Exploring the burden and contributing factors of childbirth fear in Ethiopia: A systematic review and Meta-analysis

Objective This systematic review and meta-analysis aimed to synthesize evidence on the magnitude of childbirth-related fear and its associated factors among pregnant women in Ethiopia. Methods A comprehensive literature search was conducted in PubMed (January 1–15, 2025), MEDLINE (January 16–31, 2025), Web of Science (February 1–15, 2025), Google Scholar (February 16–March 31, 2025), and Google (April 1–30, 2025), following PRISMA guidelines. Seven studies met the inclusion criteria. Data extraction was performed using a standardized checklist, and statistical analyses were conducted using STATA version 14. Heterogeneity was assessed with Cochrane Q and I 2 statistics, and publication bias was evaluated using Egger's and Begg's tests, supported by funnel plots. Results The pooled prevalence of fear of childbirth among pregnant women in Ethiopia was 26.14 % (95 % CI, 16.77, 35.51). Significant factors associated with this fear included unplanned pregnancy (OR = 4.26; 95 % CI: 1.29, 14.09), previous obstetric complications (OR = 5.51; 95 % CI: 3.34, 9.09), low educational attainment (OR = 5.82; 95 % CI: 2.57, 13.21), and the presence of medical illness (OR = 3.60; 95 % CI: 1.67, 7.78). Conclusion Childbirth-related fear is a substantial maternal health concern in Ethiopia. Addressing this issue requires strengthening antenatal education, integrating psychological support into routine maternity care, and ensuring culturally sensitive community involvement to improve women's confidence and childbirth experiences.