The relationship between fear of childbirth (tokophobia) and anxiety levels in primiparous women

Introduction. Fear of childbirth (tokophobia) is a common phenomenon in perinatal psychology, especially in primiparous women.
Objective. To assess the severity of fear of childbirth and its association with anxiety levels in primiparous women depending on the planned mode of delivery.
Materials and methods. A cross-sectional study included 60 primiparous women divided into two groups: 30 patients with planned cesarean section (CS) and 30 with planned vaginal delivery (VD). The Spielberger State and Trait Anxiety Inventory (adapted by Yu.L. Khanin), the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ, version A), and an author-developed questionnaire (non-validated, used for qualitative analysis) were administered. Statistical analysis: descriptive statistics, Mann–Whitney U test, χ² test.
Results. Moderate anxiety levels predominated in both groups. The proportion of high state anxiety in the VD group (24.1%) was more than twice that in the CS group (10.0%) (p<0.05). According to the W-DEQ, fear of childbirth (score ≥85) was absent in 100% of women in the planned CS group and present in 12.0% of women in the planned VD group (p<0.05). All three patients with identified fear had high state and/or trait anxiety.
Conclusion. A positive association was found between general anxiety and specific fear of childbirth. Planned cesarean section is associated with the absence of clinically significant tokophobia even in the presence of high trait anxiety. Women planning vaginal delivery and having high state anxiety constitute a risk group for developing tokophobia and require psychological support.

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