Fear, Choice and Childbirth: Birth Attitudes and Psychosocial Factors Behind the Preference for Caesarean Delivery
Abstract
Background
The rate of caesarean sections has been steadily increasing worldwide and in Hungary as well. Besides medical indications, psychological and social factors — such as fear of childbirth and related attitudes — also influence women's birth preferences. The aim of our study was to explore which psychosocial factors are associated with the preferred mode of delivery among pregnant women.
Methodology
In our cross-sectional, quantitative study, 105 pregnant women aged 18–40 completed an online questionnaire. We used the Rosenberg Self-Esteem Scale and the Attitudes Towards Childbirth Questionnaire. Sociodemographic data and delivery preference were also recorded. Data were analysed using SPSS 23.0, with descriptive statistics, chi-square tests, t-tests and ANOVA (p < 0.05).
Results
35.6% of participants preferred caesarean section, while 64.4% preferred vaginal birth. Women favouring caesarean section scored significantly higher on the “Fear” subscale (p = 0.047), and lower on the “Approach” (p = 0.03) and “Growth” (p = 0.002) subscales. No significant difference was found in self-esteem levels between preference groups (p > 0.05). Rural residents (p = 0.001) and women under 30 (p = 0.033) had a stronger preference for medical control, while religious participants showed a more positive attitude towards childbirth as a personal growth experience (“Growth” subscale, p = 0.003).
Conclusions
Fear of childbirth is the strongest predictor of caesarean preference. Age, residence and religiosity influence childbirth-related attitudes. The findings underline the importance of emotional support and antenatal education — especially through public health nurses — in reducing unnecessary caesarean rates and empowering women to make informed and confident choices about vaginal birth.
Keywords: caesarean section; birth attitudes; fear of childbirth; psychosocial factors; delivery preference
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