Program

Nurse-Midwifery M.S.

Number of Pages

45

Year Approved

2026

First Advisor

Diane Banigo

Second Reader

Cassidy Hemphill

Abstract

Fear of childbirth (FOC) and tokophobia have a significant impact on one in every five pregnant women and is associated with enhanced levels of anxiety, depression, pre-traumatic stress, and has led to increased requests for elective cesarean sections. Given the influence that it has on birth mode and perceived birth experience as well as postpartum wellbeing, it stands to reason that FOC represents an often-overlooked aspect of perinatal mental health.
This capstone reviews cohort, cross-sectional, randomized, and quasi-experimental studies examining prevalence, correlations, and consequences of FOC. It evaluates antenatal education, midwife-led support, and cognitive behavioral therapy as potential interventions. Outcomes include fear scores using evidence-based tools, childbirth self-efficacy, mode of birth, obstetric interventions, and evaluations of postpartum psychological adjustment.
FOC has been found to be common across parity and is a predictor of higher cesarean rates related to non-medical indications. Providing education throughout the antenatal period and incorporating management strategies has shown a reduction in overall fear, improved childbirth self-efficacy, and clear improvement in vaginal birth rates. Midwife-led psychoeducation and counseling correspond with positive birth experiences, less negative flashbacks, and a preference for vaginal birth in future pregnancies. Offering intrapartum interventions, including continuous midwifery support during labor, has been linked to an improvement in pain perception, fear reduction, and a shortened active labor phase.
Evidence indicates that FOC can significantly impact how obstetric decisions are made and even influence postpartum mental health wellbeing. It is shown to be a modifiable condition that can be improved through targeted psychosocial and educational interventions. The integration of FOC screening during the earlier antenatal interactions as well as the inclusion of proactive strategies such as stepped-care counseling, childbirth education, and implementing a plan for fear-sensitive intrapartum support has been linked to less cesarean sections with improved birth experiences. Research gaps include limited long-term outcomes, discrepancies in FOC definitions, and lower-resource settings.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

Terms of Use and License Information

Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

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