FIRST-TIME DELIVERING WOMEN’S FEAR OF CHILDBIRTH AND IT’S RELATION TO DELIVERY OUTCOMES AT A UNIVERSITY HOSPITAL IN LITHUANIA

Abstract

Introduction. Fear of childbirth (FOC) is a common women’s health problem. It might affect the mother’s and the fetus’ health, complicate and prolong the birth. Women with tokophobia (clinically significant FOC) are more likely to suffer poor birth outcomes. FOC can increase Caesarean section rates with no medical indications. There is no worldwide consensus on the diagnostic protocol and care algorithms for FOC. Material and methods. A prospective study was performed at the tertiary care university hospital (Kaunas, Lithuania). The survey included 110 first-time delivering women at the time of entering the labour ward. A scale and Fear of Delivery Questionnaire (FDQ) questionnaire were used. Medical data were collected from the hospital’s database and analyzed using Microsoft Excel and IBM SPSS software for statistical significance (p < 0.05). Results. According to a subjective scale of FOC (range min 0 – max 10), 37.3% (n = 41) of women stated they experienced FOC. The majority (25.5%; n = 28) rated their fear with 3 points. Absence of fear was indicated by 8.2% (n = 9), and 4.5% (n = 5) felt tokophobia with panic attacks. The majority were worried about newborn health (89.1%; n = 98) and labour pain (79.1%; n = 87). Based on the FDQ questionnaire slightly less than half of the respondents experienced FOC (44.5%; n = 49). No strong associations were found between FOC and neonatal parameters (p > 0.05). Pain relief methods were more frequently chosen by women with FOC (p = 0.032). Patients with FOC gave birth significantly longer than those without FOC (p = 0.047). As FOC increased in score, the time of childbirth also increased (p = 0.02). The method of delivery did not depend on the strength of FOC (p = 0.443). FOC in score was higher for women with a history of abortion (p = 0.036). Conclusions. Nearly half of the interviewed women were experiencing FOC. Newborn health and labour pain were the main reasons for FOC. History of abortion was related to FOC. No strong associations were found between tokophobia and negative newborn outcomes or method of delivery. Significantly longer labour duration was found in women with FOC. Key Message – Fear of childbirth has a great impact on pregnant women’s health and birth itself. Further research is crucial to find effective diagnostic and treatment methods for women with FOC to recognize and help before or even during childbirth. First-time delivering women’s fear of childbirth and it’s relation to delivery outcomes at a university hospital in Lithuania.