INTRODUCTION:

Pregnancy as well as motherhood is considered as happy moments and carries great significance in a woman’s life. The experience it holds has multiple dimensions, and is unique for every woman.

Pregnancy is often regarded as a joyful experience, yet it can evoke significant anxiety among primigravida women. Fear of childbirth, also known as tocophobia, may negatively affect maternal health, labor, and neonatal outcomes¹.

In most cases, it leads to severe maternal psychiatric challenges and negative birth effects. Globally, around 20–25% of pregnant women report significant fear of childbirth, with 6–10% experiencing severe forms that impair functioning². For primigravida women, the absence of previous birth experience often intensifies fears, amplified by cultural narratives, lack of knowledge, and inadequate antenatal education. Unaddressed, this fear is linked with antenatal depression, prolonged labor, obstetric complications, higher cesarean requests, and impaired maternal–infant bonding. Although interventions such as counseling and childbirth education are effective, they are underutilized, particularly in resource-limited contexts³.

Cultural beliefs, lack of prior experience, and inadequate antenatal education further intensify this fear, highlighting the importance of systematic assessment and support. Recognizing and addressing fear of childbirth during routine antenatal visits can enhance maternal confidence, reduce anxiety, and potentially improve obstetric outcomes. Interventions must be multidimensional, combining psychological support, childbirth education, pain management strategies, and active involvement of spouses and families. By integrating such measures, healthcare systems can move toward more woman-centered maternity care.

OBJECTIVES:

1. To determine the level of fear of childbirth among primigravida women attending antenatal clinics at selected hospitals of Rudrapur.

2. To find out the association between study findings with their selected socio-demographic variables.

HYPOTHESIS:

H1: There will be high fever of childbirth among primigravida women attending antenatal clinics.

H2: There will be significant association between level of fear of childbirth with their selected socio-demographic variables.

RESEARCH METHODOLOGY:

Research approach: Quantitative approach.

Research design: Non-experimental descriptive research design.

Research variable: level of fear of childbirth among primigravida women.

Setting of the study: The Medicity Hospital and JLN District Hospital, Rudrapur.

Target population: Primigravida women attending antenatal clinics.

Sample size: 150 primigravida women.

Sampling technique: Non-Probability Purposive sampling technique.

RESEARCH TOOLS AND TECHNIQUES:

The aim of the research is to determine the level of fear of childbirth in case of primigravida women attending the antenatal clinics. The tool used to collect data was in two parts:

Section A: Socio-demographic Performa:

This part consisted of the age, gestation age, educational status, occupation, type of family, income, residence and pregnancy planning status.

Section B: Standardized Scale:

It is Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ Version A) consisting of 33 questions to assess the level of fear of childbirth. Each question has a 6-point likert scale, ranging from 0 to 5.

CRITERION MEASURES:

Based on established cut-offs, scores ≤37 indicated mild fear, 38–65 moderate fear, and ≥66 severe fear. This categorization enabled systematic comparison across participants and guided statistical analysis of socio-demographic associations.

DATA COLLECTION PROCEDURE:

Data was collected using a structured questionnaire, and it consisted of a socio-demographic Performa and Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ Version A).

The collection of data was done in the OPD area of the selected hospitals, which took approximately 20 to 25 minutes. Anonymity was guaranteed and the participant would quit at any time. Hospital authorities were contacted and written informed consent was obtained from the participants.

PLAN FOR DATA ANALYSIS:

Data analysis is the systematic organization and synthesis of research findings and testing of hypotheses using collected data⁴.

The data was analyzed using SPSS, and both the descriptive and inferential statistics were applied.

Descriptive statistics:

1. Frequency and percentage distribution were used to describe socio-demographic variables of primigravida women.

2. Mean and standard deviation were calculated to summarize W-DEQ scores of fears of childbirth.

Inferential statistics:

1. Chi-square test was used to determine the association between study findings with their selected socio-demographic variables.

RESULTS:

Table 1: Frequency and percentage distribution of participants according to socio-demographic variables (N = 150)

S. No.	Socio-demographic variables	Options	Frequency (f)	%
1.	Age (in years)	18–24	87	58.0
		25–30	48	32.0
		>30	15	10.0
2.	Gestational age	<28 weeks	40	26.7
		28–35 weeks	75	50.0
		>35 weeks	35	23.3
3.	Educational status	Primary	33	22.0
		Secondary	54	36.0
		Graduate+	63	42.0
4.	Occupation	Homemaker	96	64.0
4.	Occupation	Employed	54	36.0
5.	Type of family	Nuclear	60	40.0
		Joint	70	46.7
		Extended	20	13.3
6.	Income (₹/month)	<5,000	30	20.0
		5,001–10,000	50	33.3
		10,001–15,000	40	26.7
		>15,000	30	20.0
7.	Residence	Rural	90	60.0
7.	Residence	Urban	60	40.0
8.	Pregnancy planning status	Planned	108	72.0
8.	Pregnancy planning status	Unplanned	42	28.0

Among the 150 primigravida women, the majority of the respondents were aged 18-24 (58%), a large proportion of them were between the 28 to 35 weeks of gestation, and 42% holds graduation and above. The majority (64%) of the primigravida women were stay-at-home parents. Nearly 46.7% belongs to joint families, and most of them (33.3%) have monthly income of 5,001 to 10,000. The maximum number (60%) of primigravida women belongs to rural area, and 72% reported planned pregnancies.

Table 2: Distribution of primigravida women according to their level of fear of childbirth (N=150)

Level of Fear	Score Range	Frequency	Percentage
Mild	≤37	26	17%
Moderate	38–65	93	62%
Severe	≥66	31	21%

Among the 150 primigravida women, 26(17.0%) had mild fear (W-DEQ ≤37), 93(62.0%) had moderate fear (W-DEQ 38–65), and 31(21.0%) had severe fear (W-DEQ ≥66).

Table 3: Mean and standard deviation of level of fear of childbirth among primigravida women (N=150)

Level of Fear	N	Mean	Standard deviation
Level of Fear	150	59.0	31.3

Based on the data, the calculated mean value is 59.0 which reflect moderate level of fear of childbirth, while the standard deviation is 31.3, which is quite high and indicate significant variation in the level of fear.

Table 4: Association between level of fear of childbirth with their selected socio-demographic variables. (N = 150)

Socio-demographic variables	Options (f)	Mild n (%)	Moderate n (%)	Severe n (%)	χ² Value	df	p-value	Result
Age (in years)	18–24 (87)	12 (13.8)	54 (62.1)	21 (24.1)	6.12	2	0.047*	Significant
	25–30 (48)	9 (18.8)	32 (66.7)	7 (14.6)
	>30 (15)	5 (33.3)	7 (46.7)	3 (20.0)
Gestational age	<28 wks (40)	5 (12.5)	24 (60.0)	11 (27.5)	5.99	2	0.050	Borderline
	28–35 wks (75)	15 (20.0)	48 (64.0)	12 (16.0)
	>35 wks (35)	6 (17.1)	21 (60.0)	8 (22.9)
Educational status	Primary (33)	2 (6.1)	18 (54.5)	13 (39.4)	8.54	2	0.014*	Significant
	Secondary (54)	9 (16.7)	36 (66.7)	9 (16.7)
	Graduate (63)	16 (25.4)	41 (65.1)	6 (9.5)
Occupation	Homemaker (96)	13 (13.5)	61 (63.5)	22 (23.0)	1.87	1	0.171	Not Significant
Occupation	Employed (54)	14 (25.9)	32 (59.3)	8 (14.8)	1.87	1	0.171	Not Significant
Type of family	Nuclear (60)	14 (23.3)	36 (60.0)	10 (16.7)	2.34	2	0.309	Not Significant
	Joint (70)	11 (15.7)	45 (64.3)	14 (20.0)
	Extended (20)	2 (10.0)	12 (60.0)	6 (30.0)
Income (₹/month)	<5,000 (30)	3 (10.0)	18 (60.0)	9 (30.0)	3.45	3	0.327	Not Significant
	5,001–10,000 (50)	8 (16.0)	32 (64.0)	10 (20.0)
	10,001–15,000 (40)	9 (22.5)	25 (62.5)	6 (15.0)
	>15,000 (30)	7 (23.3)	18 (60.0)	5 (16.7)
Residence	Rural (90)	13 (14.4)	56 (62.2)	21 (23.3)	0.89	1	0.345	Not Significant
Residence	Urban (60)	14 (23.3)	38 (63.3)	8 (13.3)	0.89	1	0.345	Not Significant
Pregnancy planning status	Planned (108)	24 (22.2)	70 (64.8)	14 (13.0)	9.87	1	0.002*	Significant
Pregnancy planning status	Unplanned (42)	3 (7.1)	20 (47.6)	19 (45.3)	9.87	1	0.002*	Significant

The Chi-Square test stated that the level of fear of childbirth is significantly associated with the age of women, their educational status and planning status of pregnancy. While, there is no significant association found with the gestational age, occupation, type of family, income and residence. The results revealed that younger age, lower education, and unplanned pregnancies are significant contributor in fear of childbirth among primigravida mothers.

CONCLUSION:

In this sample of 150 primigravida women attending antenatal clinics at selected hospitals of Rudrapur, 62% (majority) had moderate fear of childbirth, while 21% had severe, and 17% had mild fear. Younger age, lower educational status and unplanned pregnancy were significantly associated with higher fear.

Routine screening for childbirth fear and the integration of antenatal education and psychosocial support is recommended. These findings demonstrate the urgent need for healthcare providers to acknowledge childbirth fear as a valid clinical concern rather than a mere emotional reaction.

RECOMMENDATIONS:

1. A similar study can be conducted with a large sample size.

2. A study can be done to compare level of fear of childbirth among primigravida and multigravida women.

3. A study with implementation of structured childbirth education programs to address misconceptions and provide accurate information, can be conducted⁵_.

4. A interventional study to provide specialized psychological counselling services for women with severe fear to prevent adverse outcomes can be conducted⁶_.

5. Pregnant women should be empowered to clear their doubts and concerns regarding pregnancy and childbirth⁷_.

6. Inclusion of partners and family members in antenatal counselling to strengthen emotional support.

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Received on 01.10.2025 Revised on 04.11.2025

Accepted on 29.11.2025 Published on 23.02.2026

Available online from February 25, 2026

Int. J. Nursing Education and Research. 2026;14(1):71-74.

DOI: 10.52711/2454-2660.2026.00014

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