Report on Maternal Mental Wellbeing and its Impact on Childbirth Fear

Introduction and Alignment with Sustainable Development Goals (SDGs)

A global-first study conducted by Robert Gordon University and the University of South Australia has identified key psychological factors that mitigate fear of childbirth (FOC). This research provides critical insights for improving antenatal care, directly supporting the United Nations’ Sustainable Development Goals, particularly SDG 3: Good Health and Well-being and SDG 5: Gender Equality. By focusing on the mental and emotional empowerment of expectant mothers, the findings present a strategic approach to enhancing maternal health, reducing medical interventions, and promoting positive birth experiences for women and infants, which are central tenets of SDG 3. Furthermore, empowering women with confidence and self-belief in their childbirth capabilities aligns with the broader objectives of SDG 5.

Study Overview and Methodology

The cross-sectional study investigated the factors that contribute to confidence and calmness during pregnancy, rather than those that exacerbate fear. The research involved:

1. A survey of 88 pregnant women in their third trimester attending antenatal classes in north-east Scotland.
2. The use of the Warwick-Edinburgh Mental Wellbeing Scale to measure the relationship between a woman’s mental wellbeing, her childbirth self-efficacy, and her level of FOC.

The study found that while 12% of participants exhibited ‘severe’ FOC, a significant portion reported fewer concerns, linked directly to specific psychological and social factors.

Key Findings and Implications for SDG 3

The research identified two primary predictors for lower levels of childbirth fear, offering a clear pathway to achieving targets under SDG 3, specifically Target 3.1 (reduce maternal mortality) and Target 3.4 (promote mental health and well-being).

• Mental Wellbeing: This was the strongest predictor of reduced fear. Components of strong mental wellbeing included a sense of purpose, emotional positivity, and the presence of meaningful social relationships. Promoting these elements is a direct intervention for improving maternal mental health as outlined in SDG 3.
• Childbirth Self-Efficacy: The second most significant factor was a woman’s belief in her own ability to manage labour, particularly her confidence in applying coping strategies.

These findings underscore that a focus on psychological resilience can lead to healthier birth processes, potentially reducing the need for emergency caesareans and mitigating postpartum mental health issues, thereby improving outcomes for both mothers and infants.

Recommendations for Antenatal Care Reform

The study calls for a paradigm shift in antenatal education, moving from a risk-centric, medical model to a wellness-focused approach that builds maternal self-belief. This shift is crucial for advancing both SDG 3 and SDG 5. Recommended reforms for childbirth education programs include:

• Fostering confidence in the practical application of labour techniques such as breathing, visualisation, and relaxation.
• Enhancing psychological wellbeing by actively supporting social connection, a sense of purpose, and overall life satisfaction.
• Embracing a holistic approach that prioritizes wellness and empowerment over a singular focus on medical risks.

The Role of Antenatal Relaxation Practices

Subsequent research has validated the efficacy of specific interventions. A study on antenatal relaxation practices, led by Dr. Mo Tabib, demonstrated that women who incorporated these techniques reported “significant improvements” in their mental wellbeing and confidence. These positive effects were sustained for 4-8 weeks postpartum. This aligns with the World Health Organization’s global priority to promote the holistic health of women during pregnancy, a goal intrinsically linked to SDG 3. By addressing FOC through targeted psychological and educational support, healthcare systems can contribute to more positive birth experiences and better health outcomes.

Conclusion and Future Directions

This body of research highlights that maternal mental wellbeing and self-efficacy are powerful protective factors against the fear of childbirth. By reforming antenatal care to build psychological resilience, healthcare providers can directly contribute to the achievement of SDG 3 (Good Health and Well-being) and SDG 5 (Gender Equality). The report concludes with a call for larger, multi-site studies to validate these findings across diverse populations, ensuring that all women have the opportunity for a positive and empowered childbirth experience. Investing in the psychological health of pregnant women is a vital strategy for improving maternal-infant outcomes and advancing global health and equality agendas.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

SDG 3: Good Health and Well-being

This is the most prominent SDG in the article. The entire study focuses on the mental and physical health of pregnant women and the outcomes for both mothers and babies. The article discusses fear of childbirth, mental wellbeing, postpartum mental health, and the quality of antenatal care. It directly aligns with the goal of ensuring healthy lives and promoting well-being for all at all ages, with a specific focus on maternal and infant health. The text explicitly mentions that the findings align with “global priorities from the World Health Organization to promote the mental and physical health of women during pregnancy.”

SDG 5: Gender Equality

While not the primary focus, SDG 5 is relevant through its emphasis on empowering women and ensuring their reproductive health and rights. The article advocates for shifting antenatal care from a purely medical model to one that “empowers them to believe they can do it.” This focus on building women’s confidence, self-efficacy, and providing them with tools for a positive birth experience contributes to their empowerment in a crucial aspect of their lives. Improving maternal health and ensuring women have positive, respected healthcare experiences are integral to achieving gender equality.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
     
     The article connects to this target by addressing risk factors that contribute to maternal morbidity and mortality. It notes that fear of childbirth can lead to “prolonged labour, emergency caesareans and postpartum mental health issues,” all of which can increase risks during and after childbirth. By aiming to reduce these negative outcomes, the interventions discussed contribute to safer pregnancies and births.
   • Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
     
     This target is directly addressed. The study’s central theme is the promotion of mental health and well-being for pregnant women. It identifies a woman’s “sense of mental wellbeing” as the “strongest predictor of how fearful she felt.” The research calls for antenatal care to enhance “psychological wellbeing” and focuses on improving “maternal well-being and childbirth experiences.”
   • Target 3.8: Achieve universal health coverage, including… access to quality essential health-care services…
     
     The article critiques the current quality and approach of some antenatal care services and proposes improvements. It calls for antenatal programs to “shift from a solely medical model to one that builds self-belief” and focuses on wellness rather than just risks. This is a call to improve the quality and effectiveness of an essential healthcare service for pregnant women.

2. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights…
     
     The article’s recommendations support this target by focusing on a woman’s experience and autonomy during childbirth, a key reproductive health event. By advocating for education that “fosters confidence” and “empowers them to believe they can do it,” the research promotes a model of care where women are active, informed, and confident participants, which is a core component of reproductive rights and health.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicators for SDG 3 Targets

   • Prevalence of severe fear of childbirth (FOC): The article explicitly states that in the study, “12% exhibited ‘severe’ fear of childbirth (FOC).” Tracking and reducing this percentage would be a direct indicator of improved maternal mental health.
   • Mental wellbeing scores: The study used the “Warwick-Edinburgh Mental Wellbeing Scale to measure the link between mental wellbeing… and fear of childbirth.” This scale can be used as a quantitative indicator to measure the effectiveness of interventions designed to improve psychological wellbeing.
   • Rates of medical interventions: The article mentions that fear can lead to “prolonged labour” and “emergency caesareans.” It also states that the proposed interventions could “potentially reduce medical interventions.” Therefore, tracking the rates of emergency C-sections and the average duration of labour could serve as indicators of progress.
   • Incidence of postpartum mental health issues: The article identifies “postpartum mental health issues” as a negative consequence of childbirth fear. Measuring the incidence of conditions like postpartum depression would be a relevant indicator of improved outcomes.
   • Childbirth self-efficacy levels: The study identifies “childbirth self-efficacy” as a key predictor of fear. This can be measured through surveys to assess women’s confidence in their ability to manage labour, serving as an indicator of the effectiveness of empowering antenatal education.

2. Indicators for SDG 5 Targets

   • Women’s self-reported birth experience satisfaction: The article’s goal is to “support women to have more positive birth experiences.” A qualitative or quantitative measure of satisfaction, collected post-birth, would be a key indicator of whether women feel respected, supported, and empowered during childbirth, which aligns with reproductive rights.
   • Adoption of wellness-focused antenatal models: An indicator could be the percentage of antenatal care programs that have shifted from a “solely medical model” to one that incorporates confidence-building, psychological support, and relaxation techniques as recommended in the article.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article.

Source: newswise.com