Anna Dencker1, Christina Nilsson2, Cecily Begley3, Elisabeth Jangsten4, Margareta Mollberg5, Harshida Patel6, Helena Wigert7, Eva Hessman8, Helen Sjöblom9, Carina Sparud-Lundin10. 1. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden. Electronic address: anna.dencker@gu.se. 2. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90 Borås, Sweden. Electronic address: Christina.nilsson@hb.se. 3. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden; School of Nursing and Midwifery, Trinity College Dublin, 24, D'Olier St., Dublin 2, Ireland. Electronic address: cbegley@tcd.ie. 4. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden. Electronic address: elisabeth.jangsten@gu.se. 5. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden. Electronic address: margareta.mollberg@gu.se. 6. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden. Electronic address: harshida.patel@gu.se. 7. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden. Electronic address: helena.wigert@gu.se. 8. Biomedical Library, Gothenburg University Library at University of Gothenburg, Box 416, SE-405 30 Gothenburg, Sweden. Electronic address: eva.hessman@ub.gu.se. 9. Biomedical Library, Gothenburg University Library at University of Gothenburg, Box 416, SE-405 30 Gothenburg, Sweden. Electronic address: helen.sjoblom@ub.gu.se. 10. Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden. Electronic address: carina.s-lundin@fhs.gu.se.
Abstract
PROBLEM: Fear of childbirth negatively affects women during pregnancy and after birth. AIM: To summarise the findings of published studies regarding possible causes/predisposing factors and outcomes of fear of childbirth for childbearing women. DESIGN: A systematic review, searching five databases in March 2015 for studies on causes/predisposing factors and outcomes of fear of childbirth, as measured during pregnancy and postpartum. Quality of included studies was assessed independently by pairs of authors. Data were extracted independently by reviewer pairs and described in a narrative analysis. FINDINGS: Cross-sectional, register-based and case-control studies were included (n=21). Causes were grouped into population characteristics, mood-related aspects, and pregnancy and birth-related aspects. Outcomes were defined as mood-related or pregnancy and birth-related aspects. Differing definitions of fear of childbirth were found and meta-analysis could only be performed on parity, in a few studies. CONCLUSIONS: Stress, anxiety, depression and lack of social support are associated with fear during pregnancy. Need for psychiatric care and presence of traumatic stress symptoms are reported outcomes together with prolonged labour, longer labours, use of epidural and obstetric complications. Nulliparous and parous women have similar levels of fear but for different reasons. Since the strongest predictor for fear in parous women is a previous negative birth experience or operative birth, we suggest it is important to distinguish between fear of childbirth and fear after birth. Findings demonstrate the need for creating woman-centred birthing environments where women can feel free and secure with low risk of negative or traumatic birth experiences and consequent fear.
PROBLEM: Fear of childbirth negatively affects women during pregnancy and after birth. AIM: To summarise the findings of published studies regarding possible causes/predisposing factors and outcomes of fear of childbirth for childbearing women. DESIGN: A systematic review, searching five databases in March 2015 for studies on causes/predisposing factors and outcomes of fear of childbirth, as measured during pregnancy and postpartum. Quality of included studies was assessed independently by pairs of authors. Data were extracted independently by reviewer pairs and described in a narrative analysis. FINDINGS: Cross-sectional, register-based and case-control studies were included (n=21). Causes were grouped into population characteristics, mood-related aspects, and pregnancy and birth-related aspects. Outcomes were defined as mood-related or pregnancy and birth-related aspects. Differing definitions of fear of childbirth were found and meta-analysis could only be performed on parity, in a few studies. CONCLUSIONS: Stress, anxiety, depression and lack of social support are associated with fear during pregnancy. Need for psychiatric care and presence of traumatic stress symptoms are reported outcomes together with prolonged labour, longer labours, use of epidural and obstetric complications. Nulliparous and parous women have similar levels of fear but for different reasons. Since the strongest predictor for fear in parous women is a previous negative birth experience or operative birth, we suggest it is important to distinguish between fear of childbirth and fear after birth. Findings demonstrate the need for creating woman-centred birthing environments where women can feel free and secure with low risk of negative or traumatic birth experiences and consequent fear.
Authors: Melissa K Zochowski; Giselle E Kolenic; Kara Zivin; Anca Tilea; Lindsay K Admon; Stephanie V Hall; Agatha Advincula; Vanessa K Dalton Journal: Health Aff (Millwood) Date: 2021-10 Impact factor: 9.048
Authors: Anna Dencker; Liselotte Bergqvist; Marie Berg; Josephine T V Greenbrook; Christina Nilsson; Ingela Lundgren Journal: BMC Pregnancy Childbirth Date: 2020-04-06 Impact factor: 3.007