Women’s experiences of fear of childbirth: a metasynthesis of qualitative studies

Abstract

Purpose: Women's experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women's experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women's experiences of fear of childbirth interpreted through the metaphor "being at a point of no return". Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other's experiences will not happen to them.

Modeling Preconception Perceptions of Pregnancy and Birth: A Qualitative Study of Women Living in Italy

“…Framed properly, these interrelated positive factors could serve to create an effective characterization of pregnancy and birth as normal and safe, with medical attention and social systems present to support women and keep them healthy through the process, rather than protect or prevent risks. A "safe-supported" rather than a "riskycontrolled" cycle may decrease preconception fear-based perspectives and lead to decreased anxiety and improved outcomes through the pregnancy and birth period (5,7,24). Feeling supported on an individual and societal level may contribute to a sense of safety, conversely allowing women to freely utilize support systems without them becoming a threat to autonomy.…”

“…Fear of negative birthing outcomes or complications among women correlated with higher elective Csection rates and perinatal interventions, negative attitudes toward birthing experience, and more intense labor pains, while pre-birth fear was associated with C-section preference and less positive perceptions of being pregnant (22,24). Clustering by fear, attitudes, and beliefs to understand pre-birth perceptions and decisional preferences demonstrated that fear can impact birth experience (22,24); however, what drives these concerns remains unclear. In Italian populations speci cally, fear of negative outcomes or the unknown has been identi ed as a reason to delay preconception planning (8).…”

“…In addition to risk, fear may be associated with pregnancy and birth perceptions and decisions (21)(22)(23)(24).…”

“…Women may consider birthing methods and outcomes prior to pregnancy due to media exposure or social interactions. Thus, addressing risk misperceptions during the preconception period may reduce fears by demonstrating safe and healthy deliveries that align with normal birthing processes (5,6,8,9,24). Social construction of risk may also stem from social support systems and culture (1,2,(32)(33)(34)(35).…”

“…How women hear pregnancy and birth discussed among family and friends and in social settings may prime women toward or reduce fear and risk. Prior reproductive health work has shown negative perceptions and experiences are more frequently and vividly recalled than positive (14,24,36,37), which may tie to perceptions of pregnancy and birth.…”