Childbirth fear and related factors among pregnant and postpartum women in Malawi

Madalitso Khwepeya, Gabrielle T. Lee, Su Ru Chen, Shu Yu Kuo

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)


Background: Childbirth fear is a health concern in women living in high-income countries; however, little is known about childbirth fear among women living in low-income countries like Malawi. In this study, we explored childbirth fear and associated factors among pregnant and postpartum women in Malawi. Methods: A cross-sectional study of 152 pregnant and 153 postpartum women was conducted at a district hospital in Malawi. Participants were assessed for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ). Demographic and obstetric variables were collected using a structured questionnaire. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure social support. Using a multinomial logistic regression, factors related to childbirth fears were examined, namely demographic and obstetric characteristics, and social support. Results: The mean age of participants was 26 (standard deviation: 6.4) years. During pregnancy, 39% women reported a low level of fear, 41% reported moderate fear, and 20% reported high fear; while after birth, 49, 41, and 10% women reported low, moderate, and high fear, respectively. Pregnant women who were illiterate (odds ratio (OR): 5.0, p < 0.01) or unemployed (OR: 12.6, p < 0.01) were more likely to report moderate and high fear. Postpartum mothers who were illiterate (OR: 4.2, p < 0.01) or unemployed (OR: 11.8, p < 0.01) were more likely to have moderate and high fear. Furthermore, postpartum women who sustained perineal tears had significantly higher odds of experiencing moderate (OR: 5.3, p < 0.01) or high (OR: 19.9, p < 0.01) fear than their counterparts. Conclusions: Childbirth fear is common in Malawi, and pregnant women are more likely to experience high levels of fear than postpartum women. This study highlighted the connection between childbirth fear with mother's education, employment, and perineal tears during delivery. Identifying and developing interventions for women with these associated characteristics is of clinical importance for the reduction of childbirth fear before and after childbirth in Malawi.

Original languageEnglish
Article number391
Pages (from-to)1-10
Number of pages10
JournalBMC Pregnancy and Childbirth
Issue number1
Publication statusPublished - Oct 3 2018


  • Childbirth
  • Demographics
  • Fear
  • Obstetrics
  • Postpartum period
  • Pregnancy
  • Social support

ASJC Scopus subject areas

  • Obstetrics and Gynaecology


Dive into the research topics of 'Childbirth fear and related factors among pregnant and postpartum women in Malawi'. Together they form a unique fingerprint.

Cite this