Fear of childbirth and elective caesarean section: a population-based study

Abstract

BackgroundThis population-based cohort study aimed to investigate the demographic and psychosocial characteristics associated with fear of childbirth and the relative importance of such fear as a predictor of elective caesarean section.MethodsA sample of 1789 women from the Akershus Birth Cohort in Norway provided data collected by three self-administered questionnaires at 17 and 32 weeks of pregnancy and 8 weeks postpartum. Information about the participants’ childbirths was obtained from the hospital records.ResultsEight percent of the women reported fear of delivery, defined as a score of ≥85 on the Wijma Delivery Expectancy Questionnaire. Using multivariable logistic regression models, a previous negative overall birth experience exerted the strongest impact on fear of childbirth, followed by impaired mental health and poor social support. Fear of childbirth was strongly associated with a preference for elective caesarean section (aOR 4.6, 95 % CI 2.9–7.3) whereas the association of fear with performance of caesarean delivery was weaker (aOR 2.4, 95 % CI 1.2–4.9). The vast majority (87 %) of women with fear of childbirth did not, however, receive a caesarean section. By contrast, a previous negative overall birth experience was highly predictive of elective caesarean section (aOR 8.1, 95 % CI 3.9–16.7) and few women without such experiences did request caesarean section.ConclusionsResults suggest that women with fear of childbirth may have identifiable vulnerability characteristics, such as poor mental health and poor social support. Results also emphasize the need to focus on the subjective experience of the birth to prevent fear of childbirth and elective caesarean sections on maternal request. Regarding the relationship with social support, causality has to be interpreted cautiously, as social support was measured at 8 weeks postpartum only.

Effect of Consultation and Educating in Preparation Classes for Delivery on Pregnancy Consequences: A Randomized Controlled Clinical Trial

“…Fear of delivery is one of the factors that leads to caesarean. This is verified by the study conducted by Storksen et al (19). The results of their study showed that 80% of their participants were afraid of delivery, and, although this fear was related to elective caesarean and caesarean section, the majority of their participants did not go under caesarean operation.…”

Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1—exercise in women planning pregnancy and those who are pregnant

“…These pregnancy-related anxieties are not associated with general anxiety or depressive feelings,177 and are reported by 14.4% of pregnant women 178. Fear of giving birth has been reported by 8% of women in a general pregnant population 179. Whether athletes suffer more or less from pregnancy-related anxieties is unknown, but they might have anxieties about being able to return to their sporting career, in the same way as some women have anxiety about returning to work 180…”

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“…Moreover, in the second counseling session, if the last delivery was cesarean section was accompanied by higher success rate than if it was not, p<0.001. As a result, the only explanation could be secondary tokophobia which is known as fear of labor pain or getting normal childbirth due to last pregnancy experience [24][25][26]. If patients are worried from pain or about the fetus, they can express their fears and we can release their concerns.…”