Up to now it has been difficult to study fear of childbirth because of a shortage of adequate psychological measurements. Therefore the Wijma Delivery Expectancy/ Experience Questionnaire (W-DEQ) was developed. This paper presents the theoretical background of the W-DEQ together with a documentation of the first psychometric studies. Examination of construct validity indicates that it seems to be possible to penetrate a psychological construct related to fear of childbirth by means of the W-DEQ, both before and after delivery, in nulliparous as well as in parous women. The questionnaire measures the construct more clearly in parous than in nulliparous women. Internal consistency reliability and split-half reliability of the W-DEQ of > or = 0.87 are good for a new research instrument. More research is on its way to make the W-DEQ suitable even for measurements in applied settings.

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In a group of late pregnant women we investigated the prevalence of extreme fear of childbirth and anxiety disorders, both assessed by means of diagnostic interviews. We also explored the relation between anxiety disorders and extreme fear of childbirth on the one hand and fear of childbirth, as measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), on the other hand. A subgroup of women (2.4%) fulfilled the criteria for a phobia-like fear of childbirth. Anxiety disorders were related to fear of childbirth, as measured by the W-DEQ. The group of women with extreme fear of childbirth (with or without anxiety disorders) had obviously the highest W-DEQ scores. But also in the group of women with anxiety disorders only the W-DEQ scores were high. Clinical assessment of anxiety disorders among pregnant women should be considered, above all in women who report fear of the anticipated delivery.

The link between fear of childbirth and theories of anxiety in general is discussed. A possible expression of trait (T-fear) and state (S-fear) aspects of fear of childbirth was investigated in 77 nulliparous and 85 parous women based on data from gestational week 32, at 2 hours and at 5 weeks after childbirth. Data are based on the State Trait Anxiety Inventory and the Wijma Delivery Expectancy/Experience Questionnaire. According to their scores on the Wijma Delivery Expectancy/Experience Questionnaire during late pregnancy, women were divided into 3 groups: high, moderate and low levels of fear of childbirth. In gestational week 32, women in the low level of fear of childbirth group had lower trait anxiety than those in the moderate level of fear of childbirth group, who had lower trait anxiety than the women in the high level of fear of childbirth group. Nulliparous women had a higher level of fear of childbirth but a lower level of trait anxiety than did parous women. There was a significant decreasing trend in fear of childbirth from 2 hours to 5 weeks after delivery, in a parallel way for all 3 groups. Differences in fear of childbirth between nulliparous and parous women disappeared after delivery. These findings suggest that fear of childbirth comprises a considerable part of T-fear, with the risk of a vicious cycle, i.e. that during labour women experience what they are afraid of, which also influences the women's postpartum cognitive appraisal of the delivery.

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The aim of the study was to search for bivariate associations between on the one hand samples of background, job-related and well-being characteristics, and on the other hand longitudinally recorded sick-leave in individuals with repeated short-term sick-leave. Out of altogether 123 subjects included, 113 self-rated their well-being at the onset of, and 88 also after, a supportive programme. The well-being rating covered experience of treatment by other people, reservation, loneliness, inferiority, tension, vulnerability, guilt, security and indolence. Socio-demographic and job-related characteristics and attitudes were registered and declared at the initial contact. Correlations between these separate sets of independent variables, and sick-leave occasions and days in each of the two years following the contact were computed. There was an almost complete lack of covariation between background variables and sick-leave. Neither did job-related characteristics correlate. Only an expressed wish for a job change was vaguely associated with more absence days, but not with more spells. In striking contrast, a convincing consistent longitudinal pattern between self-rated well-being and sick-leave behaviour emerged. The poorer the well-being, the greater the subsequent sick-leave. Yet, a major part of the sick-leave variance remained unexplained. Accordingly, other etiological factors may still interact with well-being in the comprehensive setting behind the sick-leave behaviour.(ABSTRACT TRUNCATED AT 250 WORDS)