Fear of childbirth and its associated factors among pregnant women in Bangladesh: A cross-sectional study

Abstract

Background: Fear of childbirth (FOC) is a widespread maternal health concern associated with heightened anxiety, increased medical interventions, and negative birth experiences. While prevalent globally, FOC remains underexamined in low-resource settings such as Bangladesh. This study aimed to determine the level of FOC and identify associated factors among pregnant women in Bangladesh. Methods: A cross-sectional study was conducted among 262 pregnant women attending antenatal care at Shariatpur Government Upazila Health Complex (December 2023-May 2024). Data were collected using a structured questionnaire and the Melender FOC Scale. Participants were selected using a convenience sampling technique. Fear was categorized as low, moderate, or high. Descriptive analysis, Chi-square tests, ordinal logistic regression, and multivariate logistic regression were performed to identify predictors of FOC using SPSS version 25. Results: A survey of 262 pregnant women revealed a moderate mean level of fear of childbirth (FOC) (47.45 ± 6.9). Regression analysis identified several significant predictors of higher FOC. The strongest associations were with limited spousal support (AOR = 2.64; 95% CI: 1.38–5.06; p = 0.003) and not attending childbirth classes (AOR = 2.33; 95% CI: 1.21–4.49; p = 0.011). Other significant factors included younger maternal age, lower education (in both the woman and her husband), rural residence, and lower socioeconomic status. These findings underscore the multifactorial nature of FOC, highlighting the need for interventions that address its key social and educational determinants. Conclusion: FOC is highly prevalent among pregnant women in Bangladesh and is influenced by sociodemographic, obstetric, and psychosocial factors. Routine screening, culturally sensitive prenatal education, improved communication, and partner-inclusive support are recommended to reduce FOC and improve maternal outcomes.