Depressive symptoms during pregnancy and after birth in women living in Sweden who received treatments for fear of birth

Ingegerd Hildingsson,Christine Rubertsson

doi:10.1007/s00737-022-01213-z

Ingegerd Hildingsson, Christine Rubertsson

Open Access

https://doi.org/10.1007/s00737-022-01213-z

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Abstract

The aim of this study was to investigate the prevalence of depressive symptoms and associated factors in women who underwent treatments for fear of birth; internet-based cognitive therapy, counseling with midwives, continuity with a known midwife or standard care. A secondary analysis was performed using data collected from four samples of women identified with fear of birth and receiving treatment with different methods. A questionnaire was used to collect data in mid-pregnancy and at follow-up 2 months after birth. Depressive symptoms were assessed using the Edinburgh Postnatal Depressive Scale. In mid-pregnancy, 32% of the 422 women with fear of birth also reported a co-morbidity with depressive symptoms. At postpartum follow-up, 19% reported depressive symptoms 2 months after birth, and 12% showed continued or recurrent depressive symptoms identified both during pregnancy and postpartum. A history of mental health problems was the strongest risk factor for presenting with depressive symptoms. None of the treatment options in this study was superior in reducing depressive symptoms. This study showed a significant co-morbidity and overlap between fear of birth and depressive symptoms. Screening for depressive symptoms and fear of birth during pregnancy is important to identify women at risk and offer specific treatment.

Highlights

Fear of birth and depressive symptoms each affect 10–20% of all pregnant women
The proportion of women who presented with depressive symptoms in mid-pregnancy using EPDS with the cutoff of 13 was 32.2%
The main findings of this study were that women with fear of birth presented with fairly high co-morbidity with depressive symptoms during pregnancy

Summary

Introduction

Fear of birth and depressive symptoms each affect 10–20% of all pregnant women. There is, sparse knowledge about the impact of different treatment options for fear of birth when depressive symptoms are prevalent during pregnancy and after birth.There is no universal definition of fear of birth and several methods are used to identify women with fear of birth during pregnancy (Nilsson et al 2018). Fear of birth and depressive symptoms each affect 10–20% of all pregnant women. There is, sparse knowledge about the impact of different treatment options for fear of birth when depressive symptoms are prevalent during pregnancy and after birth. There is no universal definition of fear of birth and several methods are used to identify women with fear of birth during pregnancy (Nilsson et al 2018). Despite the lack of clear definition, fear of birth has been acknowledged in Sweden since the mid-1990s and women who present with fear of birth (self-reported or through a screening procedure) are currently offered counseling with midwives in all Swedish hospitals (Larsson et al 2016). Research on fear of birth is growing worldwide and international studies have shown that fear of birth overall affects around 14% of women (O'Connell et al 2017) and 10–20% in Swedish women (Hildingsson et al 2017; Nilsson et al 2018).

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