La peur de l’accouchement suscite un intérêt grandissant dans la littérature scientifique, et ce, du fait de son impact sur le vécu de la grossesse, et sur le déroulement de l’accouchement. Cette étude exploratoire cherche à déterminer l’impact de l’optimisme et de l’anxiété sur la peur de l’accouchement. Quatre-vingt douze femmes enceintes ont participé à cette étude. Parmi elles, 54 étaient primipares. La moyenne d’âge des participantes était d’environ 30ans (21–42). La durée de la grossesse variait de 7 à 9 mois. Les participantes ont répondu à différents questionnaires permettant de recueillir les informations concernant les antécédents psychologiques et gynécologiques et le vécu de la grossesse, et de mesurer la peur de l’accouchement, les symptômes anxio-dépressifs anténataux, le niveau d’optimisme et le niveau de satisfaction de vie. Les résultats indiquent que les facteurs favorisant la peur de l’accouchement sont la primiparité, les complications médicales rencontrées durant la grossesse et la présence d’une symptomatologie anxieuse. Trente-huit femmes (41,3 %) présentaient des symptômes d’anxiété. L’anxiété a un rôle médiateur dans la relation entre l’optimisme et la peur de l’accouchement. Cette étude apporte un éclairage supplémentaire concernant le rôle de l’anxiété dans la peur de l’accouchement, mais il serait intéressant de la reproduire avec une évaluation longitudinale.

Each woman experiences childbirth differently. Childbirth can be a positive or a very painful and stressful experience. Many factors can influence pregnancy and the experience of labor. Among these factors, fear of childbirth is known to be an important factor in childbirth outcomes. It may have an effect on labor pain, on the increase of pain relief, on planned caesarean requests and on the development of postpartum depression. Fear of childbirth appears to be more common among nulliparous women, but all pregnant women may have a fear of childbirth (Toohill et al., 2014; Salmela-Aro et al., 2012). Women with both anxiety and depression have the highest prevalence of fear of childbirth but some women with fear of childbirth have no symptoms of anxiety and/or depression (Storksen et al., 2012). Optimism is a trait which may vary over time. When people prepare to confront a difficulty, their state of confidence may be altered, therefore long term stability in optimism is not always high (Carver et al., 2010). Optimism confers benefits on what people are able to achieve (Scheier & Carver, 1992), so it may affect women's perceptions of their ability to cope with labor. Research into fear of childbirth focuses on risk factors but also on protective factors such as optimism (Gourounti et al., 2015). There are, however, inconsistencies in the literature; causes of fear of childbirth are not completely understood. Furthermore, little is known about how positive psychological factors may protect against fear of childbirth. This exploratory study aimed to determine the impact of optimism and anxiety on the fear of childbirth. We were interested in exploring if anxiety is a risk factor for fear of childbirth and if optimism is a protective factor.

Participants were recruited through maternity care services and maternity care providers’ offices in the South of France. Ninety-two pregnant women participated in the study. Among them, 54 were primiparous and 38 were multiparous. Participants’ average age was 30 years (21–42). All participants were in their third trimester; the duration of pregnancy was from 7 to 9 months. They were asked to complete a set of questionnaires regarding their psychological and gynecological history, their experience of pregnancy (anamnestic survey), their fear of childbirth (the Fear of Childbirth Scale; EPA), their antenatal anxiety and depression symptoms (the Hospital Anxiety and Depression Scale [HADS]), their optimism level (the Life Orientation Test–Revised; LOT-R) and their satisfaction of life (the Life Satisfaction Scale; ESDV).

The level of fear of childbirth was high in this sample (mean score EPA=63.48). Results indicated that factors promoting fear of childbirth were primiparity, medical complications during pregnancy and the presence of anxiety symptoms. In fact, primiparous women were more likely to experience fear of childbirth than multiparous women (mean score EPA=67.63 vs 57.58; P<.01). Women who had complications during pregnancy had higher scores than those without complications (mean score EPA=71.06 vs 59.80; P<.01). Women with anxiety symptoms had higher fear of childbirth scores than those without anxiety symptoms (mean score EPA=68.90 vs 58.39; P<.01). Fear of childbirth was associated with anxiety symptoms in thirty-eight women (41.30%). Variance in fear of childbirth scores was explained in part by anxiety and optimism. Anxiety mediated the relationship between optimism and fear of childbirth.

Anxiety acts as a buffer between optimism and fear of childbirth. A greater understanding of the role of anxiety in the development or in maintenance of fear of childbirth in pregnant women was gained. This current research suggests that clinical interventions which aim to reduce fear of childbirth should pay attention to anxiety symptoms before trying to develop positive strategies such as optimism. Future research should attempt to replicate these findings with a follow-up assessment. Multiple benefits could result when treating fear of childbirth. In fact, decrease in fear of childbirth among pregnant women could positively impact the quality of labor as well as the transition to motherhood and mother–infant bonding.