Trends in the epidemiology of fear of childbirth and association with intended mode of delivery: A nationwide register‐based cohort study in Finland

Vaajala, Matias; Liukkonen, Rasmus; Kuitunen, Ilari; Ponkilainen, Ville; Mattila, Ville M.; Kekki, Maiju

doi:10.1111/aogs.14521

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…It might be due to the lack of experience and information about the childbirth process for nulliparous women [ 54 ]. However, some other studies stated that multiparous women experienced FOC with a lower level [ 13 , 55 ], in which case multiparous women usually experienced traumatic or negative childbirth previously [ 7 ]. Notably, in this study, we also found higher FOC scores in pregnant women without history of cesarean section, which is inconsistent with previous findings [ 13 , 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Zhang,

Liu,

Min

et al. 2023

BMC Psychiatry

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Background Fear of childbirth (FOC) is a prevalent issue among pregnant women and significantly relates to adverse outcomes for the mother and child. However, it is not clear the prevalence and risk factors of FOC among pregnant women in a region with a moderate level of economic development in China. The aim of this study was to investigate the prevalence and risk factors of FOC among pregnant women in the third trimester of pregnancy in Lianyungang city, Eastern China. Methods A cross-sectional survey was conducted from December 2022 to February 2023 among pregnant women in the third trimester who met the inclusion criteria and visited Lianyungang Maternal and Child Health Hospital in Jiangsu Province, Eastern China. A structured questionnaire including sociodemographic characteristics, clinical characteristics, FOC, family function, doctor-patient communication, social support, general self-efficacy, anxiety, depression, insomnia symptoms, and quality of life was used to collect data. A multiple linear regression model was used to identify predictors of FOC. Results This study included 535 pregnant women in the third trimester. The mean score of FOC was 30.67 ± 10.18, and the median score was 29.00. The prevalence of FOC was 56.64%. Multiple linear regression analysis revealed that pregnant women with electronic screen exposure time more than 5 h per day (β = 2.02, 95%CI: 0.50–3.53, P < 0.05), no history of cesarean section (β = 2.66, 95%CI: 0.61–4.71, P < 0.05), likes sour food or hates greasy food (β = 1.75, 95%CI: 0.00-3.50, P < 0.05), anxiety (β = 0.50, 95%CI: 0.21–0.80, P < 0.05) and depression (β = 0.30, 95%CI: 0.04–0.57, P < 0.05) were more likely to have a greater level of FOC than their counterparts. However, a significantly lower level of FOC was observed in pregnant women who were multipara (β=-1.64, 95%CI: -3.27–0.01, P < 0.05), not worrying about delivery without family members (β=-3.75, 95%CI: -5.26–2.25, P < 0.001), had good family function (β=-0.32, 95%CI: -0.64–0.00, P < 0.05) and doctor-patient communication (β=-0.33, 95%CI: -0.64–0.02, P < 0.05). Conclusions The prevalence of FOC was high in Lianyungang city, Eastern China. FOC is influenced by multiple factors. There is an urgent need to develop interventions to reduce the prevalence of FOC in the third trimester of pregnancy, and to pay attention to pregnant women with risk factors for FOC.

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Section: Discussionmentioning

confidence: 99%

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Zhang,

Liu,

Min

et al. 2023

BMC Psychiatry

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“…As the prevalence of FOC is currently rapidly increasing, 3 studies assessing this topic are warranted. In addition, as the range of symptoms caused by FOC was recently found to be higher than thought, including lower birth rate and psychological challenges, 9,10 the studies should focus on the optimal treatment of patients with FOC, and prevent the development of FOC for women without a diagnosis FOC.…”

Section: Discussionmentioning

confidence: 99%

“…Fear of childbirth (FOC) is a common obstetrical challenge affecting women's health 1 . In Finland, the reported prevalence of FOC has increased from 1.1% in 1997 to 9.1% in 2018 2,3 . However, in other Nordic countries, the prevalence of FOC has been observed to be much higher, rising to 10%–20% 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Fear of childbirth and use of labor analgesia: A nationwide register‐based analysis in Finland

Vaajala

Kekki

Mattila

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo calculate the rates of labor analgesia among women with fear of childbirth (FOC) in multiparous and nulliparous women, because FOC might be associated with higher rates of labor analgesia.MethodsIn this retrospective register‐based cohort study, data from the National Medical Birth Register was used to evaluate the usage of labor analgesia in pregnancies with FOC, when compared with those without. The analgesia methods were stratified into neuraxial analgesia, pudendal, paracervical, nitrous oxide, other medical, other non‐medical, and no analgesia.ResultsA total of 19 285 pregnancies with diagnosed maternal FOC were found during our study period. The control group consisted of 757 997 pregnancies without diagnosed maternal FOC. Nulliparous women with diagnosed FOC had a higher rate of epidural analgesia (70.2% vs 67.1%), spinal analgesia (12.3% vs 7.6%), and pudendal block (17.6% vs 9.6%). Multiparous women with FOC had a notably higher rate for epidural analgesia (47.0% vs 29.0%).ConclusionThe main finding in this study was that women with diagnosed FOC had a higher rate of labor analgesia. The results of this study can be used by midwives, obstetricians, and anesthesiologists to provide optimal pain relief for mothers with FOC.

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“…Although previous research has demonstrated the relationship between a woman’s FOC and elective CS on maternal request ( Ryding et al, 2015 ; Vaajala et al, 2023 ), no prior research in the Saudi context has examined the association between childbirth fear and the mode of delivery preference. Therefore, the current study hypothesized that there is a significant impact of FOC on the mode of delivery preference among nulliparous women.…”

Section: Introductionmentioning

confidence: 99%

Mode of delivery preferences: the role of childbirth fear among nulliparous women

Elgzar,

Alshahrani,

Ibrahim

2023

Front. Psychol.

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IntroductionThe increasing Cesarean Section (CS) rates may be attributed to women’s increasing requests for elective CS. High Fear of Childbirth (FOC), especially among nulliparous women, may be significantly associated with CS preference without medical indications. The current study aims to investigate the impact of childbirth fear on the mode of delivery preference among nulliparous women.MethodsA cross-sectional correlational study was performed in the Maternal and Children Hospital (MCH) from the beginning of October 2022 to the end of February 2023 and incorporated a convenience sample of 342 nulliparous women. The data was collected using a self-reported questionnaire comprising participants’ demographic and obstetrics characteristics and the FOC questionnaire. A logistic regression model examined the relationship between CS preference and the other independent variables.ResultsThe results indicated that 74.3% of the nulliparous women preferred vaginal delivery, while 25.7% preferred Cesarean Section. Concerning childbirth-related fear, the highest mean scores were related to fear of clinical procedures, fear of harming or distressing the infant, and fear of pain 5.19 ± 1.13, 5.12 ± 1.27, and 5.09 ± 1.22, respectively. High FOC was present among 74.6%, moderate in 17.3%, and severe in 6.7% of the participants. Logistic regression analysis showed maternal age and monthly income were the significant sociodemographic determinants of choosing CS as the preferred delivery mode (p < 0.05). Moreover, the participants who had increased fear of harming or distressing the infant, fear from pain, fear from the body’s ability to give birth, fear from not being involved in decision-making, and overall FOC had a higher probability of choosing CS as the preferred delivery mode compared to the participants who had lower fear (p < 0.05).DiscussionHaving high FOC increases the CS preference among nulliparous women. Increased fear of harming or distressing the infant, fear from pain, fear from the body’s ability to give birth, and fear from not being involved in decision- making seem to be significant dimensions of childbirth fear associated with CS preference among nulliparous women.

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Trends in the epidemiology of fear of childbirth and association with intended mode of delivery: A nationwide register‐based cohort study in Finland

Cited by 6 publications

References 26 publications

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Fear of childbirth and its determinants in pregnant women in the third trimester: a cross-sectional study

Fear of childbirth and use of labor analgesia: A nationwide register‐based analysis in Finland

Mode of delivery preferences: the role of childbirth fear among nulliparous women

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