An evaluation of midwives' counseling of pregnant women in fear of childbirth

Ryding, Elsa Lena; Persson, Åsa; Onell, Cecilia; Kvist, Linda J.

doi:10.1034/j.1600-0412.2003.820102.x

Cited by 121 publications

(102 citation statements)

References 21 publications

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“…Women with fear of childbirth are more vulnerable in general [56,57], more often have previous mental health problems [18,19] and more previous traumatizing experiences [58] and are therefore also at a known risk of developing PTSD after delivery [7]. Our study population showed a high prevalence of PTSD profiles compared with the normal pregnant population (21% of the women who answered versus 1.5-2% in the general pregnant population) [59,60].…”

Section: Discussionmentioning

confidence: 59%

Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial

Rouhe

Salmela‐Aro

Toivanen

et al. 2014

Journal of Psychosomatic Obstetrics & Gynecology

104

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Section: Discussionmentioning

confidence: 59%

Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial

Rouhe

Salmela‐Aro

Toivanen

et al. 2014

Journal of Psychosomatic Obstetrics & Gynecology

104

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“…In being aware of women’s fears in particular, midwives and doctors then must be sensitive to anxieties which can be approached with reassurance, information and one to one support. While the role of specific counselling for fear of childbirth has not been shown to ‘cure’ fear [55,56] clinicians must remain alert to women with serious distress requiring referral for expert psychological help.…”

Section: Discussionmentioning

confidence: 99%

The influence of women’s fear, attitudes and beliefs of childbirth on mode and experience of birth

Haines

Rubertsson

Pallant

et al. 2012

BMC Pregnancy Childbirth

182

141

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BackgroundWomen’s fears and attitudes to childbirth may influence the maternity care they receive and the outcomes of birth. This study aimed to develop profiles of women according to their attitudes regarding birth and their levels of childbirth related fear. The association of these profiles with mode and outcomes of birth was explored.MethodsProspective longitudinal cohort design with self report questionnaires containing a set of attitudinal statements regarding birth (Birth Attitudes Profile Scale) and a fear of birth scale (FOBS). Pregnant women responded at 18-20 weeks gestation and two months after birth from a regional area of Sweden (n = 386) and a regional area of Australia (n = 123). Cluster analysis was used to identify a set of profiles. Odds ratios (95% CI) were calculated, comparing cluster membership for country of care, pregnancy characteristics, birth experience and outcomes.ResultsThree clusters were identified – ‘Self determiners’ (clear attitudes about birth including seeing it as a natural process and no childbirth fear), ‘Take it as it comes’ (no fear of birth and low levels of agreement with any of the attitude statements) and ‘Fearful’ (afraid of birth, with concerns for the personal impact of birth including pain and control, safety concerns and low levels of agreement with attitudes relating to women’s freedom of choice or birth as a natural process). At 18 -20 weeks gestation, when compared to the ‘Self determiners’, women in the ‘Fearful’ cluster were more likely to: prefer a caesarean (OR = 3.3 CI: 1.6-6.8), hold less than positive feelings about being pregnant (OR = 3.6 CI: 1.4-9.0), report less than positive feelings about the approaching birth (OR = 7.2 CI: 4.4-12.0) and less than positive feelings about the first weeks with a newborn (OR = 2.0 CI 1.2-3.6). At two months post partum the ‘Fearful’ cluster had a greater likelihood of having had an elective caesarean (OR = 5.4 CI 2.1-14.2); they were more likely to have had an epidural if they laboured (OR = 1.9 CI 1.1-3.2) and to experience their labour pain as more intense than women in the other clusters. The ‘Fearful’ cluster were more likely to report a negative experience of birth (OR = 1.7 CI 1.02- 2.9). The ‘Take it as it comes’ cluster had a higher likelihood of an elective caesarean (OR 3.0 CI 1.1-8.0).ConclusionsIn this study three clusters of women were identified. Belonging to the ‘Fearful’ cluster had a negative effect on women’s emotional health during pregnancy and increased the likelihood of a negative birth experience. Both women in the ‘Take it as it comes’ and the ‘Fearful’ cluster had higher odds of having an elective caesarean compared to women in the ‘Self determiners’. Understanding women’s attitudes and level of fear may help midwives and doctors to tailor their interactions with women.

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“…Treatment consists of 2–4 visits with partners, relaxation techniques, a visit to the labour ward and development of an individualized birth plan [18]. Fearful women who initially wished to be delivered by caesarean section (CS) were less inclined to do so after counselling [19-22]. In comparative studies, an evaluation of midwife-led counselling with 53 fearful women compared to matched controls produced positive results [19], however, Sjorgren et al [23] found no difference between women treated for fear and non-fearful controls.…”

Section: Introductionmentioning

confidence: 99%

“…Fearful women who initially wished to be delivered by caesarean section (CS) were less inclined to do so after counselling [19-22]. In comparative studies, an evaluation of midwife-led counselling with 53 fearful women compared to matched controls produced positive results [19], however, Sjorgren et al [23] found no difference between women treated for fear and non-fearful controls. Recently, Finnish researchers tested the effectiveness of 5 group sessions facilitated by a psychologist with first time pregnant women with intense fear and requesting a CS.…”

Section: Introductionmentioning

confidence: 99%

Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention

Fenwick

Gamble

Creedy

et al. 2013

BMC Pregnancy Childbirth

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BackgroundChildbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body’s ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women’s childbirth fear, support normal birth, and diminish the possibility of a negative birth experience.Methods/designPregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4–6 weeks after birth.DiscussionThis study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women’s childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes.Trial registrationAustralian New Zealand Controlled Trials Registry ACTRN12612000526875.

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An evaluation of midwives' counseling of pregnant women in fear of childbirth

Cited by 121 publications

References 21 publications

Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial

Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial

The influence of women’s fear, attitudes and beliefs of childbirth on mode and experience of birth

Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention

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