Does fear of childbirth during pregnancy predict emergency caesarean section?

Abstract

Objective Caesarean section rates are rising dramatically in the UK. It has been estimated that they have increased from 10% to 22% of all births over 15 years. A Swedish study has suggested that fear of childbirth during pregnancy may increase the risk of emergency caesarean section. The aim of this study is to identify whether fear of childbirth can predict the occurrence of emergency caesarean section in a UK sample. Design A prospective design using between-group comparisons.Setting Sheffield, S. Yorkshire, UK.Sample Four hundred and forty-three pregnant women, recruited at 32 weeks of gestation, over 16 years of age.Methods Participants completed self-assessment, postal questionnaires assessing fear of labour and anxiety using the Wijma Delivery Expectancy Scale (W-DEQ) and the Speilberger State Trait Anxiety Scale (STAI), together with their expectations about their mode of delivery. Delivery information was gathered via birth summary sheets. Main outcome measure Mode of delivery.Results Emergency caesarean section was associated with previous caesarean section, parity, age and a score reflecting medical risk, but not fear of childbirth or anxiety measures. There were no differences in fear between women experiencing spontaneous-vertex, forceps/ventouse, emergency or elective caesarean deliveries. The W-DEQ was factor analysed and was found to measure four distinct domains: fear, lack of positive anticipation and the degree to which women anticipate isolation and riskiness in childbirth. However, these individual factors also failed to contribute to the prediction of mode of delivery. Primiparous women in the UK sample showed highly elevated fear scores when compared with a Swedish sample. Such discrepancies were not found for the multiparous sample. Conclusions Fear of childbirth during the third trimester is not associated with mode of delivery in a UK sample. Possible cross-cultural differences are discussed.

Aetiological relationships between factors associated with postnatal traumatic symptoms among Japanese primiparas and multiparas: A longitudinal study

“…The minimum score is 0 and the maximum is 165. The JW-DEQ version A has four factors, Fear, Lack of positive anticipation, Isolation and Riskiness (Takegata et al, 2013), which were extracted from an exploratory factor analysis and are consistent with those identified in studies using the English and Swedish versions (Fenwick et al, 2009;Johnson and Slade, 2002). In the present study, Cronbach's alpha for the JW-DEQ total score was 0.93.…”

Pregnant Women's Fear of Childbirth in Midwife- and Obstetrician-Led Care in Belgium and the Netherlands: Test of the Medicalization Hypothesis

“…Moreover, it is also represented in other fear of childbirth scales, such as the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) (Wijma, Wijma, & Zar, 1998). In an exploratory factor analysis of the W-DEQ Johnson and Slade (2002) grouped the baby-related items together with other items, indicating the riskiness of birth. In addition the Cronbach's alpha for our two-item subdimension was 0.75, the inter-item correlation was 0.60, which indicates sufficient reliability and coherence of the babyrelated fear subdimension.…”

“…Several authors have hypothesized theoretical dimensions of fear, but few have tested them by means of factor analysis. One exception was the study of Johnson and Slade (2002) who identified four factors within the Wijma Delivery Expectancy Scale (W-DEQ) by means of principal components analysis. The scale reflects fear of childbirth, the positive aspects of bearing a child, the risks inherent in labour and feelings of isolation.…”

A case of successful vaginal delivery in a patient with a repair of an imperforate anus

“…항문막힘 증 교정수술을 받은 병력이 있는 산모에서 질식분만의 금기증이 존재 하지 않는다면 질식분만하는 것이 추천되고 있기는 하나, 이에 대해서 여전히 논쟁 중이다 [2]. 그래서 일부 산부인과 의사들은 항문막힘증을 포함해 항문직장기형으로 교정수술을 받은 모든 산모들에게 제왕절개 로 분만하기를 권하기도 한다 [3][4][5]. [1,6].…”

“…질식분만이 시행하기 어려울 수 있고 이미 교정된 상태 를 악화시킬 수 있어 제왕절개술을 시행해야 한다는 주장과 이전 수술 로 인한 유착과 정상인에 비해 복잡한 해부학적 구조로 인해 제왕절개 술이 질식분만보다 오히려 어려울 수 있다는 주장이 대립되고 있다 [4]. 실제 대부분의 산부의과 의사는 항문막힘증을 포함해 항문직장기형으 로 교정수술을 받은 산모들을 제왕절개로 분만하기를 선호한다 [3][4][5]. 이처럼 항문막힘증 교정술의 병력이 있는 환자들에서 가장 주된 문 제는 질식분만이 가능할지를 결정하는 것이다 [9].…”