The mechanisms of prenatal coping styles and message sources among pregnant women with fear of childbirth: A cross-sectional study

Abstract Background Pregnant women's coping styles during childbirth can be positive or negative, but maladaptive coping is linked to adverse outcomes for both mother and infant. Therefore, it is crucial to understand the mechanisms behind their coping behavior and how they receive childbirth information in order to promote maternal-infant health. However, there is a lack of research on the underlying mechanisms and message sources. The present study aimed to explore the effects of intolerance of uncertainty, childbirth self-efficacy and fear of childbirth on prenatal coping and investigate the information sources of pregnant women, so as to provide support for clinical interventions. Methods The study surveyed a sample of pregnant women ( N = 294) who completed a questionnaire included questions on the participants' demographic information investigation between October 2022 and March 2023. The Childbirth Attitude Questionnaire, The Revised Prenatal Coping Inventory, The Intolerance of Uncertainty Scale-9, and The Childbirth Self-Efficacy Inventory measured fear of childbirth, prenatal coping styles, intolerance of uncertainty and childbirth self-efficacy, respectively. Bootstrapping mediation analysis was conducted to examine the relationship between all scale score. The Mann-Whitney test was used to examine differences in coping style scores among different message sources. Results The study found that intolerance of uncertainty directly affects pregnant women's avoidance coping, while childbirth self-efficacy influences positive behavior. Fear of childbirth can drive both positive and avoidance coping. Additionally, the relationship between intolerance of uncertainty and coping is mediated by self-efficacy and fear. Besides, actively coping pregnant women seek birth information from multiple sources, while those avoiding childbirth are less skilled in utilizing informational resources. Conclusions The findings shed light on the processes through which intolerance of uncertainty, childbirth self-efficacy and fear of childbirth may exert its effects on coping styles and offer theoretical guidance for clinical intervention and highlight the important way to carry out clinical intervention. The findings suggest that improving pregnant women's correct understanding of childbirth and coping skills can effectively alleviate the fear of childbirth. Clinicians should assist active pregnant women in accessing available information support, while also providing favorable information to those who avoiding childbirth through channels that women accept it most, such as social applications and websites. In addition, China should improve the role of midwives in antenatal care.