Psychological factors and maternal-fetal attachment in relation to epidural choice

Introduction: A woman's first childbirth is an event of great importance to her life, involving her transition to parenthood. Many studies have analyzed the roles of depression, anxiety and fear of childbirth linked to childbirth expectations and the consequent choice of an epidural to avoid pain. Few studies have investigated the predictor role of maternal-fetal attachment on the choice of epidural. Objective: Explore, in a sample of low-risk pregnant nulliparous women, differences regarding the preference, or not, of epidural for vaginal childbirth. Design and Setting: 87 nulliparous women, aged 24 to 44 years of age, were recruited in the maternity ward of a public hospital of the metropolitan area of Tuscany (Italy) during the 3rd trimester of gestation. Participants were asked to complete the Pregnancy Related Anxiety Questionnaire-R, Wijma Delivery Expectancy Questionnaire, Centrality of Events Scale, and Prenatal Attachment Inventory. Findings: Multivariate analyses of variance showed that women who chose delivery without epidural reported lower levels of fear of childbirth and anxiety, and higher levels of centrality of pregnancy and prenatal attachment to unborn child, than women who chose epidural. Key conclusions: Our data highlight the importance that medical staff focus on the maternal bond, to help future mothers have the best possible childbirth experience.