes (n, %)
|
No (n, %)
|
Educational status
|
No formal education
|
10(35.7%)
|
18(64.3%)
|
1.88(0.79, 4.5)
|
0.96(0.36, 2.55)
|
Primary education
|
31(26.5%)
|
86(73.5%)
|
1.22 (0.69, 2.17)
|
0.60(0.22, 1.61)
|
Secondary education
|
23(21.7%
|
83(78.3%)
|
0.94(0.509, 1.73)
|
0.79(0.30, 2.09)
|
College and above
|
31(22.8%)
|
105(77.2%)
|
1
|
1
|
Parity
|
Nulliparous
|
38(29.5%)
|
91(70.5%)
|
1.47(0.91, 2.38)
|
1.61(0.94, 2.74
|
Multiparous
|
57(22.5%)
|
201(77.9%)
|
1
|
1
|
Planned pregnancy
|
No
|
16(41%)
|
23(59%)
|
2.34(1.2, 4.70*
|
2.30(1.12, 4.74)*
|
Yes
|
79(22.7%)
|
269(77.3%)
|
1
|
1
|
Current pregnancy complication
|
Yes
|
17(60.7%)
|
11(39.3%)
|
5.57(2.5, 12.34)**
|
6.24(2.72, 14.29)**
|
No
|
78(21.75%)
|
281(78.3%)
|
1
|
1
|
Husband support
|
No
|
11(34.4%)
|
21(65.6%)
|
1.7(0.78, 3.65)
|
0.84(0.36, 1.99)
|
Yes
|
84(23.7%)
|
271(76.3%)
|
1
|
1
|
Social support
|
Poor support
|
38(37.3%)
|
64(62.7%)
|
1.94(1.04, 3.63)*
|
1.93(1.01, 3.68)*
|
Moderate support
|
35(18.3%)
|
156(81.7%)
|
0.73(0.40, 1.34)
|
0.66 (0.35, 1.24)
|
Strong support
|
22(23.4%)
|
72(76.6%)
|
1
|
1
|
*-p-value<0.05, **- p-value=0.001, AOR-Adjusted Odd Ratio, COR-Crude Odd Ratio, CI-Confidence interval