Abstract
BackgroundTo study pregnancy and delivery outcomes in nulliparous women with severe FOC (fear of childbirth), all of whom had received routine treatment for their FOC and to make comparisons with a healthy reference group of nulliparous women.To study the possible relationship between the number of FOC-treatment sessions and the delivery method.MethodsAll nulliparous women with a diagnose FOC who received routine treatment for FOC (n = 181) and a reference group of nulliparous women without FOC (n = 431) at a university and a county hospital in the south east region of Sweden were analysed. Data from antenatal and delivery medical records were used to study outcome.ResultsThe majority of women with severe FOC had a vaginal delivery. The incidence of elective CS was greater in the index group than in the reference group (p < 0.001). The total number of women with a planned CS in the index group was 35 (19.4%) and in the control group 14 (3.2%). Thus, on average five women per year received an elective CS during the study years due to severe FOC. The women in the index group who wished to have a CS were similar to the other women in the index group with reference to age, BMI, chronic disease but had been in in-patient care more often during their pregnancy than those who did not ask for CS (p = 0.009).ConclusionIn this study of women treated for severe FOC, the majority gave birth vaginally and no relationship was found between number of treatment sessions and mode of childbirth.
Highlights
To study pregnancy and delivery outcomes in nulliparous women with severe fear of childbirth” (FOC), all of whom had received routine treatment for their FOC and to make comparisons with a healthy reference group of nulliparous women
We found that the women in the index group were more frequently employed in the group of “High white collar worker” (p = 0.047) and that they were more often obese than the women in the reference group women (p = 0.016)
If the total number of sessions is dichotomized into 1–4 sessions and ≥ 5 sessions, no relationship could be found between delivery outcome and number of treatment/ counselling sessions (See Table 2)
Summary
To study pregnancy and delivery outcomes in nulliparous women with severe FOC (fear of childbirth), all of whom had received routine treatment for their FOC and to make comparisons with a healthy reference group of nulliparous women. To study the possible relationship between the number of FOC-treatment sessions and the delivery method. During the past 20 years or so, much attention has been given by midwives and obstetricians to the phenomenon “fear of childbirth” (FOC) called tokophobia, and many studies have been carried out in an effort to learn how to help women who express such a fear [1,2,3,4]. Severe FOC has frequently been given as one explanation for the increase in the frequency of elective caesarean sections carried out solely on the basis of pregnant women’s requests, both in Sweden and in many other countries. Wiklund et al [5] found a strong connection between FOC and the requests by Swedish women for caesarean section (CS) where there was no medical indication for CS [5,6]. Studies of the prevalence of FOC have been made with very different methods, definitions of samples and settings with the result that estimates a notably wide range from 3% to 20% [7,8,9,10]
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