Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child

Abstract

Women with severe FOC generate considerably higher perinatal costs than women with low FOC when handled in care as usual.

Interventions to reduce unnecessary caesarean sections in healthy women and babies

“…16,17 The most recent systematic review on worldwide preferences reported an overall pooled preference for CS of 15%, and only 10% when excluding women with a previous CS. 16 For women who do favour CS in the absence of medical indications, reasons include fear of labour pain, particularly where epidural analgesia is not accessible or affordable, [18][19][20][21][22][23][24] fear of pelvic floor damage and urinary incontinence, 25,26 or fear of a reduced quality of sexual life. [26][27][28] Contrary to scientific evidence, most women who prefer CS perceive it to be safer for the baby and for themselves.…”

Neuroticism is associated with higher antenatal care utilization in obstetric low‐risk women

“…However, the results suggest that targeted psychological treatment might prove to be cost-effective.Our findings suggest the usefulness of measuring neuroticism as a vulnerability marker, disregarding the overlap with the clinical entities of depression and anxiety disorders. Untreated severe fear of childbirth is associated with a considerable increase in the consumption of Swedish ANC, according to a recent study by Nieminen et al,22 who F I G U R E 2 Non-linear association between neuroticism and the number of phone consultations or visits to a midwife in specialized antenatal care. Negative binomial regression with incidence rate ratios (black line) and 95% confidence intervals (gray area) comparing neuroticism scores with the 25th percentile as the reference (figures printed for the 10th, 25th, 50th, 75th and 90th percentiles).…”

“…As a standard, first-line antenatal care (ANC) is provided by midwives in primary care settings and healthy women with normal pregnancies follow a routine program of eight-nine midwife consultations and a fetal ultrasound examination at gestational week 16-18. 22 A recent meta-analysis shows that structured psychological therapy for individuals or groups, independently of approach (eg, supportive, cognitive-behavioral or psychodynamic), is effective at decreasing neuroticism. However, women with conditions requiring higher medical surveillance (eg, certain types of chronic disease or pregnancy complications) may be referred to a specialized ANC service within obstetrics/gynecology (ObGyn) departments.…”

“…Swedish women commonly attend more ANC visits than are prescheduled; 20 factors associated with these increased visits include antenatal depression and anxiety 20,21 and untreated severe fear of childbirth. 22 A recent meta-analysis shows that structured psychological therapy for individuals or groups, independently of approach (eg, supportive, cognitive-behavioral or psychodynamic), is effective at decreasing neuroticism. 23 However, currently, psychological support for subclinical anxiety in primary ANC is only given when time permits and the schedule may seldom allow for more than a few extra visits.…”

“…Untreated severe fear of childbirth is associated with a considerable increase in the consumption of Swedish ANC, according to a recent study by Nieminen et al,22 who F I G U R E 2 Non-linear association between neuroticism and the number of phone consultations or visits to a midwife in specialized antenatal care. However, the results suggest that targeted psychological treatment might prove to be cost-effective.Our findings suggest the usefulness of measuring neuroticism as a vulnerability marker, disregarding the overlap with the clinical entities of depression and anxiety disorders.…”