Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Childbirth preferences and related fears - comparison between Norway and Israel

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Login to get access

Abstract

Background

Fear of childbirth (FOC) could have significant impact on women’s childbearing choices and experience. Culture affects the way women conceptualize childbirth, influencing the fears and expectations they may hold in relation to it. In the current study, we examined differences in childbirth preferences of cesarean section and use of epidural analgesia between Norwegian and Israeli pregnant women. Later, we used the Norwegian six-factor solution of the widely-used Wijma Delivery Expectancy Questionnaire (W-DEQ-A) to compare levels of the different FOC factors. Finally, we investigated differences in the associations between FOC and childbirth preferences between the two countries.

Methods

Secondary analysis of two large surveys. Women from Israel (n = 490) and Norway (n = 2918) were recruited during prenatal check-ups in community clinics and a university hospital. At around 32 weeks of gestation, all participants filled out questionnaires, including the W-DEQ-A. Statistical analysis included exploratory factor analysis, confirmatory factor analysis, M/ANOVA, Spearman’s Rho and Fisher’s Z tests for the significance of the difference between independent correlations.

Results

The Norwegian six-factor solution of the W-DEQ fit well with the Israeli data. Norwegian women were more concerned about loneliness, feeling less self-efficacy, negatively appraising birth, and lacking positive anticipation. Israeli women were more concerned about negative outcomes for the child and experienced greater general fear and fear of pain. Norwegian women preferred more cesarean sections compared to Israeli women, who preferred more epidural use than Norwegians. FOC factors were more strongly related to childbirth preferences among Norwegians.

Conclusions

Cultural differences between Israel and Norway are reflected by the differences seen in the levels of fear reported across the six factors. In Israel, birth culture is very medicalized, motherhood is highly revered, and there is an emphasis on having “perfect babies”. In contrast, Norwegian women have fewer children, and birth is considered more natural. This could explain why Israeli women were more concerned that their child might be harmed during birth, while Norwegian women were more concerned with the physical and emotional expectations of birth.
Appendix
Available only for authorised users
Literature
2.
go back to reference Anim Somuah M, Smyth RM, Jones L. Epidural versus non‐epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011(12). Anim Somuah M, Smyth RM, Jones L. Epidural versus non‐epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011(12).
3.
go back to reference Lobel M, DeLuca RS. Psychosocial sequelae of cesarean delivery: review and analysis of their causes and implications. Soc Sci Med. 2007;64(11):2272–84.CrossRefPubMed Lobel M, DeLuca RS. Psychosocial sequelae of cesarean delivery: review and analysis of their causes and implications. Soc Sci Med. 2007;64(11):2272–84.CrossRefPubMed
4.
go back to reference Haines HM, Rubertsson C, Pallant JF, Hildingsson I. Womens' attitudes and beliefs of childbirth and association with birth preference: a comparison of a Swedish and an Australian sample in mid-pregnancy. Midwifery. 2012;28(6):e850–6.CrossRefPubMed Haines HM, Rubertsson C, Pallant JF, Hildingsson I. Womens' attitudes and beliefs of childbirth and association with birth preference: a comparison of a Swedish and an Australian sample in mid-pregnancy. Midwifery. 2012;28(6):e850–6.CrossRefPubMed
5.
go back to reference Ryding EL, Lukasse M, Kristjansdottir H, Steingrimsdottir T, Schei B. Pregnant women’s preference for cesarean section and subsequent mode of birth–a six-country cohort study. J Psychosom Obstet Gynaecol. 2016;37(3):75–83.CrossRefPubMed Ryding EL, Lukasse M, Kristjansdottir H, Steingrimsdottir T, Schei B. Pregnant women’s preference for cesarean section and subsequent mode of birth–a six-country cohort study. J Psychosom Obstet Gynaecol. 2016;37(3):75–83.CrossRefPubMed
6.
go back to reference Wassen M, Miggiels L, Devlieger R, Gyselaers W, Mertens H, Hasaart T, Wijnen E, Pd R, Roumen F, Nijhuis J. Women’s prelabour preference for epidural analgesia: a cross-sectional study among women from the Netherlands and Belgium. J Psychosom Obstet Gynaecol. 2013;34(1):22–8.CrossRefPubMed Wassen M, Miggiels L, Devlieger R, Gyselaers W, Mertens H, Hasaart T, Wijnen E, Pd R, Roumen F, Nijhuis J. Women’s prelabour preference for epidural analgesia: a cross-sectional study among women from the Netherlands and Belgium. J Psychosom Obstet Gynaecol. 2013;34(1):22–8.CrossRefPubMed
7.
go back to reference Rassin M, Klug E, Nathanzon H, Kan A, Silner D. Cultural differences in child delivery: comparisons between Jewish and Arab women in Israel. Int Nurs Rev. 2009;56(1):123–30.CrossRefPubMed Rassin M, Klug E, Nathanzon H, Kan A, Silner D. Cultural differences in child delivery: comparisons between Jewish and Arab women in Israel. Int Nurs Rev. 2009;56(1):123–30.CrossRefPubMed
8.
go back to reference Johnson R, Slade P. Does fear of childbirth during pregnancy predict emergency caesarean section? BJOG. 2002;109(11):1213–21.CrossRefPubMed Johnson R, Slade P. Does fear of childbirth during pregnancy predict emergency caesarean section? BJOG. 2002;109(11):1213–21.CrossRefPubMed
9.
go back to reference Lukasse M, Schei B, Ryding EL, Bidens Study Group. Prevalence and associated factors of fear of childbirth in six European countries. Sex Reprod Healthc. 2014;5(3):99–106.CrossRefPubMed Lukasse M, Schei B, Ryding EL, Bidens Study Group. Prevalence and associated factors of fear of childbirth in six European countries. Sex Reprod Healthc. 2014;5(3):99–106.CrossRefPubMed
10.
go back to reference Nilsson C, Hessman E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, Patel H, Sparud-Lundin C, Wigert H, Begley C. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy Childbirth. 2018;18(1):28.CrossRefPubMedPubMedCentral Nilsson C, Hessman E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, Patel H, Sparud-Lundin C, Wigert H, Begley C. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy Childbirth. 2018;18(1):28.CrossRefPubMedPubMedCentral
11.
go back to reference Waldenstrom U, Hildingsson I, Ryding EL. Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG. 2006;113(6):638–46.CrossRefPubMed Waldenstrom U, Hildingsson I, Ryding EL. Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG. 2006;113(6):638–46.CrossRefPubMed
12.
go back to reference Stoll K, Edmonds JK, Hall WA. Fear of childbirth and preference for cesarean delivery among young American women before childbirth: a survey study. Birth. 2015;42(3):270–6.CrossRefPubMed Stoll K, Edmonds JK, Hall WA. Fear of childbirth and preference for cesarean delivery among young American women before childbirth: a survey study. Birth. 2015;42(3):270–6.CrossRefPubMed
13.
go back to reference Haines HM, Pallant JF, Karlstrom A, Hildingsson I. Cross-cultural comparison of levels of childbirth-related fear in an Australian and Swedish sample. Midwifery. 2011;27(4):560–7.CrossRefPubMed Haines HM, Pallant JF, Karlstrom A, Hildingsson I. Cross-cultural comparison of levels of childbirth-related fear in an Australian and Swedish sample. Midwifery. 2011;27(4):560–7.CrossRefPubMed
14.
go back to reference Holan S, Mathiesen M, Petersen K. A National Clinical Guideline for Antenatal Care. Short version: Oslo. Norway: Directorate for Health and Social Affairs; 2005. Holan S, Mathiesen M, Petersen K. A National Clinical Guideline for Antenatal Care. Short version: Oslo. Norway: Directorate for Health and Social Affairs; 2005.
15.
go back to reference Zeitlin J, Mohangoo A, Delnord M. European perinatal health report. The health and care of pregnant women and babies in Europe in 2010. Euro Peristat: Paris; 2013. Zeitlin J, Mohangoo A, Delnord M. European perinatal health report. The health and care of pregnant women and babies in Europe in 2010. Euro Peristat: Paris; 2013.
17.
go back to reference Eberhard-Gran M, Garthus-Niegel S, Garthus-Niegel K, Eskild A. Postnatal care: a cross-cultural and historical perspective. Arch Womens Ment Health. 2010;13(6):459–66.CrossRefPubMed Eberhard-Gran M, Garthus-Niegel S, Garthus-Niegel K, Eskild A. Postnatal care: a cross-cultural and historical perspective. Arch Womens Ment Health. 2010;13(6):459–66.CrossRefPubMed
19.
go back to reference Granek L, Nakash O. The impact of militarism, patriarchy, and culture on Israeli Women’s reproductive health and well-being. Int J Behav Med. 2017;24(6):893–900.CrossRefPubMed Granek L, Nakash O. The impact of militarism, patriarchy, and culture on Israeli Women’s reproductive health and well-being. Int J Behav Med. 2017;24(6):893–900.CrossRefPubMed
20.
go back to reference Morgenstern-Leissner O. Hospital birth, military service and the ties that bind them: the case of Israel. Nashim. 2006;12:203–41. Morgenstern-Leissner O. Hospital birth, military service and the ties that bind them: the case of Israel. Nashim. 2006;12:203–41.
21.
go back to reference Remennick L. The quest for the perfect baby: why do Israeli women seek prenatal genetic testing? Sociol Health Illn. 2006;28(1):21–53.PubMed Remennick L. The quest for the perfect baby: why do Israeli women seek prenatal genetic testing? Sociol Health Illn. 2006;28(1):21–53.PubMed
22.
go back to reference Benyamini Y, Molcho ML, Dan U, Gozlan M, Preis H. Women’s attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth. Women Birth. 2017;30(5):424–30.CrossRefPubMed Benyamini Y, Molcho ML, Dan U, Gozlan M, Preis H. Women’s attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth. Women Birth. 2017;30(5):424–30.CrossRefPubMed
23.
go back to reference Hashiloni-Dolev Y. Between mothers, fetuses and society: reproductive genetics in the Israeli-Jewish context. Nashim. 2006;12(1):129–50. Hashiloni-Dolev Y. Between mothers, fetuses and society: reproductive genetics in the Israeli-Jewish context. Nashim. 2006;12(1):129–50.
24.
go back to reference Bar-On S, Benyamini Y, Ebrahimoff M, Many A. Mother knows best? Comparing primiparous parturients’ expectations and predictions with actual birth outcomes. J Perinat Med. 2014;42(4):435–9.CrossRefPubMed Bar-On S, Benyamini Y, Ebrahimoff M, Many A. Mother knows best? Comparing primiparous parturients’ expectations and predictions with actual birth outcomes. J Perinat Med. 2014;42(4):435–9.CrossRefPubMed
25.
go back to reference Aviram A. Obstetrics in Israel: Report of 2014. Ramat Gan: Proceeding of the annual conference of the Israeli maternal-fetal Society; 2015. Aviram A. Obstetrics in Israel: Report of 2014. Ramat Gan: Proceeding of the annual conference of the Israeli maternal-fetal Society; 2015.
26.
go back to reference Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World Health Rep. 2010;30:1–31. Gibbons L, Belizán JM, Lauer JA, Betrán AP, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World Health Rep. 2010;30:1–31.
27.
28.
go back to reference Salomonsson B, Wijma K, Alehagen S. Swedish midwives' perceptions of fear of childbirth. Midwifery. 2010;26(3):327–37.CrossRefPubMed Salomonsson B, Wijma K, Alehagen S. Swedish midwives' perceptions of fear of childbirth. Midwifery. 2010;26(3):327–37.CrossRefPubMed
29.
go back to reference Sjögren B. Reasons for anxiety about childbirth in 100 pregnant women. J Psychosom Obstet Gynaecol. 1997;18(4):266–72.CrossRefPubMed Sjögren B. Reasons for anxiety about childbirth in 100 pregnant women. J Psychosom Obstet Gynaecol. 1997;18(4):266–72.CrossRefPubMed
30.
go back to reference Fenwick J, Gamble J, Nathan E, Bayes S, Hauck Y. Pre- and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women. J Clin Nurs. 2009;18(5):667–77.CrossRefPubMed Fenwick J, Gamble J, Nathan E, Bayes S, Hauck Y. Pre- and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women. J Clin Nurs. 2009;18(5):667–77.CrossRefPubMed
31.
go back to reference Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ: a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. 1998;19(2):84–97.CrossRefPubMed Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ: a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. 1998;19(2):84–97.CrossRefPubMed
32.
go back to reference Haines H, Pallant J, Fenwick J, Gamble J, Creedy D, Toohill J, Hildingsson I. Identifying women who are afraid of giving birth: a comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort. Sex Reprod Healthc. 2015;6(4):204–10.CrossRefPubMed Haines H, Pallant J, Fenwick J, Gamble J, Creedy D, Toohill J, Hildingsson I. Identifying women who are afraid of giving birth: a comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort. Sex Reprod Healthc. 2015;6(4):204–10.CrossRefPubMed
33.
go back to reference Pallant J, Haines H, Green P, Toohill J, Gamble J, Creedy D, Fenwick J. Assessment of the dimensionality of the Wijma delivery expectancy/experience questionnaire using factor analysis and Rasch analysis. BMC Pregnancy Childbirth. 2016;16(1):361.CrossRefPubMedPubMedCentral Pallant J, Haines H, Green P, Toohill J, Gamble J, Creedy D, Fenwick J. Assessment of the dimensionality of the Wijma delivery expectancy/experience questionnaire using factor analysis and Rasch analysis. BMC Pregnancy Childbirth. 2016;16(1):361.CrossRefPubMedPubMedCentral
34.
go back to reference Fenaroli V, Saita E. Fear of childbirth: a contribution to the validation of the Italian version of the Wijma delivery expectancy/experience questionnaire (WDEQ). TPM Test Psychom Methodol Appl Psychol. 2013;20(2):131–54. Fenaroli V, Saita E. Fear of childbirth: a contribution to the validation of the Italian version of the Wijma delivery expectancy/experience questionnaire (WDEQ). TPM Test Psychom Methodol Appl Psychol. 2013;20(2):131–54.
35.
go back to reference Garthus-Niegel S, Størksen HT, Torgersen L, Von Soest T, Eberhard-Gran M. The Wijma delivery expectancy/experience questionnaire - a factor analytic study. J Psychosom Obstet Gynaecol. 2011;32(3):160–3.CrossRefPubMed Garthus-Niegel S, Størksen HT, Torgersen L, Von Soest T, Eberhard-Gran M. The Wijma delivery expectancy/experience questionnaire - a factor analytic study. J Psychosom Obstet Gynaecol. 2011;32(3):160–3.CrossRefPubMed
36.
go back to reference Garthus-Niegel S, Ayers S, von Soest T, Torgersen L, Eberhard-Gran M. Maintaining factors of posttraumatic stress symptoms following childbirth: a population-based, two-year follow-up study. J Affect Disord. 2015;172:146–52.CrossRefPubMed Garthus-Niegel S, Ayers S, von Soest T, Torgersen L, Eberhard-Gran M. Maintaining factors of posttraumatic stress symptoms following childbirth: a population-based, two-year follow-up study. J Affect Disord. 2015;172:146–52.CrossRefPubMed
37.
go back to reference Storksen HT, Eberhard-Gran M, Garthus-Niegel S, Eskild A. Fear of childbirth; the relation to anxiety and depression. Acta Obstet Gynecol Scand. 2012;91(2):237–42.CrossRefPubMed Storksen HT, Eberhard-Gran M, Garthus-Niegel S, Eskild A. Fear of childbirth; the relation to anxiety and depression. Acta Obstet Gynecol Scand. 2012;91(2):237–42.CrossRefPubMed
38.
go back to reference IBM Corp. IBM SPSS Statistics for Windows, Version 24.0. 2016. IBM Corp. IBM SPSS Statistics for Windows, Version 24.0. 2016.
39.
go back to reference Arbuckle JL. AMOS (version 23.0). Chicago: IBM SPSS; 2014. Arbuckle JL. AMOS (version 23.0). Chicago: IBM SPSS; 2014.
40.
go back to reference Hayton JC, Allen DG, Scarpello V. Factor retention decisions in exploratory factor analysis: a tutorial on parallel analysis. Organ Res Methods. 2004;7(2):191–205.CrossRef Hayton JC, Allen DG, Scarpello V. Factor retention decisions in exploratory factor analysis: a tutorial on parallel analysis. Organ Res Methods. 2004;7(2):191–205.CrossRef
41.
go back to reference Tveit T, Halvorsen A, Rosland J. Analgesia for labour: a survey of Norwegian practice–with a focus on parenteral opioids. Acta Anaesthesiol Scand. 2009;53(6):794–9.CrossRefPubMed Tveit T, Halvorsen A, Rosland J. Analgesia for labour: a survey of Norwegian practice–with a focus on parenteral opioids. Acta Anaesthesiol Scand. 2009;53(6):794–9.CrossRefPubMed
42.
go back to reference Israeli Ministry of Health. Natural childbirth in Hospitals 2017. Israeli Ministry of Health. Natural childbirth in Hospitals 2017.
43.
go back to reference Kolås T, Hofoss D, Daltveit AK, Nilsen ST, Henriksen T, Häger R, Ingemarsson I, Øian P. Indications for cesarean deliveries in Norway. Obstet Gynecol. 2003;188(4):864–70. Kolås T, Hofoss D, Daltveit AK, Nilsen ST, Henriksen T, Häger R, Ingemarsson I, Øian P. Indications for cesarean deliveries in Norway. Obstet Gynecol. 2003;188(4):864–70.
44.
go back to reference Pomeranz M, Arbib N, Haddif L, Reissner H, Romem Y, Biron T. “In god we trust” and other factors influencing trial of labor vs. repeat cesarean section. J Matern Fetal Neonatal Med. 2018;31(13):1777–81.CrossRefPubMed Pomeranz M, Arbib N, Haddif L, Reissner H, Romem Y, Biron T. “In god we trust” and other factors influencing trial of labor vs. repeat cesarean section. J Matern Fetal Neonatal Med. 2018;31(13):1777–81.CrossRefPubMed
45.
go back to reference Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmaki E, Saisto T. Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial. BJOG. 2013;120(1):75–84.CrossRefPubMed Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmaki E, Saisto T. Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial. BJOG. 2013;120(1):75–84.CrossRefPubMed
46.
go back to reference Nieminen K, Stephansson O, Ryding EL. Women's fear of childbirth and preference for cesarean section--a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. 2009;88(7):807–13.CrossRefPubMed Nieminen K, Stephansson O, Ryding EL. Women's fear of childbirth and preference for cesarean section--a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. 2009;88(7):807–13.CrossRefPubMed
47.
go back to reference Preis H, Benyamini Y. The birth beliefs scale – a new measure to assess basic beliefs about birth. J Psychosom Obstet Gynaecol. 2017;38(1):73–80.CrossRefPubMed Preis H, Benyamini Y. The birth beliefs scale – a new measure to assess basic beliefs about birth. J Psychosom Obstet Gynaecol. 2017;38(1):73–80.CrossRefPubMed
Metadata
Title
Childbirth preferences and related fears - comparison between Norway and Israel
Publication date
01-12-2018
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1997-5

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue