How do I overcome my fear of childbirth?

Submitted by: Anonymous



Chart summary of 25 studies examining this question
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SUMMARIES OF STUDIES
Total studies in list: 25 showing 20 studies at a time
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1
AUTHORS
Gülşen Vural
Mesut Yalvaç
Dilek Sarpkaya Güder
PUBLISHED
2018 in Quality & quantity
UNRANKED SOURCE
2
Interventions for reducing fear of childbirth: A systematic review and meta-analysis of clinical trials
"Introduction: Fear of childbirth is a problematic mental health issue during pregnancy. But, effective interventions to reduce this problem are not well understood. Objectives: To examine effective interventions for reducing fear of childbirth. Material and methods: The Cochrane Central Register of Controlled Trials, PubMed, Embase and PsycINFO were searched since inception till September 2017 without any restriction. Randomised controlled trials and quasi-randomised controlled trials comparing interventions for treatment of fear of childbirth were included. The standardized mean differences were pooled using random and fixed effect models. The heterogeneity was determined using the Cochran's test and I2index and was further explored in meta-regression model and subgroup analyses. Results: Ten studies inclusive of 3984 participants were included in the meta-analysis (2 quasi-randomized and 8 randomized clinical trials). Eight studies investigated education and two studies investigated hypnosis-based intervention. The pooled standardized mean differences of fear for the education intervention and hypnosis group in comparison with control group were -0.46 (95% CI -0.73 to -0.19) and -0.22 (95% CI -0.34 to -0.10), respectively. Conclusions: Both types of interventions were effective in reducing fear of childbirth; however our pooled results revealed that educational interventions may reduce fear with double the effect of hypnosis. Further large scale randomized clinical trials and individual patient data meta-analysis are warranted for assessing the association."
AUTHORS
Shayesteh Jahanfar
Milad Nazarzadeh
Vahideh MoghaddamHosseini
PUBLISHED
2017 in Women and Birth
High quality source
Literature Review
3
A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth
"BACKGROUND Despite a sharp increase in the number of publications that report on treatment options for pregnancy-specific anxiety and fear of childbirth (PSA/FoB), no systematic review of nonpharmacological prenatal interventions for PSA/FoB has been published. Our team addressed this gap, as an important first step in developing guidelines and recommendations for the treatment of women with PSA/FoB. METHODS Two databases (PubMed and Mendeley) were searched, using a combination of 42 search terms. After removing duplicates, two authors independently assessed 208 abstracts. Sixteen studies met eligibility criteria, ie, the article reported on an intervention, educational component, or treatment regime for PSA/FoB during pregnancy, and included a control group. Independent quality assessments resulted in the retention of seven studies. RESULTS Six of seven included studies were randomized controlled trials (RCTs) and one a quasi-experimental study. Five studies received moderate quality ratings and two strong ratings. Five of seven studies reported significant changes in PSA/FoB, as a result of the intervention. Short individual psychotherapeutic interventions (1.5-5 hours) delivered by midwives or obstetricians were effective for women with elevated childbirth fear. Interventions that were effective for pregnant women with a range of different fear/anxiety levels were childbirth education at the hospital (2 hours), prenatal Hatha yoga (8 weeks), and an 8-week prenatal education course (16 hours). CONCLUSIONS Findings from this review can inform the development of treatment approaches to support pregnant women with PSA/FoB."
AUTHORS
Patricia Janssen
Elizabeth Nethery
Nichole Fairbrother
Emma Marie Swift
Kathrin Stoll
PUBLISHED
2017 in Birth
High quality source
Literature Review
4
AUTHORS
S. Jahanfar
M. Nazarzadeh
V. MoghaddamHosseini
PUBLISHED
2017 in European Psychiatry
High quality source
Literature Review
5
AUTHORS
Elif ULUDAĞ
Merve ÇAMLIBEL
Merlinda ALUŞ TOKAT
Özlem ÇİÇEK
Samiye METE
PUBLISHED
2017 in Turkiye Klinikleri Journal of Nursing
UNRANKED SOURCE
6
Effects of extended childbirth education by midwives on the childbirth fear of first-time mothers: an RCT
"Scand J Caring Sci; 2016 Effects of extended childbirth education by midwives on the childbirth fear of first-time mothers: an RCT Objective: This study evaluates how extended childbirth education intervention affects first-time mothers' fear of childbirth and its manifestation during pregnancy. Method: A randomised controlled trial was conducted. A total of 659 first-time mothers were recruited before week 14 of gestation during the first ultrasound screen-ing at the hospital's maternity outpatient clinic. The mothers were randomly assigned into an intervention group (n = 338) or a control group (n = 321). The con-trol group received all available regular childbirth educa-tion. In addition, the intervention group received an enhanced 2-hour childbirth education at the maternity hospital. Outcome measurements and statistical analysis: The objects of childbirth fears (childbirth-related fear, fear for the mother's and the child's well-being, fear related to Cae-sarean section) were the primary outcomes. The manifes-tations of childbirth fears (everyday life, stress symptoms and the wish to have a Caesarean section) were the sec-ondary outcomes. These outcomes were measured over 34 weeks of gestation using two parts of the instrument 'Feelings of Fear and Security Associated with Pregnancy and Childbirth'. Logistic and ordinal linear regression models were used to model the effect of the intervention on the outcomes. Findings: The mothers in the intervention group had less childbirth-related fear than those in the control group [odds ratio (OR) 0.58, 95% confidence level (CL) 0.38– 0.88]. Also, fear influenced the mothers in the interven-tion group less in everyday life than it did the mothers in the control group [OR 0.64, 95% CL 0.44–0.94]. Conclusion: The effectiveness of the intervention can be considered moderate: one of three objects and one of three manifestations of fears were reduced. The interven-tion proved most efficient in alleviating relatively limited objects of fears."
AUTHORS
Päivi Åstedt-Kurki
Martti Arffman
Marja Kaunonen
Sari Haapio
PUBLISHED
2017 in Scandinavian Journal of Caring Sciences
Q2
7
The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study
"Background Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. Purpose This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Design Quasi-experimental study. Methods The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared???an antenatal education intervention group (n??=??44), and a routine prenatal care control group (n??=??46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale???Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Results Compared to the control group, women who attended antenatal education had greater childbirth self-efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, p??<??0.05). Conclusions Antenatal education appears to alleviate post-traumatic stress disorder symptoms after childbirth."
AUTHORS
Pelin Dıkmen Yıldız
Hatice Önal
Figen İnci
Gözde Gökçe İsbir
PUBLISHED
2016 in Applied Nursing Research
Q2
8
Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment
"Objective: to examine the effects of antenatal education on fear of childbirth, maternal self-efficacy, and maternal and paternal attachment. Design: quasi-experimental study, comparing an antenatal education group and a control group. Participants: 63 pregnant women and their husbands. Measurements: demographic data forms, the Wijma Delivery Expectancy/Experience Questionnaire, the Childbirth Self-Efficacy Inventory, the Maternal Attachment Inventory and the Postnatal Paternal-Infant Attachment Questionnaire were used for data collection. Findings: antenatal education was found to reduce the fear of childbirth and to increase childbirth-related maternal self-efficacy. However, antenatal education was found to have no effect on parental attachment. Key conclusions: it is recommended that widespread antenatal education programmes should be provided in developing countries, and the content of the education programme about parental attachment should be increased. Implications for practice: this study found that antenatal education has no influence on maternal and paternal attachment. As such, there is a need to increase the content of the education programme about parental attachment."
AUTHORS
Hatice Başkale
Pınar Serçekuş
PUBLISHED
2016 in Midwifery
High quality source
9
Does antenatal education reduce fear of childbirth?
"AIM: The aim of this study was to determine the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. BACKGROUND: There is insufficient evidence pertaining to the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. INTRODUCTION: The purpose of antenatal education is to help couples make the right decisions during delivery. Through antenatal education, couples prepare themselves for delivery. METHODS: This is a quasi-experimental and prospective study that employs a pre- and post-education model. In total, 192 pregnant women (education group, n = 69 and control group, n = 123) participated in the study. Data were collected using the pregnancy identification form: the Prenatal Self-Evaluation Questionnaire and a version of the Wijma Delivery Expectancy/Experience Questionnaire. RESULTS: Prior to participating in the study, the education group and control group had similar levels of acceptance of pregnancy and identification with motherhood role, whereas a significant difference was found in their fear of childbirth levels. When surveyed again after receiving education, the two groups' levels of acceptance of pregnancy and fear of childbirth were found to be significantly different. However, they had similar levels of identification with the motherhood role. CONCLUSION: Antenatal education appears to increase the acceptance of pregnancy, does not affect the identification with motherhood role and reduces the fear of childbirth. IMPLICATIONS FOR NURSING AND HEALTH POLICY: A systematic antenatal education programme, as part of routine antenatal care services, would help reduce the rate of interventional labour and facilitate pregnant women's conscious participation in the act of labour by reducing their fear of childbirth."
AUTHORS
N. Demirci
S. Cebeci Mutlu
Y. Doğan Merih
D. Coşkuner Potur
Ö. Karabulut
PUBLISHED
2016 in International Nursing Review
High quality source
10
The effects of counseling on fear of childbirth
"OBJECTIVE: To investigate women's experiences of attending existing counseling programs for childbirth-related fear and the effect of this counseling over time., DESIGN: A longitudinal survey., SETTING: Three hospitals in the central north of Sweden., SAMPLE: A selected sample of 936 women. Of these, 70 received counseling due to fear of childbirth (study-group)., METHODS: Data were collected with questionnaires 2 months and 1 year after giving birth with background data collected during midpregnancy. Comparisons were made between women with or without counseling. Crude and adjusted odds ratios (OR) were calculated., MAIN OUTCOME MEASURES: Self-reported childbirth fear, experience of counseling, birth experience and preferred mode of birth., RESULTS: Women in the counseling group reported higher childbirth fear 1 year after giving birth (OR 5.0, 95% confidence interval (95% CI) 2.6-9.3), they had a more negative birth experience that did not change over time (OR 2.1, 95% CI 1.2-3.9) and they preferred cesarean section to a greater extent (OR 12.0, 95% CI 5.1-28.1) in the case of another birth. Also, they were more often delivered by planned cesarean section (OR 4.7, 95% CI 2.4-9.1). However, 80% were satisfied with the given support., CONCLUSION: Although women were satisfied with the treatment, this study shows that counseling had a minor effect on fear of childbirth, birth experiences or cesarean section rates. To help women with their fear of childbirth, more effective methods of treatment are needed.Copyright © 2015 Nordic Federation of Societies of Obstetrics and Gynecology."
AUTHORS
Ingegerd Hildingsson
Christine Rubertsson
Annika Karlström
Birgitta Larsson
PUBLISHED
2015 in Acta Obstetricia et Gynecologica Scandinavica
High quality source
11
Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial
"BACKGROUND Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother-infant relationship. METHODS Three hundred and seventy-one nulliparous women out of 4575 scored ≥100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. RESULTS Postnatal maternal adjustment (MAMA mean score 38.1 ± 4.3 versus 35.7 ± 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 ± 29 versus 73.7 ± 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 ± 5.4 versus 8.0 ± 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. CONCLUSIONS In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care."
AUTHORS
Elsa-Lena Ryding
Erja Halmesmäki
Maiju Tokola
Riikka Toivanen
Katariina Salmela-Aro
Hanna Rouhe et al
PUBLISHED
2015 in Journal of Psychosomatic Obstetrics & Gynecology
UNRANKED SOURCE
12
Effects of continuous midwifery labour support for women with severe fear of childbirth
"BACKGROUND: Continuous support by a midwife during childbirth has shown positive effects on the duration of active labour, use of pain relief and frequency of caesarean section (CS) in women without fear of childbirth (FOC). We have evaluated how continuous support by a specially assigned midwife during childbirth affects birth outcome and the subjective experience of women with severe FOC.\n\nMETHODS: A case-control pilot study with an index group of 14 women with severe FOC and a reference group of 28 women without FOC giving birth. In this study the index group received continuous support during childbirth.\n\nRESULTS: The women with severe FOC more often had an induction of labour. The parous women with severe FOC had a shorter duration of active labour compared to the parous reference women (p = 0.047). There was no difference in caesarean section frequency between the two groups. Women with severe FOC experienced a very high anxiety level during childbirth (OR = 20.000, 95 % CI: 3.036-131.731).\n\nCONCLUSION: Women with severe FOC might benefit from continuous support by a midwife during childbirth. Midwives should acknowledge the importance of continuous support in order to enhance the experience of childbirth in women with severe FOC."
AUTHORS
Ann Josefsson
Marie Bladh
Louise Angerbjörn
Sofie Palmquist
Marie Blomberg
Gunilla Sydsjö
PUBLISHED
2015 in BMC Pregnancy and Childbirth
High quality source
13
Effectiveness of a Mindfulness-Based Childbirth Education Pilot Study on Maternal Self-Efficacy and Fear of Childbirth
"INTRODUCTION: This pilot study tested the feasibility and effectiveness of using Mindfulness-Based Childbirth Education (MBCE), a novel integration of mindfulness meditation and skills-based childbirth education, for mental health promotion with pregnant women. The MBCE protocol aimed to reduce fear of birth, anxiety, and stress and improve maternal self-efficacy. This pilot study also aimed to determine the acceptability and feasibility of the MBCE protocol. METHODS: A single-arm pilot study of the MBCE intervention using a repeated-measures design was used to analyze data before and after the MBCE intervention to determine change trends with key outcome variables: mindfulness; depression, anxiety, and stress; childbirth self-efficacy; and fear of childbirth. Pregnant women (18-28 weeks' gestation) and their support companions attended weekly MBCE group sessions over 8 weeks in an Australian community setting. RESULTS: Of the 18 women who began and completed the intervention, missing data allowed for complete data from 12 participants to be analyzed. Statistically significant improvements and large effect sizes were observed for childbirth self-efficacy and fear of childbirth. Improvements in depression, mindfulness, and birth outcome expectations were underpowered. At postnatal follow-up significant improvements were found in anxiety, whereas improvements in mindfulness, stress, and fear of birth were significant at a less conservative alpha level. DISCUSSION: This pilot study demonstrated that a blended mindfulness and skills-based childbirth education intervention was acceptable to women and was associated with improvements in women's sense of control and confidence in giving birth. Previous findings that low self-efficacy and high childbirth fear are linked to greater labor pain, stress reactivity, and trauma suggest the observed improvements in these variables have important implications for improving maternal mental health and associated child health outcomes. Ways in which these outcomes can be achieved through improved childbirth education are discussed."
AUTHORS
Robert Schutze
Sara Bayes
Colleen Fisher
Yvonne Hauck
Jean Byrne
PUBLISHED
2014 in Journal of Midwifery & Women's Health
UNRANKED SOURCE
14
The Relationship between Fear of Childbirth and Women’s Knowledge about Painless Childbirth
"<p> This study investigated the association between fear of childbirth (FOC) and women’s knowledge about painless childbirth methods. The study was performed on 900 multiparous women within the last month of pregnancy. Data was obtained through a questionnaire including the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) Turkish form A. FOC was defined as W-DEQ sum score ≥85. Women were questioned about their knowledge about painless childbirth and the most important source of this knowledge. Group 1 consists of participants with knowledge about painless childbirth. Group 2 consists of participants without knowledge about painless childbirth. Five hundred and twenty-four women (58.2%) had knowledge while 376 women (41.7%) had no knowledge about painless childbirth. Mean W-DEQ scores in group 1 ( <math id="M1"> <mn>68.46</mn> <mo>±</mo> <mn>12.53</mn> </math> ) were found to be lower than group 2 ( <math id="M2"> <mn>71.35</mn> <mo>±</mo> <mn>12.28</mn> </math> ) ( <math id="M3"> <mi>P</mi> <mo>=</mo> <mn>0.001</mn> </math> ). FOC was associated with increased maternal request for elective caesarean section (OR 4.22, 95% CI 2.91–6.11). Better informed pregnant women about painless childbirth methods may reduce the number of women with FOC and the rate of preferred elective caesarean section. </p>"
AUTHORS
Ilker Ince
Mine Gursac Celik
Aysenur Dostbil
Ayse Nur Aksoy
Mehmet Aksoy
PUBLISHED
2014 in Obstetrics and Gynecology International
Q2
15
Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care
"The impact of maternal mental health disorders on women and their children is significant. Stress and psychological problems during pregnancy are associated with preterm labour, poor infant outcomes and greater cognitive, behavioural and interpersonal problems in young children (Glasheen et al., 2010). Similarly, postnatal psycholo-gical problems have an adverse impact on the woman, child, and relationships. The World Health Organisation lists psychological illness as a significant indirect cause of maternal death in the first year after birth (WHO, 2008). This has led to an international call for the integration of maternal mental health into maternal and child health care programmes (Rahman et al., 2013). In the UK, the importance of women's mental health during pregnancy and after birth has been the focus of a number of recent reports from organisations such as the NSPCC (Hogg, 2013), Royal College of Midwives, Institute of Health Visitors and charities (Boots Family Trust, 2013), and a cross-party parliamentary manifesto (Leadsom et al., 2013). In November 2013 the Maternal Mental Health Alliance published a report on the importance and role of specialist mental health midwives (MMHA, 2013) and the UK Government announced specialist perinatal mental health staff would be trained for all birthing units by 2017 (Department of Health, 2013). In this context, recognition of the range of mental health problems that women can suffer from becomes even more important. Historically, research has focused on the most common or severe psychological disorders that occur, namely postnatal depression and puerperal psychosis, which has raised public awareness of these disorders. However, evidence is clear that women can suffer from a range of disorders at this time including anxiety disorders such as panic, generalised anxiety, phobias and adjustment or stress-related disorders, such as post-traumatic stress disorder (PTSD). Collectively, anxiety disorders appear to be as common as depression. For example, a meta-analysis of postnatal depression suggests it affects up to 19% of women (Gavin et al., 2005). Similarly, a Canadian study found 16% of women had postnatal anxiety disorders (Wenzel et al., 2005). Two, less recognised disorders are particularly relevant to mid-wifery care because they directly affect women's perinatal experiences or arise as a result of birth experience. These are fear of childbirth (tokophobia) in pregnancy and PTSD in response to difficult or traumatic births. These disorders can have an impact on women throughout pregnancy and after birth. They can also negatively affect women's relationships with their partner and infant (Nicholls and Ayers, 2007; Parfitt et al., 2013). These disorders can be inter-related in that fear of childbirth can arise as a result of a previous traumatic birth experience. The important point for midwifery is that both disorders are potentially preventable or reducible through appropriate midwif-ery and perinatal mental health care. This special issue of Midwifery focusses on fear of childbirth and postnatal PTSD in order to inform our understanding and hence prevention and treatment. As a relatively new area of research there are still many gaps in our knowledge. However, research is rapidly increasing and this journal includes papers on key issues as well as reviews synthesising the evidence. The first section focusses on fear of childbirth and includes papers on the aetiology of fear of child-birth, women's perceptions of morbidity, and midwives views on antenatal management. The second section focusses on postnatal PTSD and includes papers examining diagnostic criteria, the role of support, the impact on women, and treatment. Consideration of fear of childbirth, PTSD, and how papers in this issue contribute to our knowledge is provided below. Fear of childbirth Intense fear of childbirth occurs in 7–26% of pregnant women (Fenwick et al., 2009; Laursen et al., 2009), with a smaller proportion developing extreme fear or tokophobia (Nieminen et al., 2009). The BIDENS study of 7200 women in six European countries found significant differences between countries with prevalence ranging from 1.9% to 14.2% (Van Parys et al., 2012). Symptoms include high levels of anxiety about pregnancy and birth, fear of harm or death during birth, poor sleep and somatic complaints. As with most psychological problems the cause of fear of childbirth is multifactorial. It has been associated with factors such as nulliparity (Rouhe et al., 2009), increased gestation (Rouhe et al., 2009), poor mental health (Laursen et al., 2008; Storksen et al., 2012), a history of abuse (Nerum et al., 2006; Lukasse et al., 2011), younger age (Laursen et al., 2008), lower education (Laursen et al., 2008), and low self-efficacy (Salomonsson et al., 2013). Although fear of childbirth is more common in nulliparous women, women who have a negative or traumatic experience of birth are almost five times more likely to report fear of childbirth in a subsequent pregnancy (Storksen et al., 2013). The importance of fear of childbirth for midwifery is apparent from the impact it has on women's preferences for intervention during birth. There is good evidence from large epidemiological studies that women with fear of childbirth are more likely to want interventions such as epidural analgesia and caesarean sections (Nieminen et al., 2009; Rouhe et al., 2009). Evidence on the Contents lists available at ScienceDirect"
AUTHOR
Susan Ayers
PUBLISHED
2014 in Midwifery
High quality source
Literature Review
16
The effect of exercise and childbirth classes on fear of childbirth and locus of labor pain control
"This study sought to track changes in intensity of fear of childbirth and locus of labor pain control in women attending an exercise program for pregnant women or traditional childbirth classes and to identify the predictors of these changes. The study was longitudinal/non-experimental in nature and run on 109 healthy primigravidae aged from 22 to 37, including 62 women participating in an exercise program for pregnant women and 47 women attending traditional childbirth classes. The following assessment tools were used: two scales developed by the present authors—the Fear of Childbirth Scale and the Control of Birth Pain Scale, three standardized psychological inventories for the big five personality traits (NEO Five Factors Inventory), trait anxiety (State Trait Anxiety Inventory) and dispositional optimism (Life Oriented Test-Revised) and a questionnaire concerning socioeconomic status, health status, activities during pregnancy, relations with partners and expectations about childbirth. Fear of childbirth significantly decreased in women participating in the exercise program for pregnant women but not in women attending traditional childbirth classes. Several significant predictors of post-intervention fear of childbirth emerged: dispositional optimism and self-rated health (negative) and strength of the belief that childbirth pain depends on chance (positive). (PsycINFO Database Record (c) 2016 APA, all rights reserved)"
AUTHOR
Monika Guszkowska
PUBLISHED
2014 in Anxiety, Stress, & Coping
UNRANKED SOURCE
17
Fear of childbirth in expectant fathers, subsequent childbirth experience and impact of antenatal education: subanalysis of results from a randomized controlled trial
"OBJECTIVE: To explore if antenatal fear of childbirth in men affects their experience of the birth event and if this experience is associated with type of childbirth preparation. DESIGN: Data from a randomized controlled multicenter trial on antenatal education. SETTING: 15 antenatal clinics in Sweden between January 2006 and May 2007. SAMPLE: 762 men, of whom 83 (10.9%) suffered from fear of childbirth. Of these 83 men, 39 were randomized to psychoprophylaxis childbirth preparation where men were trained to coach their partners during labor and 44 to standard care antenatal preparation for childbirth and parenthood without such training. METHODS: Experience of childbirth was compared between men with and without fear of childbirth regardless of randomization, and between fearful men in the randomized groups. Analyses by logistic regression adjusted for sociodemographic variables. MAIN OUTCOME MEASURES: Self-reported data on experience of childbirth including an adapted version of the Wijma Delivery Experience Questionnaire (W-DEQ B). RESULTS: Men with antenatal fear of childbirth more often experienced childbirth as frightening than men without fear: adjusted odds ratio 4.68, 95% confidence interval 2.67-8.20. Men with antenatal fear in the psychoprophylaxis group rated childbirth as frightening less often than those in standard care: adjusted odds ratio 0.30, 95% confidence interval 0.10-0.95. CONCLUSIONS: Men who suffer from antenatal fear of childbirth are at higher risk of experiencing childbirth as frightening. Childbirth preparation including training as a coach may help fearful men to a more positive childbirth experience. Additional studies are needed to support this conclusion."
AUTHORS
Helle Kieler
Ulla Waldenström
Ann Rudman
Malin Bergström
PUBLISHED
2013 in Acta Obstetricia et Gynecologica Scandinavica
High quality source
18
Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention
"BACKGROUND: Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body's ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women's childbirth fear, support normal birth, and diminish the possibility of a negative birth experience. METHODS/DESIGN: Pregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4-6 weeks after birth. DISCUSSION: This study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women's childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes. TRIAL REGISTRATION: Australian New Zealand Controlled Trials Registry ACTRN12612000526875."
AUTHORS
Anne Sneddon
Erika Turkstra
Anne Buist
Debra K Creedy
Jenny Gamble
Jennifer Fenwick et al
PUBLISHED
2013 in BMC Pregnancy and Childbirth
High quality source
19
Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial
"OBJECTIVE: To compare the numbers of vaginal deliveries and delivery satisfaction among women with fear of childbirth randomised to either psychoeducation or conventional surveillance during pregnancy.\n\nDESIGN: Randomised controlled trial.\n\nSETTING: Maternity unit of Helsinki University Central Hospital.\n\nPOPULATION: Fear of childbirth was screened during early pregnancy by the Wijma Delivery Expectancy Questionnaire (W-DEQ-A). Of 4575 screened nulliparous women, 371 (8.1%) scored ≥ 100, showing severe fear of childbirth.\n\nMETHODS: Women with W-DEQ-A ≥ 100 were randomised to intervention (n = 131) (psychoeducative group therapy, six sessions during pregnancy and one after childbirth) or control (n = 240) (care by community nurses and referral if necessary) groups. Obstetric data were collected from patient records and delivery satisfaction was examined by questionnaire.\n\nMAIN OUTCOME MEASURES: Delivery mode and satisfaction.\n\nRESULTS: Women randomised to the intervention group more often had spontaneous vaginal delivery (SVD) than did controls (63.4% versus 47.5%, P = 0.005) and fewer caesarean sections (CSs) (22.9% versus 32.5%, P = 0.05). SVD was more frequent and CSs were less frequent among those who actually participated in intervention (n = 90) compared with controls who had been referred to consultation (n = 106) (SVD: 65.6% versus 47.2%, P = 0.014; CS: 23.3% versus 38.7%, P = 0.031). Women in intervention more often had a very positive delivery experience (36.1% versus 22.8%, P = 0.04, n = 219).\n\nCONCLUSIONS: To decrease the number of CSs, appropriate treatment for fear of childbirth is important. This study shows positive effects of psychoeducative group therapy in nulliparous women with severe fear of childbirth in terms of fewer CSs and more satisfactory delivery experiences relative to control women with a similar severe fear of childbirth."
AUTHORS
T Saisto
E Halmesmäki
M Tokola
R Toivanen
K Salmela-Aro
H Rouhe
PUBLISHED
2013 in BJOG: An International Journal of Obstetrics & Gynaecology
UNRANKED SOURCE
20
Fear of childbirth, mental health, and medication use during pregnancy
"The aim of this work was to study the associations between medication use, fear of childbirth, and maternal mental health. Pregnant women (n = 1,984) were recruited through routine antenatal care at a Norwegian hospital from November 2008 through April 2010. Data were collected by three self-completed questionnaires at pregnancy week 17 and 32 and at 8 weeks postpartum. Fear of childbirth was measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ). Symptoms of anxiety were measured by the Hopkins Symptom Checklist (SCL-25) and symptoms of depression by the Edinburgh Postnatal Depression Scale (EPDS). In total, 57.7 % of the women used medications during pregnancy. Analgesics were used by 55.8 % of the women and psychotropic medications by 1.8 %. In all, 7.8 % of the women reported fear of childbirth (W-DEQ >85), the prevalence of anxiety (SCL >18) was 11.8 % and the prevalence of depression (EPDS >13) was 8.1 %. Fear of childbirth was significantly associated with use of psychotropic drugs (OR 3.63; 95 % CI 1.39-9.43) but not with the use of analgesics or medications in general. The presence of symptoms of anxiety or depression increased the magnitude of this association. Fear of childbirth is associated with an increased use of psychotropic medication. This finding could not only be explained by an overlap between fear of childbirth and impaired mental health."
AUTHORS
Malin Eberhard-Gran
Susan Garthus-Niegel
Cathrine Hansen
Hedvig Nordeng
PUBLISHED
2012 in Archives of Women's Mental Health
High quality source







ADDITIONAL STUDIES TO CONSIDER ADDING TO LIST
Total additional studies: 26
State of K's algorithms generated the list of studies below based on the studies that were added to the above list. Some of these studies may also examine: "How do I overcome my fear of childbirth?" If a study examines this question, add it to the list by pressing the button.

Only add studies that examine the same question. Do not add studies that are merely on the same topic.

I Study What I Stink At: Lessons Learned from a Career in Psychology
"I describe what I have learned from a rather long career in psychology. My goal is to aid those younger than I to learn from my experience and avoid my mistakes. I discuss topics such as the damage that self-fulfilling prophecies can do, the importance of resilience, the need to overcome fear of failure, the importance of being flexible in one's goals and changing them as needed, the relevance of professional ethics, and the need to be wise and not just smart. In the end, we and our work are forgotten very quickly and one should realize that, after retirement, it likely will be one's family, not one's professional network, that provides one's main source of support and comfort. "
AUTHOR
Robert J. Sternberg
PUBLISHED

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I Study What I Stink At: Lessons Learned from a Career in Psychology
"I describe what I have learned from a rather long career in psychology. My goal is to aid those younger than I to learn from my experience and avoid my mistakes. I discuss topics such as the damage that self-fulfilling prophecies can do, the importance of resilience, the need to overcome fear of failure, the importance of being flexible in one's goals and changing them as needed, the relevance of professional ethics, and the need to be wise and not just smart. In the end, we and our work are forgotten very quickly and one should realize that, after retirement, it likely will be one's family, not one's professional network, that provides one's main source of support and comfort."
AUTHOR
L. Rowell Huesmann Laramie D. Taylor
PUBLISHED
2014 in Annual Review of Psychology

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“We Wanted a Birth Experience, not a Medical Experience”: Exploring Canadian Women's Use of Midwifery
"In this study I explore Canadian women's use of midwifery to examine whether their choice represents a resistance to the medicalization of pregnancy/childbirth. Through my analysis of the data I identified eight ways the women's deliberate decision to pursue midwifery care represented resistance to medicalization. In so doing, I demonstrate how women actively assert their agency over reproduction thus shaping their own reproductive health experiences. The outcome of their resistance and resultant use of midwifery was empowerment. Theoretically the research contributes to understanding the intentionality of resistance and a continuum of resistant behavior."
AUTHOR
Diana Parry
PUBLISHED
2008 in Health Care for Women International

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Women's experiences of intense fear related to childbirth investigated in a Swedish qualitative study
"Objectives: To investigate and describe how intense fear related to childbirth is experienced, dealt with and communicated from the perspective of the women themselves.

Design: Qualitative interviews analysed by a grounded theory approach.

Setting: The study was conducted in a mid-sized city in the northern part of Sweden.

Participants: A purposeful sample of 20 women, aged 24-41 with experiences of intense fear related to childbirth.

Findings: The experience of fear was described in relation to 'manifestations', 'time and fluctuation' and 'judgements according to perceptions of self and others'. Ways of dealing with the fears could be divided into the approaches of 'evading', 'processing' and 'seeking help'. These were often used in parallel and as exchangeable depending on which approach seemed to be most effective to a particular situation. Although some informants indicated that talking through their fears had helped them, all women underlined that talking about the fear was not an easy thing to do. 'Preconditions' for being able to disclose their fears often concerned the interest and behaviour of antenatal health-care professionals, and an understanding midwife was described as crucial.

Key Conclusions And Implications For Practice: The findings suggest that antenatal health-care professionals need further training in how to meet and support women with intense fear related to childbirth. Such training should include how to uncover and counter socially constructed norms and expectations about what pregnant women should feel in relation to childbirth.

"
AUTHORS
Katarina Hamberg
Lilian Jansson
Carola Eriksson
PUBLISHED
2006 in Midwifery

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Doctors, pregnancy, childbirth and abortion during the Third Reich.
"This paper does not attempt to deal with the legitimate ethical or moral debate on abortion. Utilizing abortion as a subject I will show how science and medicine in general, and abortion in particular, were used as weapons of mass destruction by Nazi physicians in their zeal to comply with the political climate of the time. Nazi policy on abortion and childbirth was just one of the methods devised and designed to ensure the extermination of those whom the Nazis deemed had "lives not worth living." Physicians implemented these policies, not with the fate of their patients in mind, but rather in the name of the "state." When discussing pregnancy, abortion and childbirth during the Holocaust it is imperative to include an essay of how these issues affected the Jewish prisoner doctors in the ghettos and camps. Nazi policy dictated their actions too. From an extensive search of their testimonies, I conclude that for these doctors ethical discourse comprised a fundamental component of their functioning. I do not propose to judge them in any way and one should not, in my opinion, argue whether their behavior was or was not morally acceptable under such duress; nevertheless, unlike their Nazi counterparts, a key theme in their testimonies was to "keep their medical values.""
AUTHOR
Tessa Chelouche
PUBLISHED
2007 in The Israel Medical Association journal : IMAJ

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Amnesia, Anesthesia, and Warranted Fear
"Is a painful experience less bad for you if you will not remember it? Do you have less reason to fear it? These questions bear on how we think about medical procedures and surgeries that use an anesthesia regimen that leaves patients conscious - and potentially in pain - but results in complete 'drug-induced amnesia' after the fact. I argue that drug-induced amnesia does not render a painful medical procedure a less fitting object of fear, and thus the prospect of amnesia does not give patients a reason not to fear it. I expose three mistakes in reasoning that might explain our tendency to view pain or discomfort as less fearful in virtue of expected amnesia: a mistaken view of personal identity; a mistaken view of the target of anticipation; and a mistaken method of incorporating past evidence into calculations about future experiences. Ultimately my argument has implications for whether particular procedures are justified and how medical professionals should speak with anxious patients about the prospect of drug-induced amnesia. "
AUTHOR
Vanessa Carbonell
PUBLISHED
2012 in Bioethics

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'In a dark time, the eye begins to see'.
"In this paper I discuss a patient whose shadow became his rival, or as Jung put it, 'The shadow is lived'. I describe the beginning of a process of the assimilation of shadow contents, whereby the rupture between ego and shadow can no longer be maintained. I also discuss how it is primarily through the mutual experience and analysis of archetypal images that the unconscious contents become more integrated. In my clinical illustrations I also explore the relationship between my patient's fight with his shadow and his experiences of childhood shame. I consider how fear expressed through a panic attack may open a royal door to the unconscious, and the way in which its mediation through empathy and analysis can lead to unconscious infantile contents becoming more accessible. In addition, I show how, once some of the fear had subsided, it became possible for play to enter into the analysis."
AUTHOR
J Haynes
PUBLISHED

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I had a Dream!
"Three weeks ago, I had a dream. In the dream, I gave birth to a bunch of baby girls .. J am not pregnant. I am not even married ... the dream baffles me. I try to describe the dream to my mom. She does not want to hear it. .. my dreams give her the creeps. They always come true. I call my aunt and tell her about my dream .. .I am obsessed with interpreting this dream. My aunt says baby girls in dreams are a good omen. I wonder what good omens are in the horizon. I do not wonder for long ... When you live with the fear of war, you stop wondering about goodomens."
AUTHOR
Abir Hamdar
PUBLISHED
1970 in Al-Raida Journal

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Chances and Battles in Stroke Research
"Here I have reviewed how good luck, bad luck and barriers determined my research directions in stroke over the last 30 or so years. Good luck should be exploited, and very often barriers can be not just overcome but put to good use as well. It is crucial for the young researcher to find mentors as good as I have had, and to move around to gain a broad experience, and for the experienced researchers to bring on the younger generation as I have tried to do."
AUTHOR
Charles P. Warlow
PUBLISHED
2007 in Cerebrovascular Diseases

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Eloise Amelia Kahn’s Birth Story
"Eloise Amelia Kahn's birth story highlights my experience as a nursing student preparing to be a mother and how studying nursing during my pregnancy influenced my thought process during pregnancy and labor, my evolving relationship with my certified nurse-midwife, and my unmedicated childbirth in a hospital setting. "
AUTHOR
Kristien Marie Kahn
PUBLISHED
2013 in The Journal of Perinatal Education

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Fear of childbirth and pregnancy-related anxiety in women conceiving with assisted reproduction.
"Objective: To compare the prevalence and predictors of severe fear of childbirth and pregnancy-related anxiety in groups of assisted reproduction treatment (ART) and spontaneously conceiving women with singleton pregnancies.

Methods: The ART group (n = 367, nulliparous 260) represented a cohort from five Finnish infertility clinics in 1999. The control group (n = 379, nulliparous 135) was enrolled in this study by consecutive sampling the same year. Fear of childbirth was assessed by means of the revised version of the Fear-of-Childbirth Questionnaire and pregnancy-related anxiety by means of the Pregnancy Anxiety Scale at gestational week 20 +/- 3.2 (mean+/-standard deviation).

Results: The frequency of severe fear of childbirth and anxiety (classified as total scores in the 90th percentile or higher in the revised Fear of Childbirth Questionnaire and Pregnancy Anxiety Scale) did not differ between the groups. Nulliparity was associated with more frequent severe anxiety only in the controls. In nulliparous participants, a partnership of more than 5 years decreased the risk of severe fear of childbirth (odds ratio 0.3, 95% confidence interval 0.2-0.7). In the nulliparous ART group, a long duration of infertility (7 or more years) increased the risk of severe fear of childbirth (odds ratio 4.4, 95% confidence interval 1.2-16.9).

Conclusion: Women conceiving after ART do not experience severe fear of childbirth or pregnancy-related axiety more often than spontaneously conceiving controls. However, a long duration of infertility is an independent risk factor regarding severe fear of childbirth.

Level Of Evidence: II-2.

"
AUTHORS
M Tulppala
T Saisto
P Poikkeus
L Repokari
L Unkila-Kallio
A Tiitinen et al
PUBLISHED
2006 in Obstetrics and Gynecology

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The battle scars of pregnancy: can they be prevented?
"I have feared developing stretch marks since my first pregnancy. Getting to grips with my changing shape was a big challenge, but I was safe in the knowledge that post-pregnancy I could work towards losing the weight. But stretch marks are permanent, and to me-disfiguring. I researched how stretch marks can be prevented and after finding little evidence for a particular cream or lotion: I scanned forums and asked friends what worked for them. Many people claimed that by keeping skin hydrated and supple, the dreaded stretch marks can be kept at bay or at least to a minimum. So I opted for regularly massaging oil across vulnerable areas and maintaining a balanced diet, including drinking lots of water. I was lucky the first time round; time will tell if my skincare routine will work for my second pregnancy."
AUTHOR
Emma Razi
PUBLISHED

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Fear of childbirth: predictors and temporal changes among nulliparous women in the Danish National Birth Cohort
"Objectives  To describe the association between fear of childbirth and social, demographic and psychological factors in a cohort of 30 480 healthy nulliparous women with uncomplicated singleton pregnancies.

Design  Nationwide population-based study.

Setting  The Danish National Birth Cohort.

Population  Healthy nulliparous women (n= 30 480) with singleton pregnancies.

Methods  Data from computer-assisted telephone interviews twice in pregnancy linked with national health registers.

Main outcome measures  Characteristics of women with fear of childbirth in early (mean, 16 weeks) and late pregnancy (mean, 32 weeks) and changes in fear of childbirth between 1997 and 2003.

Results  Low educational level, lack of a social network, young age and unemployment were associated with fear of childbirth, as were being a smoker and having low self-rated health. The odds ratio for fear of childbirth among women with anxiety symptoms was 4.8 (4.1–5.7) after adjustment for socio-demographic, lifestyle, fertility and depression variables. During the study period, the prevalence of fear of childbirth was stable. Fear of childbirth was reported by 7.6% in early pregnancy and 7.4% in late pregnancy. Only 3.2% of the women expressed fear of childbirth in both interviews.

Conclusions  The prevalence of fear of childbirth among healthy nulliparous women with singleton pregnancies did not increase during the study period. Fear of childbirth among nulliparous women was most often seen in individuals with few social and psychological resources. Testing the women twice, we found the same prevalence of fear in early and late pregnancy, but found that half the women who expressed fear during early pregnancy had no fear later in pregnancy, an effect that was counterbalanced by a similar number of women who became fearful between the two interviews."
PUBLISHED
2008 in BJOG: An International Journal of Obstetrics & Gynaecology

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Childbirth fear in Swedish fathers is associated with parental stress as well as poor physical and mental health
"Objective: to compare self-rated health and perceived difficulties during pregnancy as well as antenatal attendance, birth experience and parental stress in fathers with and without childbirth related fear.

Design: a longitudinal regional survey. Data were collected by three questionnaires.

Setting: three hospitals in the middle-north part of Sweden.

Participants: 1047 expectant fathers recruited in mid-pregnancy and followed up at two months and one year after birth.

Measurements: childbirth fear was assessed using the Fear of Birth Scale (FOBS). Self-rated physical and mental health and perceived difficulties were assessed in mid pregnancy. Two months after birth antenatal attendance, mode of birth and the birth experience were investigated. Parental stress was measured using the Swedish Parental Stress Questionnaire (SPSQ). Crude and adjusted odds ratios were calculated between expectant fathers who scored 50 and above (childbirth fear) and those that did not (no fear).

Findings: expectant fathers with childbirth related fear (13.6%) reported poorer physical (OR 1.8; 95% CI 1.2-2.8) and mental (OR 3.0; 1.8-5.1) health than their non-fearful counterparts. The fearful fathers were more likely to perceive difficulties in pregnancy (OR 2.1; 1.4-3.0), and the forthcoming birth (OR 4.3; 2.9-6.3) compared to fathers without childbirth fear. First-time fathers with fear attended fewer antenatal classes. Fathers with high fear reported higher mean scores in four of the five subscales of the SPSQ. Childbirth related fear was not associated with mode of birth or fathers' birth experience.

Key Conclusions: expectant fathers with childbirth related fear had poorer health, viewed the pregnancy, birth and the forthcoming parenthood with more difficulties. They were less often present during antenatal classes and had higher parental stress.

Implications For Practice: this study provides insight into the health of expectant fathers during pregnancy and highlights the importance of understanding how childbirth fear may affect expectant fathers in both the short and longer term.

"
AUTHORS
Jennifer Fenwick
Christine Rubertsson
Margareta Johansson
Helen Haines
Ingegerd Hildingsson
PUBLISHED
2014 in Midwifery

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Childbirth Fear: Relation to Birth and Care Provider Preferences
"Introduction: The purpose of this study was to assess how preferences for place of birth and mode of birth relate to different dimensions of childbirth fear and whether there is an association between Canadian women's prenatal fear of childbirth and the type and quality of prenatal care they received.

Methods: A link to an online survey was posted on Canadian pregnancy and birth websites; 409 women completed the survey that included sociodemographic questions, questions about the current pregnancy and previous pregnancy experiences (if applicable), and the Childbirth Fear Questionnaire, a validated 40-item scale that measures 9 dimensions of childbirth fear.

Results: Women under physician care and those with a preference for cesarean birth were generally more fearful of pain associated with vaginal birth, fear of loss of sexual pleasure and attractiveness, and fear of harm to themselves or their infant. Conversely, women under the care of midwives and women who preferred to give birth vaginally were more fearful of interventions. Women who preferred a cesarean birth were significantly more likely to report that fear of childbirth interfered with daily functioning, compared to women who preferred a vaginal birth. Satisfaction with care was associated with lower scores on the Childbirth Fear Questionnaire full and subscales, especially among midwifery clients.

Discussion: At present there are no guidelines in Canada or the United States for the treatment and/or referral of pregnant women who suffer from childbirth fear. Until such guidelines are developed, findings from the current study can help maternity care providers identify and address specific fears among women in their care and understand how different fear domains relate to care provider choice, satisfaction with care, and women's preferences for place and mode of birth.

"
AUTHORS
Dana S. Thordarson
Nichole Fairbrother
Kathrin Stoll
PUBLISHED

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Association between fear of childbirth and maternal acceptance of pregnancy
"Aim: This descriptive study aimed to explore the associations between fear of childbirth, acceptance of pregnancy and identification with the motherhood role among primipara women.

Background: Women who have difficulty accepting their pregnancy have a harder time adapting to pregnancy and motherhood and experience more fears related to childbirth. The number of studies conducted on this topic is limited.

Methods: This study involved 310 pregnant women admitted to a public hospital in Istanbul between January and June of 2013. A participant identification form, the Prenatal Self-Evaluation Questionnaire and the Wijma Delivery Expectancy/Experience Questionnaire Version A were used for data collection.

Results: Pregnant women participating in the study experienced moderate levels fear of childbirth. Pregnant women who requested caesarean section experienced more intense fear of childbirth. Fear of childbirth scores had significant but weak correlations with acceptance of pregnancy and identification with the motherhood role.

Conclusion: The findings showed that acceptance of pregnancy and identification with the motherhood role are weakly associated with fear of childbirth.

Implications For Nursing And Health Policy: The results from this study can be used to help: increase awareness among health professionals (doctors, nurses, midwives) in antenatal care services about a mother's adaptation to pregnancy and the negative effects of fear of childbirth; direct future research examining factors affecting adaptation to pregnancy and fear of childbirth; establish routine assessments for adaptation to pregnancy and fear of childbirth; provide professional support for women with difficulties adapting to pregnancy and with fear of childbirth; result in reduced complications from invasive methods such as caesarean section due to less requests for these procedures; and promote the health of mothers and babies.

"
AUTHORS
Y. Hamlaci
N. Demirci
N.H. Şahin
R. Mamuk
D. Coşkuner Potur
PUBLISHED
2017 in International Nursing Review

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Swedish midwives’ perceptions of fear of childbirth
"Objectives: to describe midwives' experiences with, and perceptions of, women with fear of childbirth.

Design: a qualitative study with a phenomenographic approach. Data were collected by means of interviews in focus groups.

Setting: four focus groups at four types of hospital in Southern Sweden over a period of 18 months, 2004-2006.

Participants: 21 experienced midwives.

Findings: four description categories emerged, i.e. appearance of fear of childbirth, origins of fear of childbirth, consequences of fear of childbirth, and fear of childbirth and midwifery care.

Key Conclusion: fear of childbirth is seen as a continuum from normal to irrational, severe fear. It has various origins which are more or less difficult to operationalise. Fear of childbirth influences the experience of pregnancy, the labour process and the transition to parenthood. Midwifery care of women with fear of childbirth is emotionally demanding and time consuming. Aspects of care required early identification of women with fear of childbirth, individual care, preparation for giving birth, support of a companion during labour, and postpartum follow-up.

"
AUTHORS
Siw Alehagen
Klaas Wijma
Birgitta Salomonsson
PUBLISHED
2010 in Midwifery

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Fine tuning fear of childbirth: the relationship between Childbirth Fear Questionnaire subscales and demographic and reproductive variables
FUNDERS
University of British Columbia, Island Medical Program
"Objective: The objective of the current study was to investigate the relationship between the newly developed Childbirth Fear Questionnaire (CFQ) and demographic and reproductive variables.

Background: The CFQ was developed in an effort to improve measurement and understanding of women's childbirth fears. To our knowledge the CFQ is the only multidimensional measure of childbirth fears in which (a) multiple domains of childbirth fear are assessed and (b) individual subscales have been psychometrically developed.

Methods: Participants were 643 pregnant women residing in English-speaking countries, recruited via online forums. Participants completed a set of questionnaires, including the multidimensional CFQ, via an online survey. Given the differences in childbirth fear between nulliparous and multiparous women, findings are stratified by parity.

Results: Gestational age was largely unrelated to fear of childbirth. Age, income and education were negatively related to fear of childbirth. Assisted vaginal delivery and episiotomy in a previous pregnancy were positively associated with a fear of pain. Self-reported history of traumatic vaginal birth was associated with higher scores on all aspects of fear of childbirth. History of caesarean birth was not generally associated with increased childbirth fears, but women with a prior, self-reported traumatic caesarean birth reported more fear of future caesarean births.

Conclusions: Findings are consistent with previous reports of fear of childbirth. However, the CFQ provides increased specificity with respect to women's childbirth fears. This information is relevant to both education and treatment planning for pregnant women and women wishing to reproduce.

"
AUTHORS
Kathrin Stoll
Dana S. Thordarson
Nichole Fairbrother
PUBLISHED
2018 in Journal of Reproductive and Infant Psychology

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Prevalence of childbirth fear in an Australian sample of pregnant women.
"Background: Childbirth fear is reported to affect around 20% of women. However reporting on levels of symptom severity vary. Unlike Scandinavian countries, there has been limited focus on childbirth fear in Australia. The aim of this paper is to determine the prevalence of low, moderate, high and severe levels of childbirth fear in a large representative sample of pregnant women drawn from a large randomised controlled trial and identify demographic and obstetric characteristics associated with childbirth fear.

Method: Using a descriptive cross-sectional design, 1,410 women in their second trimester were recruited from one of three public hospitals in south-east Queensland. Participants were screened for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire Version A (WDEQ-A). Associations of demographic and obstetric factors and levels of childbirth fear between nulliparous and multiparous women were investigated.

Results: Prevalence of childbirth fear was 24% overall, with 31.5% of nulliparous women reporting high levels of fear (score ≥ 66 on the WDEQ-A) compared to 18% of multiparous women. Childbirth fear was associated with paid employment, parity, and mode of last birth, with higher levels of fear in first time mothers (p < 0.001) and in women who had previously had an operative birth (p < 0.001).

Conclusion: Prevalence of childbirth fear in Australian women was comparable to international rates. Significant factors associated with childbirth fear were being in paid employment, and obstetric characteristics such as parity and birth mode in the previous pregnancy. First time mothers had higher levels of fear than women who had birthed before. A previous operative birth was fear provoking. Experiencing a previous normal birth was protective of childbirth fear.

"
AUTHORS
Debra K Creedy
Jenny Gamble
Jennifer Fenwick
Jocelyn Toohill
PUBLISHED
2014 in BMC Pregnancy and Childbirth

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Personality and fear of childbirth
"Background. Socioeconomic factors and previous experiences of delivery are known to influence pregnant women's fear of childbirth. The aim of this study was to investigate the associations between stable personality traits, fear of childbirth during late pregnancy, and experience of the delivery. Methods. Self-report questionnaires were completed twice, during gestation week 34–37, and at 1-week postpartum. Comparisons were made between 85 women who had sought help from a fear-of-childbirth team, and a group (n = 177) from routine antenatal care. Correlations between fear of childbirth, personality variables and experience of childbirth were calculated. Results. The women who had sought help tended to be more anxiety-prone, more short-tempered, and lower in socialisation, although within the normal range. In spite of counselling, they reported more intense fear of delivery and fear of pain compared with the comparison group. Women with intense fear of childbirth, who were low in socialisation and high in psychasthenia, had a more negative experience of their current childbirth. Conclusion. Women with intense fear of childbirth differ from other pregnant women also in personality. Methods for treating fear of childbirth should be further developed in order to diminish the risk of a negative birth experience."
PUBLISHED
2007 in Acta Obstetricia et Gynecologica Scandinavica

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Personality and fear of childbirth
"Background: Socioeconomic factors and previous experiences of delivery are known to influence pregnant women's fear of childbirth. The aim of this study was to investigate the associations between stable personality traits, fear of childbirth during late pregnancy, and experience of the delivery.

Methods: Self-report questionnaires were completed twice, during gestation week 34-37, and at 1-week postpartum. Comparisons were made between 85 women who had sought help from a fear-of-childbirth team, and a group (n=177) from routine antenatal care. Correlations between fear of childbirth, personality variables and experience of childbirth were calculated.

Results: The women who had sought help tended to be more anxiety-prone, more short-tempered, and lower in socialisation, although within the normal range. In spite of counselling, they reported more intense fear of delivery and fear of pain compared with the comparison group. Women with intense fear of childbirth, who were low in socialisation and high in psychasthenia, had a more negative experience of their current childbirth.

Conclusion: Women with intense fear of childbirth differ from other pregnant women also in personality. Methods for treating fear of childbirth should be further developed in order to diminish the risk of a negative birth experience.

"
AUTHORS
Eva Wirfelt
Ing-Britt Wängborg
Eva Wirfelt
Gunnar Edman
Berit Sjögren
Elsa Lena Ryding et al
PUBLISHED
2007 in Acta Obstetricia et Gynecologica Scandinavica

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Fear of childbirth in primiparous Italian pregnant women: The role of anxiety, depression, and couple adjustment
"Background: The prevalence of fear of childbirth in pregnant women is described to be about 20-25%, while 6-10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia.

Aims: The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women.

Methods: Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth.

Findings: Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth.

Conclusions: Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions.

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AUTHORS
Annamaria Trovato
Cristina Sechi
Luca Rollè
Laura Elvira Prino
Valentina Fenaroli
Sara Molgora et al
PUBLISHED

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The Lived Experience of Childbearing From Survivors of Sexual Abuse: “It Was the Best of Times, It Was the Worst of Times”
"Introduction: In the United States, one in every 5 women will experience sexual violence. Survivors are at risk for difficult pregnancies, substance abuse, stress, fear, and preterm births. A history of sexual abuse can impact several aspects of a woman's childbirth, thereby affecting her long-term physical and emotional well-being. The adverse pregnancy outcomes, combined with the prevalence of sexual abuse, underscore the need for research to understand survivors' experiences.

Methods: This study's purpose was to understand the lived experience of pregnancy, labor, and birth from survivors. A qualitative, descriptive phenomenological research design was utilized. The purposeful sample included 8 female, self-identifying survivors of sexual abuse with at least one childbearing experience.

Results: Analysis identified 302 significant statements that formed 7 overarching themes: 1) No one asked me. Just ask me!; 2) An emotional roller coaster: From excitement to grief for what could have been a better experience; 3) All of a sudden I was that little girl again and/or I compartmentalized it: The all-or-nothing experience; 4) Am I even here?: Nothing was explained and I had no voice; 5) All too familiar: No support, nowhere to turn; 6) Holding on to the choices I can make: Who my doctor is and how I feed my baby; and 7) Overprotection: Keeping my child safe.

Discussion: The final result was the essence of childbearing for survivors in this study. They were not screened for a history of sexual abuse. Enjoyment and excitement were juxtaposed with guilt and fear. They had no voice, lacked support, and overwhelmingly desired control. They overprotected their children, from infancy into adulthood. The childbearing experience was a complex, emotional roller coaster permeated by the past. Women's health care providers can utilize the results to provide therapeutic care to survivors to prevent revictimization. The results elucidate the importance of screening for a history of sexual abuse and discussing the implications such a history can have on the childbearing experience.

"
AUTHORS
Cheryl T. Beck
Jenna A. LoGiudice
PUBLISHED
2016 in Journal of Midwifery & Women's Health

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Fear of childbirth: predictors and temporal changes among nulliparous women in the Danish National Birth Cohort
"Objectives: To describe the association between fear of childbirth and social, demographic and psychological factors in a cohort of 30 480 healthy nulliparous women with uncomplicated singleton pregnancies.

Design: Nationwide population-based study.

Setting: The Danish National Birth Cohort.

Population: Healthy nulliparous women (n= 30 480) with singleton pregnancies.

Methods: Data from computer-assisted telephone interviews twice in pregnancy linked with national health registers.

Main Outcome Measures: Characteristics of women with fear of childbirth in early (mean, 16 weeks) and late pregnancy (mean, 32 weeks) and changes in fear of childbirth between 1997 and 2003.

Results: Low educational level, lack of a social network, young age and unemployment were associated with fear of childbirth, as were being a smoker and having low self-rated health. The odds ratio for fear of childbirth among women with anxiety symptoms was 4.8 (4.1-5.7) after adjustment for socio-demographic, lifestyle, fertility and depression variables. During the study period, the prevalence of fear of childbirth was stable. Fear of childbirth was reported by 7.6% in early pregnancy and 7.4% in late pregnancy. Only 3.2% of the women expressed fear of childbirth in both interviews.

Conclusions: The prevalence of fear of childbirth among healthy nulliparous women with singleton pregnancies did not increase during the study period. Fear of childbirth among nulliparous women was most often seen in individuals with few social and psychological resources. Testing the women twice, we found the same prevalence of fear in early and late pregnancy, but found that half the women who expressed fear during early pregnancy had no fear later in pregnancy, an effect that was counterbalanced by a similar number of women who became fearful between the two interviews.

"
AUTHORS
M Hedegaard
C Johansen
M Laursen
PUBLISHED
2008 in BJOG: An International Journal of Obstetrics and Gynaecology

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Pharmacological pain relief and fear of childbirth in low risk women; secondary analysis of the RAVEL study.
"Background: Fear of childbirth may reduce the womens' pain tolerance during labour and may have impact on the mother-infant interaction. We aimed to assess (1) the association between fear of childbirth antepartum and subsequent request for pharmacological pain relief, and (2) the association between the used method of pain relief and experienced fear of childbirth as reported postpartum in low risk labouring women.

Methods: Secondary analysis of the RAVEL study, a randomised controlled trial comparing remifentanil patient controlled analgesia (PCA) and epidural analgesia to relieve labour pain. The RAVEL study included 409 pregnant women at low risk for obstetric complications at 18 midwifery practices and six hospitals in The Netherlands (NTR 3687). We measured fear of childbirth antepartum and experienced fear of childbirth reported postpartum, using the Wijma Delivery Expectancy/Experience Questionnaire.

Results: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association did not reach statistical significance (adjusted odds ratio (aOR2.0; 95% confidence interval (CI) 0.8-4.6). Women who received epidural analgesia more frequently reported fear of childbirth postpartum compared to women who did not receive epidural analgesia (aOR3.5; CI 1.5-8.2), while the association between remifentanil-PCA and fear of childbirth postpartum was not statistically significant (aOR1.7; CI 0.7-4.3).

Conclusions: Women with fear of childbirth antepartum more frequently requested pain relief compared to women without fear of childbirth antepartum, but this association was not statistically significant. Women who received pharmacological pain relief more frequently reported that they had experienced fear of childbirth during labour compared to women who did not receive pain relief. Based on our data epidural analgesia with continuous infusion does not seem to be preferable over remifentanil-PCA as method of pain relief when considering fear of childbirth postpartum.

Trial Registration: Netherlands Trial Register 3687 ; Register date: 5 Nov 2012.

"
AUTHORS
Ben Willem Mol
Katrien Oude Rengerink
Sabine L M Logtenberg
Anne-Marie Sluijs
François G Schellevis
Corine J Verhoeven et al
PUBLISHED
2018 in BMC Pregnancy and Childbirth

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Childbirth Fear, Anxiety, Fatigue, and Sleep Deprivation in Pregnant Women
"Objective: To explore women's levels of childbirth fear, sleep deprivation, anxiety, and fatigue and their relationships during the third trimester of pregnancy.

Design: A cross-sectional descriptive survey of a community sample.

Participants: Six hundred and fifty English-speaking nulliparous and multiparous women, 17 to 46 years of age and between 35 and 39 weeks gestation, with uncomplicated pregnancies.

Methods: Wijma Delivery Expectancy/Experience Questionnaire, Spielberger State Anxiety Inventory, Mindell's Sleep Questionnaire, and the Multidimensional Assessment of Fatigue Questionnaire.

Results: Twenty-five percent of women reported high levels of childbirth fear and 20.6% reported sleeping less than 6 hours per night. Childbirth fear, fatigue, sleep deprivation, and anxiety were positively correlated. Fewer women attending midwives reported severe fear of childbirth than those attending obstetricians. Women with high childbirth fear were more likely to have more daily stressors, anxiety, and fatigue, as well as less help. Higher levels of anxiety predicted higher levels of childbirth fear among women.

Conclusion: One fourth of women reported high childbirth fear. Women's fear of childbirth was related to fatigue, available help, stressors, and anxiety. Fear of childbirth appears to be part of a complex picture of women's emotional experiences during pregnancy.

"
AUTHORS
Wendy A. Hall
Kathrin Stoll
Yvonne L. Hauck
Elaine M. Carty
Eileen K. Hutton
Jennifer Fenwick
PUBLISHED
2009 in Journal of Obstetric, Gynecologic & Neonatal Nursing

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