Fear of childbirth: a neglected dilemma

Abstract

Severe fear of childbirth complicates 6% to 10% of parturients and is manifested as nightmares, physical complaints and difficulties in concentrating on work or on family activities. Very often fear of childbirth leads to request for an elective cesarean section (CS). In Finland, Sweden, and the United Kingdom, fear of childbirth or maternal request is the reason for about 7-22% of CS births. Fear of childbirth is as common in nulliparous as in parous women. Fear of labor pain is strongly associated with the fear of pain in general, and a previous complicated childbirth or inadequate pain relief are the most common reasons for requesting a CS among parous women. Previous psychological morbidity and a great number of daily stressors expose a woman to a great risk of fear of childbirth. Fear of childbirth is not an isolated problem but associated with the woman's personal characteristics, mainly general anxiety, low self-esteem, and depression, and dissatisfaction with their partnership, and lack of support. Also the partners of women with fear have a certain pattern of low psychological well-being, resulting in low life-satisfaction, dissatisfaction with partnerships, and depression. A vivid debate about the woman's right to choose the mode of delivery is going on in obstetric literature, but discussion on the reasons for women to request a CS, or on the possibilities to help them overcome the fear of vaginal childbirth is scanty. Preliminary Swedish and Finnish reports demonstrated the results of treatment during pregnancy, when more than half of the women withdrew their request after being able to discuss their anxiety and fear, and vaginal deliveries after treatment were successful.

Predictors of Fear Related to Childbirth among Iranian Primigravidae

“…Based on their results, 31.1% of Swedish pregnant women and 29.5% of Australian pregnant women suffered from severe fear related to childbirth. The rate of severe fear in the present study is higher than what has been reported in developed countries which may be due to difference in culture, attitude, and perception of pregnant women, different instruments, time of measurement, quality of prenatal care, and education (Haines et al, 2012;Haines et al, 2011;Saisto & Halmesmäki, 2003;Weaver et al, 2007). Despite availability of prenatal care for all women in Iran, childbirth education programs are lacking in the Iranian prenatal care system.…”

“…Melender (2002) reported that pregnant women experience a variety of fears about the baby's well-being, which manifest as symptoms of stress. Lack of social support, low self esteem, high level of daily stressors and dissatisfaction of marital relationship are predisposing factors of fear related to pregnancy (Saisto & Halmesmäki, 2003). Social and psychosocial aspects of the woman's life, self esteem, social support and quality of marital relationship, as well as a negative experience of labour and delivery are associated with the fear related to childbirth.…”

The Validity and Reliability of Persian Version of Wijma Delivery Expectancy/Experience Questionnaire (Version A) among Iranian Nulliparous Women

“…Severe fear of childbirth affects around 6-10% of women worldwide (Saisto & Halmesmäki, 2003). A study in Australia on 1410 women showed that the prevalence of fear of childbirth was 24% and 31.5% of nulliparous women had severe fear of childbirth (Toohil et al, 2014).…”

The Fear of Childbirth: A Study in the North of Portugal

“…It influences daily life activities, the decision on a cesarean section delivery, and sometimes even the postponement of pregnancy (Melender, 2002;Hildingsson, Rådestad, Rubertsson & Waldenstrom, 2002;Bahl, Strachan & Murphy, 2004;Nilsson & Lundgren, 2009). During childbirth, fear leads to an increased perception of pain (Lang, Sorrell, Rodgers & Lebeck, 2006), potentially causing the woman to request an elective caesarean section (Saisto, Salmela-Aro, Nurmi, & Halmesmäki, 2001;Hildingsson et al, 2002;Saisto, & Halmesmäki. 2003;Bahl et al, 2004), prolong labour, and contribute to a negative birth experience and low satisfaction levels with childbirth (Larsen, O'Hara, Brewer, & Wenzel, 2001;Hildingsson et al, 2002;Johnson, & Slade 2002;Melender, 2002;Hofberg, & Ward, 2003;Saisto, & Halmesmäki, 2003;Wax Cartin, Pinette, & Blackstone, 2004;Waldenstrom, Lang et al, 2006;Hildingsson, 2008;Rouhe, Salmela-Aro, Halmesmäki, & Saisto, 2008;Nilsson & Lundgren, 2009;Fenwick, Gamble, Nathan, Bayes, & Hauck, 2009).…”