Influence of intimate partner violence during pregnancy on fear of childbirth

- Prevalence of IPV and fear of birth is high among Iranian pregnant women.
- In nullipara, physical IPV significantly increases chance of experiencing fear of childbirth.
- In multipara, psychological IPV is inversely associated with fear of birth.
- Regardless of parity, physical IPV is linked to a significant increase in level of fear.
- Screening for IPV and fear of birth across the duration of pregnancy is recommended.

ObjectiveWomen are at increased risk of intimate partner violence (IPV) during pregnancy. This may impact women's positive anticipation for birth. Negative feelings around birth often translate to a fear of childbirth. Our aim was to examine the prevalence IPV and whether physical, sexual, psychological IPV during pregnancy predicts fear of childbirth among Iranian pregnant women.MethodA population-based cross sectional study was conducted in North-East Iran. Pregnant women (n = 174) at least 14 weeks gestation attending health centers were selected for inclusion through a stratified sampling method. IPV, fear of birth, state and trait anxiety and socio-demographic variables were collected using validated instruments. To achieve the final models the Bayesian information criterion was used. A p value of <0.05 was considered statistically significant.ResultsSeventy-three percent of women reported experiencing IPV at least once within their current pregnancy. Fear of birth was prevalent (61.5%). Logistic regression analysis revealed that after adjusting for confounding factors, in nulliparous physical IPV significantly predicted fear of birth (adjusted OR = 12.15; 95% CI, 1.33, 110.96) while, in multiparous psychological IPV associated inversely with fear of birth (adjusted OR = 0.18; 95% CI, 0.04, 0.73). For all participants, physical IPV increased the chance of fear of birth, (adjusted OR = 2.47; 95% CI, 1.01, 6.02).ConclusionAll pregnant women experiencing physical violence had a higher chance of fear of birth. Screening programs for fear of birth and IPV need to be implemented in particular for nulliparous women. Providing continuity of midwifery care and family therapy may be strategies for early support to reduce IPV to pregnant women.