Fear of child birth and its associated factors among pregnant women in Ethiopia: systematic review and meta-analysis

Abstract

Fear of childbirth (FOCB) significantly contributes to labor abnormalities, needless caesarean sections, and postpartum psychotic illnesses that occur throughout pregnancy, childbirth, and the postpartum period. This directly or indirectly increases unfavorable maternal and neonatal outcomes. However, there was a paucity of data regarding the scope and contributing factors of birthing fear in Ethiopia. To assess the pooled prevalence of fear of childbirth and its associated factors among pregnant women in Ethiopia. This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. A comprehensive search was conducted using PubMed, Cochrane Library, Scopus, Web of science and African Journals Online databases and search engines like Google Scholar. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) quality assessment tool for cross-sectional studies. Heterogeneity among the studies was evaluated using the I² statistic, while publication bias was assessed with funnel plot, and Egger’s test. A fixed-effects model was applied to calculate the pooled prevalence and odds ratios, with results presented as 95% confidence intervals. A total of six studies, involving 2,579 pregnant women, were included in this review. The pooled prevalence of FOCB was found to be 25.48% (95% CI: 23.77–27.16). In Ethiopia unplanned pregnancy (AOR: 4.45, 95% CI: 2.68–7.38), a previous history of pregnancy complications (AOR: 6.43, 95% CI: 2.43–16.98), and a previous history of labor and delivery complications (AOR: 6.05, 95% CI: 3.65–10.01) were significantly associated with FOCB. The prevalence of FOCB in Ethiopia is higher than in other countries. Key factors contributing to FOCB include unplanned pregnancies, a history of pregnancy complications, and past labor or delivery issues. To reduce FOCB, reducing unplanned pregnancies through various strategies and offering preconception counseling, especially for women with prior obstetric complications, is recommended. CRD42024538215.