Women's experiences of interventions for fear of childbirth in the perinatal period: A meta-synthesis of qualitative research evidence

Abstract

Issue: Fear of childbirth (FOC) can be debilitating, impacting women's lives in pregnancy, the puerperium and beyond. Research investigated various interventions for FOC in the perinatal period, but there been no synthesis of the experiences of women who engaged with these interventions, which would inform clinical practice guidance and the development of future interventions.

Aim: To conduct a review and synthesis of qualitative studies of interventions for fear of childbirth in the perinatal period and women's experiences of them.

Methods: A meta-synthesis was performed to examine all relevant qualitative studies describing women's experiences of interventions for FOC, in all languages. A comprehensive search of relevant databases from 1978 to 2019 was conducted. In total, following appraisal, seven qualitative studies were eligible for inclusion. The findings were integrated using thematic synthesis for the final stages in the thematic analysis.

Findings: One overarching theme "Ownership of Childbirth" and three analytical themes "Facing the fear", "Feeling empowered", "Managing the fear with a sense of security" were generated through the synthesis. There were no studies outside of Scandinavia located.

Discussion: This meta-synthesis provides a new way to describe the process of moving from fear to "Ownership of childbirth". The first step in the process appears to be acknowledging and identifying the individual's fears. Women can be empowered to self-manage FOC but may be influenced by external factors such as the support of partners and staff.

Conclusion: These findings provide evidence to inform the development of future interventions for FOC and highlight the need for further qualitative research globally.

Keywords: Fear of birth; Fear of childbirth; Pregnancy anxiety; Tocophobia.