Therapeutic group psychoeducation and relaxation in treating fear of childbirth

Saisto, Terhi; Toivanen, Riikka; Salmela‐Aro, Katariina; Halmesmäki, Erja

doi:10.1080/00016340600756920

Cited by 115 publications

(150 citation statements)

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“…26 Previous studies have shown that treatment for fear of childbirth is effective, 15,[27][28][29][30] and this study adds a new important result by showing a possible reduction in postpartum mental health problems. To achieve this reduction it is important to offer women with fear of childbirth or demand for caesarean section professional support during pregnancy, as these problems cannot be solved by operative care.…”

Section: Discussionmentioning

confidence: 62%

“…For example, in the study hospitals the women who show a fear of childbirth are sent for consultations in a specialist maternity clinic where they are treated by trained midwives, psychologists, obstetricians and with group psychoeducation. 15,27 In addition to this support, recognition of the problem and further referral for psychiatric consultation or to a clinical psychologist might have improved the mental well-being. Hence, we assume that the care and support they received during pregnancy may explain the fact that women with a fear of childbirth were at lower risk of needing postpartum psychiatric care than controls.…”

Section: Discussionmentioning

confidence: 99%

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Mental health problems common in women with fear of childbirth

Rouhe

Salmela‐Aro

Gissler

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

133

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Objective To investigate whether women with fear of childbirth have more mental health problems than women of childbearing age in general.Design Register-based retrospective study.Setting The maternity clinic of Helsinki University Central Hospital.Population In all, 2405 women referred for consultation because of fear of childbirth during 1996-2002 and 4676 comparable control women.Methods Data were linked to the Medical Birth Register, the Hospital Discharge Register and the Drug Reimbursement Register 5-12 years before and after the initial childbirth (during 1990-2008).Main outcome measures Prevalence of psychiatric care as evidenced by the use of psychotropic medication, and episodes of either psychiatric inpatient or outpatient care in women with fear of childbirth compared with nonfearful controls.Results Women with fear of childbirth had significantly more often had psychiatric care (54.0% versus 33.6%, P < 0.001) during the study period. Fearful and nonfearful women differed from each other (P < 0.001) regarding psychiatric inpatient care (7.2% versus 3.6%), outpatient care (19.0% versus 9.8%) and the use of psychotropic medication (51.3% versus 31.3%). Mood and anxiety disorders were the most common psychiatric diagnoses in both groups. The major predictors for a need for psychiatric care after the initial childbirth were previous psychiatric care (adjusted odds ratio 4.5; 95% CI 4.0-5.1) and fear of childbirth (adjusted odds ratio 1.9; 95%CI 1.7-2.1).Conclusions A remarkable mental morbidity was seen among women of childbearing age. Mental health problems were twice as common among women with a fear of childbirth as in nonfearful controls. Clinical practice on how to evaluate and treat women fearing childbirth should be developed.Keywords Fear of childbirth, psychiatric care, psychotropic medication.Please cite this paper as: Rouhe H, Salmela-Aro K, Gissler M, Halmesmäki E, Saisto T. Mental health problems common in women with fear of childbirth. BJOG 2011;118:1104-1111. IntroductionIt has been estimated that 6-10% of all pregnant women suffer from a severe fear of childbirth. [1][2][3][4][5] Several studies have shown a connection between fear of childbirth and psychiatric disorders (such as depression, anxiety disorders, eating disorders, bipolar disorder), 6-8 but there are also contradictory results suggesting that only a small part of fear is related to general anxiety and depression 9 or that postpartum depression is not related to fear of vaginal delivery. 10 Previously, all studies have concentrated on symptoms of depression and anxiety during pregnancy 6-9 or they have excluded women with diagnosed psychiatric illnesses, 10 but the well-being of fearful women before and after pregnancy and childbirth has not been examined using large-scale registers. As far as psychological predictors of fear of childbirth are concerned, previous studies have shown that the fear of childbirth is related to certain personality types, anxiety, low self-esteem, nonfunctional relationship with the partner and lac...

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Mental health problems common in women with fear of childbirth

Rouhe

Salmela‐Aro

Gissler

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

133

View full text Add to dashboard Cite

show abstract

“…Encouraging the woman with severe FOC to verbalize her thoughts about the upcoming birth could be one way to reveal individual needs and thus increase the probability of providing her with relevant care. In comparison, Saisto et al [40] showed that psychoeducation and training relaxation during pregnancy were successful methods for helping women with FOC, even ending up in withdrawals of requests for a caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Self-efficacy beliefs and fear of childbirth in nulliparous women

Salomonsson

Gullberg

Alehagen

et al. 2013

Journal of Psychosomatic Obstetrics & Gynecology

121

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Objective: To explore how childbirth self-efficacy, i.e. outcome expectancy and efficacy expectancy, was associated with fear of childbirth (FOC) and how efficacy expectancy and FOC respectively were related to socio-demographic characteristics, mental problems and preference for a caesarean section. Methods:In this cross sectional study, a consecutive sample of 1000 pregnant nulliparous women was sent the Wijma Delivery Expectancy Questionnaire and Childbirth Self-Efficacy Inventory. Statistical analyses were performed on data from 423 women.Results: Outcome expectancy and efficacy expectancy correlated significantly and positively, FOC correlated significantly and negatively with both outcome expectancy and efficacy expectancy. Women with severe FOC (20.8 %) had a significantly lower level of education (p= 0.001), and had more often sought help because of mental problems (p= 0.004). They were more likely to have low efficacy expectancy (p<0.001) and to prefer a caesarean section instead of a vaginal birth (p<0.001).Conclusions: Lower efficacy expectancy was associated with higher FOC while preference for a caesarean section was not. Improvement of self-efficacy could be a part of care for women with FOC during pregnancy; however, it would not be enough for fearful women who wish to have a caesarean section.

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“…High levels of childbirth fear in pregnancy are thought to influence women's decisions about birth mode. Previously Saisto et al [12] identified that in Sweden and the United Kingdom, between 7% and 22% of requests for CS were due to childbirth fear.…”

Section: Introductionmentioning

confidence: 99%

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

Toohill¹,

Fenwick²,

Gamble³

et al. 2014

OJOG

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Background: Around 20% of birthing women report high levels of childbirth fear. Fear potentially impacts women's emotional health, preparation for birth, and birth outcomes. Evidence suggests that personal and external factors contribute to childbirth fear, however results vary. Aim: To identify pyscho-social factors associated with childbirth fear and possible antenatal predictors of childbirth fear according to women's parity. Method: 1410 women in second trimester and attending one of three public hospitals in south-east Queensland were screened for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Other measures included the Edinburgh Depression Scale (EPDS), Decisional Conflict Scale (DCS) and items from the EuroQol (EQ-5D) targeting Anxiety/Depression and Pain/Discomfort. In addition items measuring a previous mental health condition, social support and knowledge were used. Preferred mode of birth was also collected. Psycho-social factors were analysed to determine associations with childbirth fear. Multivariate analysis was used to determine predictors of fear. Results: Thirty-one percent (n = 190/604) of nulliparous and 18% (n = 143/782) of multiparous women reported high fear levels. Having a mental health history, desiring a caesarean section, reporting moderate to high pain during pregnancy, having a non-supportive partner and perceiving less childbirth knowledge than peers, were associated with childbirth fear. Standard multiple regression analyses by parity determined that depression, decisional conflict, low social support and less perceived knowledge predicted levels of childbirth fear. The model explained 32.4% of variance in childbirth fear for nulliparous and 29.4% for multiparous women. Conclusion: Psychosocial factors are significantly associated with childbirth fear. The identification of predictive psychosocial factors for childbirth fear indicates the importance of observing, assessing, and developing support strategies for women. Such strategies are required to decrease anxiety and depression for women during pregnancy, promote normal birth, and build social support to improve women's feelings J. Toohill et al. 532 and positive expectations of birth.

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Therapeutic group psychoeducation and relaxation in treating fear of childbirth

Abstract: Group psychoeducation and relaxation exercises were well received and rated as very helpful. More cesarean section requests were withdrawn than in the comparison group and in previous studies.

Cited by 115 publications

References 38 publications

Mental health problems common in women with fear of childbirth

Mental health problems common in women with fear of childbirth

Self-efficacy beliefs and fear of childbirth in nulliparous women

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

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