ABSTRACT
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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Subject(s)
Anxiety/therapy , Fear/psychology , Labor, Obstetric/psychology , Midwifery/methods , Parturition/psychology , Phobic Disorders/therapy , Adult , Analgesia, Obstetrical/statistics & numerical data , Anxiety/psychology , Case-Control Studies , Cesarean Section/statistics & numerical data , Female , Humans , Phobic Disorders/psychology , Pilot Projects , Pregnancy , Severity of Illness Index , Social Support , Time FactorsABSTRACT
OBJECTIVE: Most pregnant women are anxious about the delivery and up to 30% develop varying degrees of fear of childbirth (FOC). Secondary FOC occurs in parous women who have experienced a traumatic delivery. The aim of this study was to investigate the time to subsequent delivery and delivery outcome in women with secondary FOC, compared with a reference group. SETTING: Southeast Sweden. SAMPLE: 356 parous pregnant women with secondary FOC and a reference group of 634 parous women without FOC. DESIGN: Descriptive, retrospective case-control study. MAIN OUTCOME MEASURES: Time to next pregnancy and delivery outcome. RESULTS: More women with secondary FOC had a longer interval to subsequent delivery compared with parous women without FOC (p = 0.005). Women with secondary FOC had 5.2 times higher probability of having a cesarean section than the reference group. Women with secondary FOC also had on average a 40-minute longer duration of active labor than women without FOC (p < 0.001). CONCLUSIONS: Secondary fear of childbirth prolongs the time to subsequent delivery and the active phase of labor itself, and increases the risk for cesarean section.
