A qualitative examination of factors influencing pregnancy-related anxiety in Northern Ghana

Gilbert Abotisem Abiiro; Abdul-Malik Abdul-Latif; Dominic Akaateba; Killian Ramatu Laale Braimah; Mustapha Alhassan; Kelly Hadfield; Kristin Hadfield

doi:10.1016/j.midw.2024.104014

A qualitative examination of factors influencing pregnancy-related anxiety in Northern Ghana

Midwifery. 2024 Apr 22:134:104014. doi: 10.1016/j.midw.2024.104014. Online ahead of print.

Authors

Gilbert Abotisem Abiiro¹, Abdul-Malik Abdul-Latif², Dominic Akaateba³, Killian Ramatu Laale Braimah⁴, Mustapha Alhassan⁴, Kelly Hadfield³, Kristin Hadfield⁵

Affiliations

¹ Department of Health Services, Policy, Planning, Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana; Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana. Electronic address: gabiiro@uds.edu.gh.
² Institute of Interdisciplinary research and consultancy services, University for Development Studies, Tamale(,) Ghana.
³ Ghana Medical Help, Accra, Ghana.
⁴ Department for Social and Behavioural Change, School of Public Health, University for Development Studies, Tamale, Ghana.
⁵ Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland.

PMID: 38669757
DOI: 10.1016/j.midw.2024.104014

Abstract

Introduction: Despite high prevalence of anxiety among pregnant women in low- and -middle-income countries, research on context-specific conceptualisation, measurement, and predictors of pregnancy-related anxiety (PrA) is limited in these contexts. We explored local conceptualisations of factors influencing PrA in the Northern Region of Ghana.

Methods: We conducted 15 focus group discussions with antenatal care seekers in the Mion District, Savelugu Municipality, and Tamale Metropolis of the Northern Region, in July and August 2021. Multistage stratified purposive sampling was used to select respondents (n = 108). The data were audio-recorded and transcribed, and then we conducted a thematic analysis of the data.

Results: At the individual level, fear of anaemia; pre-existing health conditions; challenges with daily activities; and physical, emotional, and sexual abuses from spouses contributed to PrA. Health system failures resulting in unexpected out-of-pocket payments, negative health worker attitudes, diagnostic errors, constraints on birth preparation and birth process, and potential adverse birth outcomes were understood as driving PrA. Socio-cultural factors influencing PrA comprised beliefs and practices around baby naming/outdooring ceremonies, fear of spiritual attacks, social construction of gender roles, and contextual factors such as transportation challenges.

Conclusion: Pregnant women in the region understood, experienced, and could identify perceived predictors of PrA. To address PrA, we recommend that mental health services should be integrated into the basic package of antenatal care and rural health services should be improved. Perceived predictors of PrA identified here could be included in the design of a context-specific PrA measure for use in the region.

Keywords: Fear of childbirth; Ghana; Maternal health; Pregnancy; Pregnancy-related anxiety.