How do I overcome my fear of childbirth?
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Summary produced by: State of K
25 studies examined this question
Executive SummaryWe found 25 studies that examine this question. The 25 studies were published from 1998 to 2018. View summaries of each of those studies.
Literature ReviewsAlthough we recommend you consider all of the studies below, we believe the following studies are literature reviews, which survey and evaluate many studies on this question:
- Interventions for reducing fear of childbirth: A systematic review and meta-analysis of clinical trials
- A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth
- Interventions for reducing fear of childbirth: A systematic review and meta-analysis of clinical trials
- Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care
- Fear of childbirth: Understanding the causes, impact and treatment
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List of studies last updated: Feb. 19, 2018
Summaries of Studies
Studies found that examine this question: 25
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The effect of pregnancy Pilates-assisted childbirth preparation training on childbirth fear and neonatal outcomes: a quasi-experimental/quantitative research
Authors: Dilek Sarpkaya Güder, Mesut Yalvaç, Gülşen Vural
Published: 2018 in Quality & Quantity
We aren't able to display the abstract here, but you can view it at: https://doi.org/10.1007/s11135-018-0682-0
The Effect of Childbirth Preparation Classes on Fear of Childbirth, Birth Preference and Preparation of Labor
Authors: Merlinda ALUŞ TOKAT, Merve ÇAMLIBEL, Elif ULUDAĞ et al
Published: 2017 in Turkiye Klinikleri Journal of Nursing
We aren't able to display the abstract here, but you can view it at: https://doi.org/10.5336/nurses.2016-53977
A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth
Authors: Nichole Fairbrother, Elizabeth Nethery, Patricia Janssen et al
Published: 2017 in Birth
"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."
Interventions for reducing fear of childbirth: A systematic review and meta-analysis of clinical trials
Authors: V. MoghaddamHosseini, M. Nazarzadeh, S. Jahanfar
Published: 2017 in European Psychiatry
We aren't able to display the abstract here, but you can view it at: https://doi.org/10.1016/j.eurpsy.2017.01.1226
Effects of extended childbirth education by midwives on the childbirth fear of first-time mothers: an RCT
Authors: Marja Kaunonen, Martti Arffman, Päivi Åstedt-Kurki et al
Published: 2017 in Scandinavian Journal of Caring Sciences (Highly Regarded Source)
"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: Vahideh MoghaddamHosseini, Milad Nazarzadeh, Shayesteh Jahanfar
Published: 2017 in Women and Birth (Highly Regarded Source)
"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."
The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study
Authors: Figen İnci, Hatice Önal, Pelin Dıkmen Yıldız et al
Published: 2016 in Applied Nursing Research
"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."
Does antenatal education reduce fear of childbirth?
Authors: Y. Doğan Merih, S. Cebeci Mutlu, N. Demirci et al
Published: 2016 in International Nursing Review
"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."
Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment
Authors: Pınar Serçekuş, Hatice Başkale
Published: 2016 in Midwifery (Highly Regarded Source)
"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."
The effects of counseling on fear of childbirth
Authors: Annika Karlström, Christine Rubertsson, Ingegerd Hildingsson et al
Published: 2015 in Acta Obstetricia et Gynecologica Scandinavica (Highly Regarded Source)
"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."
Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial
Authors: Erja Halmesmäki, Elsa-Lena Ryding, Terhi Saisto et al
Published: 2015 in Journal of Psychosomatic Obstetrics & Gynecology
"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."
Effects of continuous midwifery labour support for women with severe fear of childbirth
Authors: Louise Angerbjörn, Marie Bladh, Ann Josefsson et al
Published: 2015 in BMC Pregnancy and Childbirth (Highly Regarded Source)
"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."
The Relationship between Fear of Childbirth and Women’s Knowledge about Painless Childbirth
Authors: Aysenur Dostbil, Mine Gursac Celik, Ilker Ince et al
Published: 2014 in Obstetrics and Gynecology International
"<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>"
The effect of exercise and childbirth classes on fear of childbirth and locus of labor pain control
Author: Monika Guszkowska
Published: 2014 in Anxiety, Stress, & Coping
"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)"
Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care
Author: Susan Ayers
Published: 2014 in Midwifery (Highly Regarded Source)
"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"
Effectiveness of a Mindfulness-Based Childbirth Education Pilot Study on Maternal Self-Efficacy and Fear of Childbirth
Authors: Colleen Fisher, Sara Bayes, Robert Schutze et al
Published: 2014 in Journal of Midwifery & Women's Health
"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."
Fear of childbirth in expectant fathers, subsequent childbirth experience and impact of antenatal education: subanalysis of results from a randomized controlled trial
Authors: Ann Rudman, Ulla Waldenström, Helle Kieler et al
Published: 2013 in Acta Obstetricia et Gynecologica Scandinavica (Highly Regarded Source)
"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."
Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention
Authors: Elsa L Ryding, Vivian Jarrett, Jocelyn Toohill et al
Published: 2013 in BMC Pregnancy and Childbirth (Highly Regarded Source)
"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."
Obstetric outcome after intervention for severe fear of childbirth in nulliparous women - randomised trial
Authors: M Tokola, E Halmesmäki, T Saisto et al
Published: 2013 in BJOG: An International Journal of Obstetrics & Gynaecology
"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."
Fear of childbirth, mental health, and medication use during pregnancy
Authors: Cathrine Hansen, Susan Garthus-Niegel, Malin Eberhard-Gran et al
Published: 2012 in Archives of Women's Mental Health
"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."
Fear of childbirth: Understanding the causes, impact and treatment
Author: Henrietta Otley
Published: 2011 in British Journal of Midwifery
"This article is based on a review of the literature related to fear of childbirth, and pragmatically considers issues for midwifery practice. Research shows that around one in ten women in the developed world is affected by severe and disabling fear of childbirth during pregnancy (Saisto and Halmesmaki, 2003). An important finding in the research is the significant link between fear of childbirth and caesarean section (for which the UK currently has very high rates). Fear is also associated with a negative birth experience. While personality and social factors are shown to raise the risk of severe fear of childbirth, midwives need to recognize that loss of control, misinformation and previous traumatic experiences have a serious detrimental effect on women's perceived capacity to give birth vaginally."
O668 The effect of childbirth preparation classes on fear of childbirth and severity of labor pain in pregnant women reoffered to Akbarabady hospital of Tehran, 2008
Authors: B. Mohammadi Zeidi, A. Malekzadegan, F. Hossaini et al
Published: 2009 in International Journal of Gynecology & Obstetrics
"Background: Childbirth is one of the greatest events in every woman's life. Despite, their fantasies about pregnancy and motherhood, when they confronted with the reality, many of them doubt their ability to cope with this great event in their lives. Influenced by family, friends and relatives, they get prepared in different ways as they approach the experience of childbirth. This preparation may be positive or negative, realistic or inaccurate. At this time, the mother needs lot of help for the realization and acceptance of childbirth as a normal physiological phenomenon. She needs to accept a healthy attitude towards pregnancy so that she might have a safe and emotionally satisfying experience of labor. Objectives: The purpose of this study was to investigate the effect of childbirth preparation classes on fear of childbirth and labor pain intensity in pregnant women visited to Akbarabady hospital of Tehran, 2008. Methods: It was a program evaluation that performed in quasiexperimental approach. Questionnaire was used for data collection was Areskogs the fear of childbirth questionnaire that we added demographic characteristics and a standard pain number rating scale. Sample: 120 prim gravid pregnant women, aged 18-30 between 20-24 wells gestation, without any infertility, abortion and abnormal fetus history that referred to Akbarbady Hospital for delivery. Setting: Akbarabady hospital of Tehran. Result: There was statistical significant deference between means of fear of childbirth score of pregnant women that participated in preparation classes, before of education and after that (p = 0.000). But there wasn't statistical difference between means of fear of childbirth score of pregnant women that didn't participate in preparation classes, at 20-24th weeks gestation and 37th week (p = 0.438). It wan statistical significant deference between means of difference of fear of scores of two groups (p = 0.000). Difference in severity of labor pain between two groups were statistically significant (p = 0.000). Discussion and Conclusion: According to the study findings it seems that childbirth preparation class can be an effective way to decrease fear of childbirth, attendance in such classes could be a pleasant for the mother and probably an effective step in decreasing the number of selective caesarian section, witch are performed mainly because of fear of labor pain."
A Randomized Controlled Trial of Intervention in Fear of Childbirth
Authors: Jari-Erik Nurmi, Teija Könönen, Erja Halmesmäki et al
Published: 2001 in Obstetrics & Gynecology (Highly Regarded Source)
We aren't able to display the abstract here, but you can view it at: https://doi.org/10.1097/00006250-200111000-00019
Fear of childbirth and psychosomatic support - A follow up of 72 women
Author: Berit Sjögren
Published: 1998 in Acta Obstetricia et Gynecologica Scandinavica (Highly Regarded Source)
We aren't able to display the abstract here, but you can view it at: https://doi.org/10.1080/j.1600-0412.1998.770807.x