Fear of childbirth among antenatal care attendees in a primary care setting in Kumasi, Ghana: Prevalence and parity-stratified determinants
6 affiliations
- 1Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- 2HopeXchange Medical Centre, Kumasi, Ghana
- 3University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- 4Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- 5St. Dominic Catholic Hospital, Akwatia, Ghana
- 6Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Abstract
Background: Previous studies on Fear of Childbirth (FoC) across sub-Saharan Africa have typically reported prevalence separately by parity or treated it as a covariate in multivariable analyses, with little attention given to identifying parity-specific determinants. However, first-time mothers and those with previous birth experiences may require different forms of antenatal support. To address this gap, we assessed the prevalence of FoC and identified parity-specific determinants among antenatal care attendees in Ghana to inform targeted interventions. Methods: A facility-based cross-sectional study was carried out among pregnant women attending antenatal care (ANC) at a primary healthcare facility in Kumasi. Data were collected using an interviewer-administered questionnaire. The primary outcome of the study, FoC, was assessed using the English version of the Wijma Delivery Expectation/Experience Questionnaire (W-DEQ). Additional data included sociodemographic and obstetric characteristics. Stratified multivariable linear regression models were applied to identify parity-specific determinants among the participants. Results: Of the 282 women who participated in the study, 22% had high-to-severe FoC. Nulliparous women (median: 46.0, IQR: 37.0–66.0) reported significantly higher median W-DEQ scores than parous women (median: 39.0, IQR: 32.0–58.5). In a parity-stratified analysis, among nulliparous women, factors such as a history of family abuse (adjusted Β = 16.32, 95% CI: 2.50 to 30.14) and late ANC booking (adjusted Β = 13.13, 95% CI: 1.43 to 24.84) were significantly associated with FoC. Among parous women, factors such as secondary education (adjusted Β = −7.63, 95% CI: −14.88 to −0.37), intimate partner violence (adjusted Β = 10.87, 95% CI: 0.69 to 21.04), unplanned pregnancy (adjusted Β = 8.38, 95% CI: 2.51 to 14.26), and strong family support (adjusted Β = −27.94, 95% CI: −38.77 to −17.11) were significantly associated with FoC. Conclusion: FoC is common among this cohort of pregnant women, and its determinants differed by parity and across parity-specific factors. The parity-stratified determinants underscore the need for parity-tailored psychosocial care at ANC, incorporating targeted screening and support procedures aligned with parity-associated risk pathways to enhance maternal well-being.
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BibTeX
@article{addo2026fear,
title = {{Fear of childbirth among antenatal care attendees in a primary care setting in Kumasi, Ghana: Prevalence and parity-stratified determinants}},
author = {Juliana Ofosua Addo and Douglas Aninng Opoku and Julius Kwabena Karikari and Emmanuel Konadu and Mercy Addae and Francis Kwabena Kyei and Mawuse Kanfra and Obed Kwabena Offe Amponsah and Eric Adjei Boadu},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0358457},
url = {https://doi.org/10.1371/journal.pone.0358457},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Fear of childbirth among antenatal care attendees in a primary care setting in Kumasi, Ghana: Prevalence and parity-stratified determinants
AU - Juliana Ofosua Addo
AU - Douglas Aninng Opoku
AU - Julius Kwabena Karikari
AU - Emmanuel Konadu
AU - Mercy Addae
AU - Francis Kwabena Kyei
AU - Mawuse Kanfra
AU - Obed Kwabena Offe Amponsah
AU - Eric Adjei Boadu
PY - 2026
DA - 2026/09/21
JO - PLOS One
DO - 10.1371/journal.pone.0358457
UR - https://doi.org/10.1371/journal.pone.0358457
AB - Background: Previous studies on Fear of Childbirth (FoC) across sub-Saharan Africa have typically reported prevalence separately by parity or treated it as a covariate in multivariable analyses, with little attention given to identifying parity-specific determinants. However, first-time mothers and those with previous birth experiences may require different forms of antenatal support. To address this gap, we assessed the prevalence of FoC and identified parity-specific determinants among antenatal care attendees in Ghana to inform targeted interventions. Methods: A facility-based cross-sectional study was carried out among pregnant women attending antenatal care (ANC) at a primary healthcare facility in Kumasi. Data were collected using an interviewer-administered questionnaire. The primary outcome of the study, FoC, was assessed using the English version of the Wijma Delivery Expectation/Experience Questionnaire (W-DEQ). Additional data included sociodemographic and obstetric characteristics. Stratified multivariable linear regression models were applied to identify parity-specific determinants among the participants. Results: Of the 282 women who participated in the study, 22% had high-to-severe FoC. Nulliparous women (median: 46.0, IQR: 37.0–66.0) reported significantly higher median W-DEQ scores than parous women (median: 39.0, IQR: 32.0–58.5). In a parity-stratified analysis, among nulliparous women, factors such as a history of family abuse (adjusted Β = 16.32, 95% CI: 2.50 to 30.14) and late ANC booking (adjusted Β = 13.13, 95% CI: 1.43 to 24.84) were significantly associated with FoC. Among parous women, factors such as secondary education (adjusted Β = −7.63, 95% CI: −14.88 to −0.37), intimate partner violence (adjusted Β = 10.87, 95% CI: 0.69 to 21.04), unplanned pregnancy (adjusted Β = 8.38, 95% CI: 2.51 to 14.26), and strong family support (adjusted Β = −27.94, 95% CI: −38.77 to −17.11) were significantly associated with FoC. Conclusion: FoC is common among this cohort of pregnant women, and its determinants differed by parity and across parity-specific factors. The parity-stratified determinants underscore the need for parity-tailored psychosocial care at ANC, incorporating targeted screening and support procedures aligned with parity-associated risk pathways to enhance maternal well-being.
SN - 1932-6203
ER -