Abstract:
Background: Many women experience fear of childbirth (FoB) and depressive symptoms (DS) during pregnancy, but
little is known about FoB among Tanzanian women. The current study aimed to assess the prevalence of FoB and DS
among pregnant women and determine predictors of each and both, focusing on sociodemographic and obstetric
predictors.
Methods: A cross-sectional study was conducted at six health facilities in two districts in Tanzania between 2018 and
2019. In total, 694 pregnant women with gestational age between 32 and 40weeks and expecting vaginal delivery
were consecutively recruited and assessed for FoB and DS. We collected data through interviews using 6 and 4-points
Likert Scale of the Wijma Delivery Expectancy Questionnaire Version A and Edinburgh Postnatal Depression Scale,
respectively. Women who scored ≥66 and≥10 were categorised as having FoB and DS, respectively. We performed
multivariable logistic regression to investigate the predictors of FoB and DS.
Results: The prevalence rates of FoB and DS among pregnant women were 15.1 and 17.7%, respectively. FoB and
DS were more likely in women aged above 30 years [Adjusted Odds Ratio (AOR) 6.29, 95%CI 1.43–27.84] and in single
mothers (AOR 2.57, 95%CI 1.14–5.78). Women with secondary education and above (AOR 0.22, 95%CI 0.05–0.99) and
those who had given birth previously (AOR 0.27, 95% CI 0.09–0.87) were less likely to have FoB in combination with
DS Women who had previous obstetric complications, and those who did not receive any social support from male
partners in previous childbirth were more likely to have FoB and DS. FoB was strongly associated with DS (AOR 3.42,
95%CI 2.12–5.53). DS only was more common in women who had inadequate income (AOR 2.35, 95%CI 1.38–3.99) or
had previously experienced a perineal tear (AOR 2.32, 95%CI 1.31–4.08).
Conclusions: Not having a formal education, having only primary education, being aged above 30 years, being
single, being nulliparous, having experienced obstetric complications, and having a lack of social support from a male
partner during previous pregnancy and childbirth were predictors of FoB and DS during pregnancy. FoB and DS werestrongly associated with each other. It is vital to identify at-risk women early, to ofer support during pregnancy and
childbirth
