title: Factors associated with childbirth self-efficacy in Australian childbearing women.
abstract: BACKGROUND
  Childbirth confidence is an important marker of women's coping abilities during labour and birth. This study investigated socio-demographic, obstetric and psychological factors affecting self-efficacy in childbearing women.
  
  
  METHODS
  This paper presents a secondary analysis of data collected as part of the BELIEF study (Birth Emotions - Looking to Improve Expectant Fear). Women (n = 1410) were recruited during pregnancy (≤24 weeks gestation). The survey included socio-demographic details (such as age and partner support); obstetric details including parity, birth preference, and pain; and standardised psychological measures: CBSEI (Childbirth Self-efficacy Inventory), W-DEQ A (childbirth fear) and EPDS (depressive symptoms). Variables were tested against CBSEI first stage of labour sub-scales (outcome expectancy and self-efficacy expectancy) according to parity.
  
  
  RESULTS
  CBSEI total mean score was 443 (SD = 112.2). CBSEI, W-DEQ, EPDS scores were highly correlated. Regardless of parity, women who reported low childbirth knowledge, who preferred a caesarean section, and had high W-DEQ and EPDS scores reported lower self-efficacy. There were no differences for nulliparous or multiparous women on outcome expectancy, but multiparous women had higher self-efficacy scores (p < .001). Multiparous women whose partner was unsupportive were more likely to report low self-efficacy expectancy (p < .05). Experiencing moderate pain in pregnancy was significantly associated with low self-efficacy expectancy in both parity groups, as well as low outcome expectancy in nulliparous women only. Fear correlated strongly with low childbirth self-efficacy.
  
  
  CONCLUSIONS
  Few studies have investigated childbirth self-efficacy according to parity. Although multiparous women reported higher birth confidence significant obstetric and psychological differences were found. Addressing women's physical and emotional wellbeing and perceptions of the upcoming birth may highlight their level of self-efficacy for birth.
  
  
  BACKGROUND
  Australian New Zealand Controlled Trials Registry ACTRN12612000526875 , 17(th) May 2012.
authors: School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. L.Schwartz@griffith.edu.au.
authors: Lianne
authors: L
authors: Schwartz
authors: School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. J.Toohill@griffith.edu.au.|Griffith Health Institute, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. J.Toohill@griffith.edu.au.
authors: Jocelyn
authors: J
authors: Toohill
authors: School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. D.Creedy@griffith.edu.au.|Griffith Health Institute, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. D.Creedy@griffith.edu.au.
authors: Debra K
authors: DK
authors: Creedy
authors: School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. K.Baird@griffith.edu.au.|Griffith Health Institute, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. K.Baird@griffith.edu.au.
authors: Kathleen
authors: K
authors: Baird
authors: School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. J.Gamble@griffith.edu.au.|Griffith Health Institute, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. J.Gamble@griffith.edu.au.
authors: Jenny
authors: J
authors: Gamble
authors: School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. J.Fenwick@griffith.edu.au.|Griffith Health Institute, Griffith University, University Drive, Meadowbrook, QLD, 4131, Australia. J.Fenwick@griffith.edu.au.|Gold Coast University Hospital, Parklands Drive, Southport, QLD, 4215, Australia. J.Fenwick@griffith.edu.au.
authors: Jennifer
authors: J
authors: Fenwick
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001315:Australia; D002585:Cesarean Section / Q000523:psychology; D003863:Depression / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007743:Labor, Obstetric / Q000523:psychology*; D010146:Pain / Q000523:psychology; D010298:Parity; D036801:Parturition / Q000523:psychology*; D057240:Patient Preference; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D037841:Pregnant People / Q000523:psychology*; D012044:Regression Analysis; D020377:Self Efficacy; D012944:Social Support; D018454:Spouses