Fear of childbirth according to parity, gestational age, and obstetric history

Abstract

Objective To examine fear of childbirth according to parity, gestational age, and obstetric history.Design A questionnaire study.Population and setting 1400 unselected pregnant women in outpatient maternity clinics of a university central hospital.Methods Visual analogue scale (VAS) and Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and preferred mode of delivery.Main outcome measures W-DEQ and VAS scores according to parity, gestational age, obstetric history, and preferred mode of delivery.Results The W-DEQ and VAS scores were higher in nulliparous (W-DEQ 72.0 ± 20.0 [mean ± SD] and VAS 4.7 [median]) than parous women (65.4 ± 21.9; 3.2, P < 0.001 for both W-DEQ and VAS). Higher W-DEQ and VAS scores were found for those beyond 21 weeks of gestation compared with those before (W-DEQ 71.6 ± 23.0 versus 66.6 ± 20.0, P < 0.001; VAS 4.7 versus 3.2, P < 0.001). Caesarean section was preferred mode of delivery for 8.1% and these women scored higher on fear (W-DEQ 87.6 ± 26.5, VAS median 7.0) than those who preferred vaginal delivery (W-DEQ 61.8 ± 18.7, VAS 2.7, P < 0.001, respectively). Those with a previous caesarean scored higher on fear (W-DEQ 73.2 ± 23.5, VAS 5.1) than parous women without previous caesarean (W-DEQ 63.3 ± 20.8, VAS 2.9, P < 0.001, respectively). Those with a history of a vacuum extraction (VE) (W-DEQ 70.6 ± 19.7, VAS 5.0) had higher fear scores than those without (W-DEQ 64.8 ± 22.0, P < 0.05 and VAS 3.0, P < 0.001).Conclusion Severe fear of childbirth was more common in nulliparous women, in later pregnancy, and in women with previous caesarean section or VE. Caesarean section as a preferred mode of childbirth was strongly associated with high score in both W-DEQ and VAS.

Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care

“…It has been associated with factors such as nulliparity (Rouhe, Salmela-Aro, Halmesmaki, & Saisto, 2009), increased gestation (Rouhe et al, 2009), poor mental health (Laursen, Hedegaard, & Johansen, 2008;Storksen, Eberhard-Gran, Garthus-Niegel, & Eskild, 2012), a history of abuse (Lukasse, Vangen, Oian, & Schei, 2011;Nerum, Halvorsen, Sorlie, & Oian, 2006), younger age (Laursen et al, 2008), lower education (Laursen et al, 2008), and low self-efficacy (Salomonsson, Gullberg, Alehagen, & Wijma, 2013). Although fear of childbirth is more common in nulliparous women, women who have a negative or traumatic experience of birth are almost five times more likely to report fear of childbirth in a subsequent pregnancy (Storksen, Garthus-Niegel, Vangen, & Eberhard-Gran, 2013).…”

“…There is good evidence from large epidemiological studies that women with fear of childbirth are more likely to want interventions such as epidural analgesia and caesarean sections (Nieminen et al, 2009;Rouhe et al, 2009). Evidence on the relationship between fear of childbirth and birth outcomes is inconsistent, however the balance of evidence suggests fear of birth is associated with negative outcomes such as increased labour duration (Adams, Eberhard-Gran, & Eskild, 2012) and caesarean section (Laursen et al, 2009;Sydsjo et al, 2013;Waldenstrom, Hildingsson, & Ryding, 2006).…”

Psycho-Social Predictors of Childbirth Fear in Pregnant Women: An Australian Study

“…Questions are presented in positive and negative formats on a six point Likert scale from 0 -5 requiring reverse scoring of positively formulated questions. A score equal to or lower than 37 is considered low fear, a score between 38 and 65 equates to moderate fear and a score equal to or higher than 66 represents a high level of fear [20].…”

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

“…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). Compared to available international data, evidence on the extent and causes of childbirth fear in the Portuguese population is limited.…”