Depression and Fear Associated with Childbirth in Primigravid Women – A Cross-Sectional Study

Abstract

Background: Pregnancy represents a major transitional phase in a woman’s life; however, a substantial proportion experience apprehension related to childbirth, commonly referred to as tokophobia, which may adversely affect maternal well-being and pregnancy outcomes. Antenatal depression and anxiety are recognized predictors of postpartum psychological morbidity. Primigravid women appear particularly susceptible, yet Indian data on antenatal fear and depressive symptoms remain limited. Aim: To determine the prevalence of fear of childbirth and depression among primigravid women and to evaluate their association with selected sociodemographic and obstetric factors. Materials and Methods: This cross-sectional study was carried out over 18 months in the Obstetrics and Gynecology outpatient department of Aarupadai Veedu Medical College and Hospital, Puducherry. A total of 115 primigravid women aged 18–40 years, with no history of abortion or diagnosed medical or psychiatric illness, were enrolled through convenience sampling. Sociodemographic and obstetric details were obtained using a semi-structured proforma. Fear of childbirth was assessed using a standardized (FOC) questionnaire, and depressive symptoms were screened with the Edinburgh Postnatal Depression Scale (EPDS). Statistical analysis was done using descriptive statistics, chi-square tests, and logistic regression analysis, with statistical significance at p < 0.05. Results: The mean age of the participants was 25.5 ± 4.7 years, with most participants from lower socioeconomic groups (77.4%) and rural settings (80.9%). Fear of childbirth was common, with 31.3% experiencing mild fear, 27.8% moderate fear, and 27.0% severe fear. Mild depressive symptoms were found in 13% of the participants. Fear of childbirth was significantly associated with socioeconomic status, rural residence, and increasing gestational age, whereas depressive symptoms were significantly associated with rural residence and increasing gestational age. Educational status, religion, and family structure had no significant associations. Conclusion: Fear of childbirth is very common in primigravid women, whereas antenatal depression is relatively rare and mild. Socioeconomic disadvantage, rural residence, and advancing pregnancy are important determinants of psychological susceptibility, emphasizing the need for early screening and targeted antenatal care.