Fear of childbirth and its relationship with depression and anxiety in spouses of pregnant women referring to health centers of Tabriz, 2021-22

Abstract

Abstract Introduction: Pregnancy and childbirth are natural periods and events accompanied by significant changes in life for parents, which should be approached with awareness and knowledge. During this period, in addition to women experiencing physiological and psychological changes, men are also affected by these events, and it can even be said that behaviors influenced by these events lead to intricate psychological and emotional problems in men compared to women. These simultaneous changes with pregnancy begin in a man and reach their peak during childbirth. Since these psychological changes can have a negative impact on the father's relationship with the newborn and the mother, and most mental health problems of fathers have been studied in developed countries with limited data available in developing countries, this present study was conducted to determine the status of childbirth fear and its relationship with anxiety and depression in Iranian fathers. Method: The present study is an observational cross-sectional descriptive-analytical study in which 302 eligible men (whose wives were pregnant for more than 28 weeks) from one-fourth of the health centers in Tabriz city (32 health centers) were selected using cluster sampling method through the website www.random.org in a random manner. Then, the researcher visited the selected centers and extracted the list of spouses of pregnant women with gestational age over 28 weeks along with their telephone numbers from Iran’s Integrated Health System (IHS), also known as the ′SIB System′. The data collection tools in this study were personal-social characteristics questionnaire, fathers' fear of childbirth questionnaire, Spielberger's State-Trait Anxiety Inventory (STAI), and Edinburgh Postnatal Depression Scale (EPDS). Descriptive statistics including frequency distribution, as well as measures of central tendency and dispersion such as mean and standard deviation, were used to assess the fear of childbirth, anxiety, and depression in the spouses of pregnant women. Pearson correlation test was used for analyzing the relationship between fear of childbirth and anxiety and depression in univariate analysis, assuming normal distribution of data, and Spearman correlation test was used in cases of non-normal distribution. In multivariate analysis, a modified general linear model was used to control for potential confounding variables. Findings: The mean (Standard Deviation) of the total score of fear of childbirth in fathers was 39.48 (10.14) within a score range of 17 to 85. According to Pearson correlation test, there was a significant positive correlation between fear of childbirth and depression (p< 0.001, r= 0.47), explicit anxiety (p< 0.001, r= 0.60), and implicit anxiety (p< 0.001, r= 0.51). The results of the modified general linear model with adjustment for personal-social characteristics showed that with an increase in the fear of childbirth score, the depression score significantly increased (B= 18.0; 95% CI= 13.0 to 22.0), the explicit anxiety score significantly increased (B= 45.0; 95% CI= 38.0 to 53.0), and the implicit anxiety score significantly increased (B= 35.0; 95% CI= 27.0 to 42.0). Conclusion: The results of the present study demonstrate that fathers' fear of childbirth during pregnancy plays a role in the occurrence of anxiety and depression in them. Therefore, it is recommended that fathers, like mothers, undergo screening for fear of childbirth and psychological distress, and appropriate preventive and therapeutic measures be implemented.