Fear of childbirth in the puerperal period
fear, childbirth, questionnaire, cross-cultural adaptation, puerperium, Brazil
Introduction: The fear of childbirth is referred to as an irrational fear of the approaching birth, affecting the mental health of women in the pregnancy-puerperal cycle. The most widely used research instrument is currently the Wijma Delivery Expectancy/Experience Questionnaire, which has been translated into several languages and can be applied both in the gestational and postpartum periods, versions A and B, respectively. The present study aimed to perform a cross-cultural adaptation of version B of the questionnaire for the Portuguese of Brazil and then apply the instrument in a sample of Brazilian puerperal women.
Methodology: We conducted a cross-sectional study covering a process of cross-cultural adaptation of WDEQ-B in Portuguese of Brazil, and then applied the instrument to 186 postpartum women hospitalized in three different public maternity hospitals in Maceió, in the state of Alagoas. Clinical-obstetric information and perception of social support of the puerperal women were also evaluated, considering possible associations with severe fear of childbirth.
Results: A cross-cultural adaptation of the WDEQ-B was performed, with reasonable correspondence of the original instrument and widely understood by the participants. The prevalence of severe fear of childbirth found in our sample was 7.54% (mean 62.95). The non-occurrence of complete high school education proved to be a protective factor against severe fear of childbirth, with a prevalence ratio of 0.24 (CI 0.03 - 0.85) p = 0.03. The following variables showed a positive correlation with severe fear of childbirth: perception of low social support (prevalence ratio 3.83, CI 1.39 - 10.51 and p < 0.01), disagreement between preference of mode of delivery and current delivery (prevalence ratio 4.97, CI 1.43 - 17.27 and p < 0.01) and presence of diabetes mellitus prior to pregnancy (prevalence ratio 3.32, CI 1.14 - 9.64, p = 0.03).
Conclusions: The WDEQ-B was successfully adapted to the Brazilian Portuguese and proved to be an adequate research instrument to identify the presence of severe fear of childbirth among Brazilian women in the puerperal period. The results found raise several questions about the fear of childbirth in Brazil, emphasizing the importance of expanding our knowledge in this area.