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Souto SPAD, de Albuquerque RS, Silva RCGD, Guerra MJ, Prata AP. Midwifery interventions to reduce fear of childbirth in pregnant women: a scoping review protocol. JBI Evid Synth 2021; 18:2045-2057. [PMID: 32813435 DOI: 10.11124/jbisrir-d-19-00198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The objective of the review is to map and analyze midwifery interventions to reduce fear of childbirth in pregnant women. INTRODUCTION Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy, as well as after childbirth. During the previous few decades, there has been a growing interest in research into interventions to reduce the fear of childbirth in childbearing women. Currently, providing an appropriate model of care for pregnant women with fear of childbirth is a challenge in midwifery care. Therefore, further efforts are needed to identify and examine the characteristics of different midwifery interventions to reduce fear of childbirth in pregnant women. INCLUSION CRITERIA This scoping review will consider studies that include interventions to reduce fear of childbirth in pregnant women, led and implemented by midwives, during the antenatal period, in all possible birth scenarios. Quantitative, qualitative, and mixed methods studies will be included. METHODS The JBI methodology for conducting scoping reviews will be employed. Published and unpublished literature in English, Portuguese, and Spanish, from 1981 to the present, will be included. MEDLINE, CINAHL Complete, Scopus, Web of Science, Embase, and Cochrane Library databases will be searched. Searches for gray literature will be performed. Data will be extracted using a tool developed specifically for the scoping review objectives.
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Affiliation(s)
- Sandra Patrícia Arantes do Souto
- Universidade Católica Portuguesa - Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Porto, Portugal
| | | | - Rosa Carla Gomes da Silva
- Universidade Católica Portuguesa - Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Porto, Portugal.,Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence
| | - Maria João Guerra
- Universidade Católica Portuguesa - Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Porto, Portugal
| | - Ana Paula Prata
- Nursing School of Porto, Porto, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
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52
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Cantwell R. Mental disorder in pregnancy and the early postpartum. Anaesthesia 2021; 76 Suppl 4:76-83. [PMID: 33682099 DOI: 10.1111/anae.15424] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 12/31/2022]
Abstract
Perinatal mental illness is common, affecting up to 20% of women, but remains under-recognised and under-diagnosed. It may have adverse effects on pregnancy and neonatal outcomes, and mental disorder remains one of the leading causes of maternal death in the UK. Women with mental ill health face difficult decisions in balancing risks and benefits of treatment. Stigma related to mental disorder may lead to non-engagement with maternity care. Some disorders bring specific challenges for anaesthetists working in maternity settings and it is vital that anaesthetists have knowledge of these disorders so they may offer care which is sensitive and appropriate.
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Affiliation(s)
- R Cantwell
- NHS Scotland National Services Division, Perinatal Mental Health Network Scotland, Edinburgh, UK
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53
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Factors associated with fear of childbirth among Polish pregnant women. Sci Rep 2021; 11:4397. [PMID: 33623084 PMCID: PMC7902668 DOI: 10.1038/s41598-021-83915-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/02/2021] [Indexed: 11/30/2022] Open
Abstract
The purpose of our study was to elucidate the association between obstetric and psychological factors and fear of childbirth (FOC) during the third trimester of pregnancy and to identify women at risk of severe FOC in Poland. An additional goal of the study was to verify the Polish version of the Wijma Delivery Expectancy Questionnaire (W-DEQ) and to establish its psychometric characteristics. Cross-sectional study with a total of 359 women recruited during routine visits to an antenatal clinic in Poland during the third trimester (≥ 27 weeks gestation). The survey included obstetric details (parity, obstetric history and preferred mode of delivery), and standardized psychological measures: the W-DEQ (fear of childbirth) and the EPDS (depressive symptoms). We demonstrated the satisfactory psychometric properties of the Polish version of the W-DEQ. Our findings confirm the one-factor structure found by the authors of the original version of the scale. A greater FOC was reported by women with unplanned pregnancies, women whose preferred mode of delivery was a cesarean section, and women who had previously undergone psychiatric treatment. The risk factors for severe FOC were depression, unplanned pregnancy or parity, and disagreement with the birth plan proposed by the obstetrician. The W-DEQ is a widely used, valid instrument for the assessment of FOC in pregnant women and can be used in Poland. Findings support the key role of obstetric and psychological variables in predicting fear of childbirth.
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Ganeriwal SA, Ryan GA, Purandare NC, Purandare CN. Examining the role and relevance of the critical analysis and comparison of cesarean section rates in a changing world. Taiwan J Obstet Gynecol 2021; 60:20-23. [PMID: 33495002 DOI: 10.1016/j.tjog.2020.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 11/30/2022] Open
Abstract
Cesarean section (CS) is one of the most commonly performed surgical operations in the world and has resulted in improved maternal and neonatal morbidity and mortality rates internationally. However, concerns have been raised regarding the ever increasing CS rates to what has been described as 'epidemic' proportions. Global CS rates have increased from 6.7% in 1990 to 19.1% in 2014. However, there is a vast variation in the CS rates between countries with CS rates of 44.3% reported across Latin America & the Caribbean and CS rates as low as 4.1% in central and West Africa. There is much controversy regarding the optimal figure for CS in a population. The optimal CS rates for a population have been recommend in various studies, ranging from 10% to 19%, above which no reported improvement in maternal and neonatal mortality rates is observed. This review examines the evolution of the changing indications for CS and increasing CS rates in a world where family sizes are reducing and maternal age at first pregnancy is increasing. Efforts must be made to agree on an appropriate classification system whereby CS rates can be compared accurately between units and countries as a useful tool to audit and monitor our practice. Obstetricians should consider the indications for each CS performed, be conscious of the CS rate in our own countries and institutions and most importantly, be cognizant of how the CS rate impacts the maternal and perinatal morbidity and mortality rates and adjust our practice accordingly, to minimize harm.
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Affiliation(s)
- Simran A Ganeriwal
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gillian A Ryan
- Department of Obstetrics and Gynecology, National Maternity Hospital, Holles St, Dublin 2, Ireland.
| | - Nikhil C Purandare
- Department of Obstetrics and Gynecology, National University of Ireland Galway, Galway University Hospital, Ireland
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55
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Kemppainen V, Niinimäki M, Bloigu A, Saisto T, Rouhe H, Gissler M, Heikinheimo O, Mentula M. Fear of childbirth after medical vs surgical abortion. Population-based register study from Finland. Acta Obstet Gynecol Scand 2021; 100:743-750. [PMID: 33393097 DOI: 10.1111/aogs.14078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION To evaluate the effect of method of induced abortion and other abortion-associated variables on the incidence of fear of childbirth in subsequent pregnancy. MATERIAL AND METHODS This population-based register study cohort includes all nulliparous women with their first pregnancy ending in an induced abortion in 2000-2015 and subsequent pregnancy with live singleton delivery between 2000 and 2017 (n = 21 479). Data were derived from three national registers maintained by the Finnish Institute for Health and Welfare. We divided the study population in three cohorts: (a) medical and (b) surgical abortion during first trimester (≤84 days of gestation), and (c) medical abortion during second trimester (85-168 days of gestation). Primary outcome measures were the incidence of registry-identified fear of childbirth and cesarean delivery related to it. RESULTS The overall incidence of fear of childbirth was 5.6% (n = 1209). Altogether, 19.2% (n = 4121) of women underwent cesarean delivery. The odds were elevated especially for elective cesarean delivery (odds ratio [OR] 9.30, 95% CI 7.95-10.88, P < .001) in women with fear of childbirth. In multivariable analysis, the odds for fear of childbirth (adjusted OR [aOR] 0.80, 95% CI 0.68-0.94) and cesarean delivery (aOR 0.66, 95% CI 0.84-0.90) were decreased in women with a history of first-trimester medical abortion compared with those with first-trimester surgical abortion. Second-trimester medical abortion had no effect on the odds for fear of childbirth (aOR 1.04, 95% CI 0.71-1.50). Maternal age of 30-39 years and interpregnancy interval over 2 years were additional risk factors for both fear of childbirth and cesarean delivery, but surgical evacuation of uterus after the abortion was not. CONCLUSIONS One first- or second-trimester medical abortion does not increase the odds for fear of childbirth, and cesarean delivery related to it in subsequent pregnancy when compared with first-trimester surgical abortion. Older maternal age and longer interpregnancy interval emerged as risk factors for fear of childbirth.
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Affiliation(s)
- Venla Kemppainen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maarit Niinimäki
- Department of Obstetrics and Gynecology, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Aini Bloigu
- Department of Obstetrics and Gynecology, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Terhi Saisto
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Rouhe
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mika Gissler
- Finnish Institute of Health and Welfare (THL), Helsinki, Finland.,Karolinska Institute, Stockholm, Sweden
| | - Oskari Heikinheimo
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maarit Mentula
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Naghibi SA, Khazaee-Pool M, Moosazadeh M. The Iranian version of theory-based intention for cesarean section (IR-TBICS) scale: development and first evaluation. BMC Pregnancy Childbirth 2021; 21:5. [PMID: 33402125 PMCID: PMC7784005 DOI: 10.1186/s12884-020-03498-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rate at which mothers experience a cesarean section in the absence of medical signs is growing worldwide. Women's beliefs and intentions play an essential role in the request or choice of a delivery method. At present, there is no comprehensive, validated scale for assessing pregnant women's beliefs about cesarean section in the Iranian population. This study was performed to develop and assess the validity and reliability of the intention-based cesarean section scale using the theory of reasoned action (TRA) constructs as a theoretical framework for measuring intention toward the selection of a delivery method. METHODS In this cross-sectional validation study, 480 pregnant women were recruited from Sari, in northern Iran, through a multistage random sampling approach. Content validity was examined using the content validity index (CVI) and content validity ratio (CVR). Furthermore, both exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were applied to assess the construct validity of the developed scale. Reliability was measured by internal consistency and the intraclass correlation coefficient (ICC). Quality criteria for floor and ceiling effects were derived from existing guidelines and consensus within our research group. RESULTS The results obtained from the factor analysis showed that the data were fit to the model (χ2 = 2298.389, P < 0.001). The TRA comprised 24 items assessing five domains, which described 62.46% of the common variance. The CFA showed a model with suitable fitness for the data. Cronbach's alpha coefficient for the domains of the scale ranged from 0.609 to 0.843, and the ICC value ranged from 0.71 to 0.84, which is within the satisfactory range. The IR-TBICS scale had no floor or ceiling effect on the total score or any of the dimensions. CONCLUSIONS The belief-based cesarean section scale appears to be a reliable instrument. It is considered suitable and can be applied in other research in Iran.
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Affiliation(s)
- Seyed Abolhassan Naghibi
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
- Health Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran
| | - Maryam Khazaee-Pool
- Department of Public Health, School of Health, Mazandaran University of Medical Sciences, Sari, Iran.
- Health Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Research Institutes, Mazandaran University of Medical Sciences, Sari, Iran
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57
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Yoosefi Lebni J, Khalajabadi Farahani F, Solhi M, Ebadi Fard Azar F. Causes and Grounds of Childbirth Fear and Coping Strategies Used by Kurdish Adolescent Pregnant Women in Iran: A Qualitative Study. J Reprod Infertil 2021; 22:47-56. [PMID: 33680885 PMCID: PMC7903670 DOI: 10.18502/jri.v22i1.4995] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/31/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Fear of childbirth is one of the most common problems among pregnant women that can threaten their and their baby's health. Therefore, the purpose of this study was to explore the causes and grounds of childbirth fear and the strategies used by pregnant adolescent women in Iran to overcome such fears. METHODS In this study, which was conducted among primiparous Kurdish women in Iran, conventional qualitative content analysis was used. Data were selected through purposive sampling and semi-structured interviews. Data saturation was reached with 15 participants. The Lincoln and Guba criteria were used to strengthen the research. RESULTS After analyzing the data, two main categories were resulted. The first category was fear of childbirth with subcategories of fear of child health, fear of childbirth process, fears about inappropriate medical staff performance, fears about hospital environment, and postpartum fears. The second category was strategies to reduce childbirth fear with subcategories of choosing appropriate medical centers, increasing information on childbirth, avoiding stressful sources, improving self-care, getting prepared for delivery day in advance, and resorting to spirituality. CONCLUSION Pregnancy in adult age is better than adolescent age. The women's fear can be reduced by increasing their assurance about child health, providing appropriate training during pregnancy, explaining the whole process of childbirth and making it easier, improving the hospital environment and medical staff specialization, as well as providing appropriate conditions for further care and support after birth.
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Affiliation(s)
- Javad Yoosefi Lebni
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farideh Khalajabadi Farahani
- Department of Population and Health, National Population Studies and Comprehensive Management Institute, Tehran, Iran
| | - Mahnaz Solhi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farbod Ebadi Fard Azar
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
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58
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Baas MAM, van Pampus MG, Stramrood CAI, Dijksman LM, Vanhommerig JW, de Jongh A. Treatment of Pregnant Women With Fear of Childbirth Using EMDR Therapy: Results of a Multi-Center Randomized Controlled Trial. Front Psychiatry 2021; 12:798249. [PMID: 35222106 PMCID: PMC8866441 DOI: 10.3389/fpsyt.2021.798249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
Fear of childbirth (FoC) occurs in 7. 5% of pregnant women and has been associated with adverse feto-maternal outcomes. Eye Movement Desensitization and Reprocessing (EMDR) therapy has proven to be effective in the treatment of posttraumatic stress disorder (PTSD) and anxiety; however, its effectiveness regarding FoC has not yet been established. The aim was to determine the safety and effectiveness of EMDR therapy for pregnant women with FoC. This single-blind RCT (the OptiMUM-study, www.trialregister.nl, NTR5122) was conducted in the Netherlands. FoC was defined as a score ≥85 on the Wijma Delivery Expectations Questionnaire (WDEQ-A). Pregnant women with FoC and a gestational age between 8 and 20 weeks were randomly assigned to EMDR therapy or care-as-usual (CAU). The severity of FoC was assessed using the WDEQ-A. Safety was indexed as worsening of FoC symptoms, dropout, serious adverse events, or increased suicide risk. We used linear mixed model analyses to compare groups. A total of 141 women were randomized (EMDR n = 70; CAU n = 71). No differences between groups were found regarding safety. Both groups showed a very large (EMDR d = 1.36) or large (CAU d = 0.89) reduction of FoC symptoms with a mean decrease of 25.6 (EMDR) and 17.4 (CAU) points in WDEQ-A sum score. No significant difference between both groups was found (p = 0.83). At posttreatment, 72.4% (EMDR) vs. 59.6% (CAU) no longer met the criteria for FoC. In conclusion, the results are supportive of EMDR therapy as a safe and effective treatment of FoC during pregnancy, albeit without significant beneficial effects of EMDR therapy over and above those of CAU. Therefore, the current study results do not justify implementation of EMDR therapy as an additional treatment in this particular setting.
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Affiliation(s)
- M A M Baas
- Department of Obstetrics and Gynecology, OLVG, Amsterdam, Netherlands
| | - M G van Pampus
- Department of Obstetrics and Gynecology, OLVG, Amsterdam, Netherlands
| | - C A I Stramrood
- Department of Obstetrics and Gynecology, OLVG, Amsterdam, Netherlands
| | - L M Dijksman
- Department of Quality and Safety, St. Antonius Hospital, Nieuwegein, Netherlands
| | - J W Vanhommerig
- Department of Research and Epidemiology, OLVG, Amsterdam, Netherlands
| | - A de Jongh
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Vrije Universiteit University Amsterdam, Amsterdam, Netherlands.,PSYTREC, Bilthoven, Netherlands.,School of Health Sciences, Salford University, Manchester, United Kingdom.,Institute of Health and Society, University of Worcester, Worcester, United Kingdom.,School of Psychology, Queen's University, Belfast, United Kingdom
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59
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Til A, Bostanci M. The effect of structured delivery preparation education on birth preference. Int J Gynaecol Obstet 2020; 154:459-465. [PMID: 33368237 DOI: 10.1002/ijgo.13569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/04/2020] [Accepted: 12/22/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To demonstrate the effect of the health belief model on the birth preferences of an education program that is applicable, sustainable, structured by all health personnel, and evaluating the woman as a whole, based on Bandura's Social Learning Theory. METHODS Our research is a controlled intervention study. Central stratified randomization was used, and each group consists of eight centers. Control and intervention groups were formed from an equal number of people, and 160 people participated in the study. The participants were given structured delivery preparation education, and breathing exercises were performed. The data of the study were evaluated using χ2 test, and logistic regression analysis was used. A P value <0.05 was considered significant. RESULTS Forty-five (56.3%) of the responders in the control group and 60 (75.0%) of the responders in the intervention group had vaginal deliveries (p = 0.013). According to the results of multiple analyses of the factors affecting the delivery method performed by the participants, women in the control group had 2.41 times (95% confidence interval 1.07-5.41) more cesarean deliveries than women in the intervention group. CONCLUSION It has been shown that structured delivery preparation education increases vaginal delivery rates.
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Affiliation(s)
- Aysen Til
- Burdur Provincial Health Directorate, Burdur, Turkey
| | - Mehmet Bostanci
- Pamukkale University Medical School Public Health Department, Denizli, Turkey
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SOYSAL C, IŞIKALAN MM. Gebelik süresince doğum korkusunu etkileyen risk faktörlerinin belirlenmesi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.723669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jomeen J, Martin CR, Jones C, Marshall C, Ayers S, Burt K, Frodsham L, Horsch A, Midwinter D, O'Connell M, Shakespeare J, Sheen K, Thomson G. Tokophobia and fear of birth: a workshop consensus statement on current issues and recommendations for future research. J Reprod Infant Psychol 2020; 39:2-15. [PMID: 33206580 DOI: 10.1080/02646838.2020.1843908] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective: To discuss and develop a statement on the current state of the evidence and opinion in Fear of Childbirth (FoC) and Tokophobia (Tocophobia), and to provide recommendations. Background: A group met in 2019 to discuss the state of clinical and academic knowledge relating to FoC/Tokophobia. Five key areas were agreed as the focus of the meeting. Methods: 12 internationally acknowledged experts, in this or a closely related area (e.g. PTSD) met to discuss their understanding of the evidence for FoC/ Tokophobia and current practice. The consensus described in this paper constitutes the expression of the general opinion of the participants and does not necessarily imply unanimity. Keys points: Work focussed on tokophobia is recent and there remains a wide range of issues, which were addressed in the workshop including complexity in defining prevalence, a theoretical lack of understanding, which creates challenge for robust assessment and the identification of risk factors. An improved aetiological and developmental understanding of the tokophobia is required to underpin appropriate, effective and evidence-based interventions. Evaluation of pathways of care and relevant interventions, should be a focus of future research. Conclusion: Significant gaps remain within the FoC/tokophobia knowledge base. Further research is necessary.
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Affiliation(s)
- J Jomeen
- School of Health & Human Sciences, Southern Cross University , Bilinga, Australia.,Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK
| | - C R Martin
- School of Health & Human Sciences, Southern Cross University , Bilinga, Australia.,Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK.,School of Nursing and Allied Health, Buckinghamshire New University , High Wycombe, UK
| | - C Jones
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull , Hull, UK
| | - C Marshall
- Perinatal Mental Health Team, Humber Teaching NHS Foundation Trust , Hull, UK
| | - S Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London , London, UK
| | - K Burt
- Expert by Experience , UK
| | - L Frodsham
- Obstetric Medicine, Guy's and St Thomas' NHS Foundation Trust , London, UK
| | - A Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne , Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital , Lausanne, Switzerland
| | - D Midwinter
- Maternity and Midwifery Services, North Lincolnshire and Goole NHS Foundation Trust , Scunthorpe, UK
| | - M O'Connell
- School of Nursing and Midwifery, Royal College of Surgeons Ireland in Bahrain , Adliya, Bahrain
| | | | - K Sheen
- School of Psychology, Faculty of Health, Liverpool John Moores University , Liverpool, UK
| | - G Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire , Lancashire, UK.,School of Education, Health and Social Studies, Dalarna University , Falun, Sweden
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Putnick DL, Sundaram R, Bell EM, Ghassabian A, Goldstein RB, Robinson SL, Vafai Y, Gilman SE, Yeung E. Trajectories of Maternal Postpartum Depressive Symptoms. Pediatrics 2020; 146:peds.2020-0857. [PMID: 33109744 PMCID: PMC7772818 DOI: 10.1542/peds.2020-0857] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To identify homogenous depressive symptom trajectories over the postpartum period and the demographic and perinatal factors linked to different trajectories. METHODS Mothers (N = 4866) were recruited for Upstate KIDS, a population-based birth cohort study, and provided assessments of depressive symptoms at 4, 12, 24, and 36 months postpartum. Maternal demographic and perinatal conditions were obtained from vital records and/or maternal report. RESULTS Four depression trajectories were identified: low-stable (74.7%), characterized by low symptoms at all waves; low-increasing (8.2%), characterized by initially low but increasing symptoms; medium-decreasing (12.6%), characterized by initially moderate but remitting symptoms; and high-persistent (4.5%), characterized by high symptoms at all waves. Compared with the high-persistent group, older mothers (maximum odds ratio [OR] of the 3 comparisons: 1.10; 95% confidence interval [CI]: 1.05 to 1.15) or those with college education (maximum OR: 2.52; 95% CI: 1.36 to 4.68) were more likely to be in all other symptom groups, and mothers who had a history of mood disorder (minimum OR: 0.07; 95% CI: 0.04 to 0.10) or gestational diabetes mellitus diagnosis (minimum OR: 0.23; 95% CI: 0.08 to 0.68) were less likely to be in other symptom groups. Infertility treatment, multiple births, prepregnancy BMI, gestational hypertension, and infant sex were not differentially associated with depressive symptom trajectories. CONCLUSIONS One-quarter of mothers in a population-based birth cohort had elevated depressive symptoms in 3 years postpartum. Screening for maternal depression beyond the postpartum period may be warranted, particularly after mood and diabetic disorders.
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Affiliation(s)
| | | | - Erin M. Bell
- Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, New York
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, Grossman School of Medicine, New York University, New York, New York; and
| | - Risë B. Goldstein
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | | | | | - Stephen E. Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland;,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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63
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Moore MF. Birth Observation Among African American Women Prior to Pregnancy. J Perinat Educ 2020; 29:181-187. [PMID: 33223791 PMCID: PMC7662164 DOI: 10.1891/j-pe-d-19-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A focused ethnography among African American college students who had observed a live birth prior to their own pregnancy was pursued. Women described two reasons to attend births: curiosity about birth, or a desire to support the birth mother. Women attended the births of friends, family members, or saw their mother give birth to a younger sibling. Themes included pain, operative or traumatic birth, and surprise at the length and/or stages of labor. Some language suggested lingering trauma. Future expectations included painful labor, operative birth or damage, or traumatic labor and birth. Other women felt closer to the infant, or felt more prepared for their own births after observing birth. Prior personal experiences at birth should be explored prenatally.
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Firouzan L, Kharaghani R, Zenoozian S, Moloodi R, Jafari E. The effect of midwifery led counseling based on Gamble's approach on childbirth fear and self-efficacy in nulligravida women. BMC Pregnancy Childbirth 2020; 20:522. [PMID: 32907547 PMCID: PMC7488155 DOI: 10.1186/s12884-020-03230-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/02/2020] [Indexed: 11/22/2022] Open
Abstract
Background Studies show that childbirth fear is a common problem among Iranian women. Therefore, most Iranian women prefer caesarean section for giving birth. This study investigated the effectiveness of a psychoeducational intervention by midwives (birth emotions - looking to improve expectant fear (BELIEF)) on decreasing childbirth fear and self-efficacy among first-time pregnant women who were afraid of giving birth. Methods A number of 80 pregnant women participated in the study. They had received a score of ≥66 on the Wijma delivery expectancy/experience questionnaire. They were randomly assigned into two groups: intervention (n = 40) and control groups (n = 40). The intervention group received two face-to-face counseling sessions based on the BELEF protocol in the 24th and 34th weeks of pregnancy. Between these two sessions, it also received eight telephone-counseling sessions once a week. The control group only received the prenatal routine care. The outcome measures were childbirth fear, childbirth self-efficacy, and childbirth preference. Results The intervention group showed significantly more reduction in childbirth fear and more increase in childbirth self-efficacy compared to the control group. In addition, more women in the intervention group reported that they preferred to give normal vaginal birth than women in the control group. Conclusion The BELIEF protocol could be an effective approach in reducing childbirth fear and increasing childbirth self-efficacy among first-time pregnant women who are afraid of giving birth. Trial registration number IRCT20101219005417N3, Date of Registration: 19-12-2018.
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Affiliation(s)
- Laya Firouzan
- Department of Midwifery, School of Nursing and Midwifery. Zanjan University of Medical Sciences, Zanjan, Iran
| | - Roghieh Kharaghani
- Department of Midwifery, School of Nursing and Midwifery. Zanjan University of Medical Sciences, Zanjan, Iran
| | - Saeedeh Zenoozian
- Department of Midwifery, School of Nursing and Midwifery. Zanjan University of Medical Sciences, Zanjan, Iran.,Department of Clinical Psychology, Beheshti Hospital and Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Moloodi
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Elham Jafari
- Department of Midwifery, School of Nursing and Midwifery. Zanjan University of Medical Sciences, Zanjan, Iran.
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Striebich S, Ayerle GM. Fear of childbirth (FOC): pregnant women's perceptions towards the impending hospital birth and coping resources - a reconstructive study. J Psychosom Obstet Gynaecol 2020; 41:231-239. [PMID: 32838630 DOI: 10.1080/0167482x.2019.1657822] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Background: To provide obstetric care which meets the needs of pregnant women with fear of childbirth (FOC), a deeper understanding is required of the beliefs of these women regarding their impending birth and the coping resources they possess to cope with their fear.Methods: Problem-centred interviews were carried out with 12 pregnant women who self-reported high FOC. Data analysis was performed using Bohnsack's Documentary Method to reconstruct collective frames of orientation and implicit and explicit orientations in daily practice and interaction.Results: The interviewees see birth as a field of tension between the poles of naturalness and medicalization. Their need for information displays a need to be in control and fear of losing control. Medical and technological monitoring and one-to-one care promote security. Pregnant women with FOC want to know how they can contribute to a physiological birth.Conclusions: Structural, organizational and conceptual changes in obstetric care are needed to cater to the needs of pregnant women with FOC. Alongside the need for evidence-based information about non-medical and medical pain-relief as well as decision-making aids, the provision of a continuity model of midwifery care is important.
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Affiliation(s)
- Sabine Striebich
- Medical Faculty, Institute for Health and Nursing Sciences, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | - Gertrud M Ayerle
- Medical Faculty, Institute for Health and Nursing Sciences, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
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66
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Zarshenas M, Zhao Y, Binns CW, Scott JA. Incidence and Determinants of Caesarean Section in Shiraz, Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165632. [PMID: 32764231 PMCID: PMC7459978 DOI: 10.3390/ijerph17165632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/02/2020] [Accepted: 08/03/2020] [Indexed: 11/22/2022]
Abstract
The rate of Caesarean section (CS) without medical indication has increased markedly worldwide in the past decades. This study reports the incidence of CS and identifies the determinants of elective and emergency CS as separate pregnancy outcomes in a cohort of Iranian women. Mothers (n = 700) of healthy, full-term infants were recruited from five maternity hospitals in Shiraz. The association between maternal socio-demographic and biomedical factors with mode of delivery was explored using multivariable, multinomial logistic regression. Most mothers underwent either an elective (35.4%) or emergency (34.7%) CS. After adjustment, women were more likely to deliver by elective CS than vaginally if they were older (≥30 year) compared to younger mothers (<25 year) (Relative Risk Ratio (RRR) 2.22; 95% Confidence Interval (CI) 1.28, 3.84), and had given birth at a private hospital (RRR 3.64; 95% CI 1.79, 7.38). Compared to those educated to primary or lower secondary level, university educated women were more likely to have undergone an elective (RRR 2.65; 95% CI 1.54, 4.58) or an emergency CS (RRR 3.92; 95% CI 2.27, 6.78) than a vaginal delivery. Similarly, overweight or obese women were more likely than healthy weight women to have undergone an elective (RRR 1.91; 95% CI 1.27, 2.87) or an emergency CS (RRR 2.02; 95% CI 1.35, 3.02) than a vaginal delivery. Specialist education of obstetricians and midwives along with financial incentives paid to private hospitals to encourage natural delivery may help in the reduction of unnecessary CS in Iran. In addition, to increase their childbirth knowledge and self-efficacy, pregnant women need to have the opportunity to attend purposefully designed antenatal childbirth preparation classes where they receive evidence-based information on natural childbirth and alternative methods of pain control, as well as the risks and indications for CS.
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Affiliation(s)
- Mahnaz Zarshenas
- Fatemeh College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz 71348-14336, Iran
| | - Yun Zhao
- School of Public Health, Curtin University, Perth 6102, Australia
| | - Colin W Binns
- School of Public Health, Curtin University, Perth 6102, Australia
| | - Jane A Scott
- School of Public Health, Curtin University, Perth 6102, Australia
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67
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Freedman S, Reshef S, Weiniger C. Post-traumatic stress disorder and postpartum depression and their reported association with recent labor and delivery: a questionnaire survey cohort. Int J Obstet Anesth 2020; 43:18-24. [DOI: 10.1016/j.ijoa.2020.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 04/26/2020] [Accepted: 04/30/2020] [Indexed: 01/23/2023]
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68
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Ilska M, Banaś E, Gregor K, Brandt-Salmeri A, Ilski A, Cnota W. Vaginal delivery or caesarean section – Severity of early symptoms of postpartum depression and assessment of pain in Polish women in the early puerperium. Midwifery 2020; 87:102731. [DOI: 10.1016/j.midw.2020.102731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 11/29/2022]
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69
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Swift EM, Zoega H, Stoll K, Avery M, Gottfreðsdóttir H. Enhanced Antenatal Care: Combining one-to-one and group Antenatal Care models to increase childbirth education and address childbirth fear. Women Birth 2020; 34:381-388. [PMID: 32718800 DOI: 10.1016/j.wombi.2020.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND We designed and implemented a new model of care, Enhanced Antenatal Care (EAC), which offers a combined approach to midwifery-led care with six one-to-one visits and four group sessions. AIM To assess EAC in terms of women's satisfaction with care, autonomy in decision-making, and its effectiveness in lowering childbirth fear. METHODS This was a quasi-experimental controlled trial comparing 32 nulliparous women who received EAC (n=32) and usual antenatal care (n=60). We compared women's satisfaction with care and autonomy in decision-making post-intervention using chi-square test. We administered a Fear of Birth Scale pre- and post-intervention and assessed change in fear of birth in each group using the Cohen's d for effect size. To isolate the effect of EAC, we then restricted this analysis to women who did not attend classes alongside maternal care (n=13 in EAC and n=13 in usual care). FINDINGS Women's satisfaction with care in terms of monitoring their and their baby's health was similar in both groups. Women receiving EAC were more likely than those in usual care to report having received enough information about the postpartum period (75% vs 30%) and parenting (91% vs 55%). Overall, EAC was more effective than usual care in reducing fear of birth (Cohen's d=-0.21), especially among women not attending classes alongside antenatal care (Cohen's d=-0.83). CONCLUSION This study is the first to report findings on EAC and suggests that this novel model may be beneficial in terms of providing education and support, as well as lowering childbirth fear.
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Affiliation(s)
- Emma Marie Swift
- Faculty of Nursing/Department of Midwifery, University of Iceland, Eirberg við Eiríksgötu, 101 Reykjavík, Iceland.
| | - Helga Zoega
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, 101 Reykjavík, Iceland; Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Kathrin Stoll
- Division of Midwifery, University of British Columbia, Vancouver, Canada
| | - Melissa Avery
- University of Minnesota, School of Nursing, Minneapolis, MN, USA
| | - Helga Gottfreðsdóttir
- Faculty of Nursing/Department of Midwifery, University of Iceland, Eirberg við Eiríksgötu, 101 Reykjavík, Iceland; Women's Clinic, Landspitali University Hospital, 101 Reykjavik, Iceland
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70
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Kuipers J, Henrichs J, Evans K. A comparison of the Fear of Childbirth Scale with the Tilburg Pregnancy Distress Scale to identify childbirth-related fear in a sample of Dutch pregnant women: a diagnostic accuracy comparative cross-sectional study. Int J Nurs Stud 2020; 109:103615. [PMID: 32553993 DOI: 10.1016/j.ijnurstu.2020.103615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Because of the considerable negative effects of women's childbirth-related anxiety, fear and worries, and the time constraints that midwives perceive to assess women's antenatal emotional wellbeing, it is important that midwives can identify women with a more severe fear of birth with an easy to administer, validated tool. OBJECTIVE To investigate the ability of the two-item Fear of Childbirth Scale (FOBS) to discriminate between pregnant women with and without birth-related fear, compared with the 16-item Tilburg Pregnancy Distress Scale (TPDS). METHODS A diagnostic accuracy comparative cross-sectional study was performed, comparing two screening tests. Sensitivity, specificity, positive and negative predictive values and accuracy and discriminant property of the FOBS were determined and compared with the TPDS and with the negative affect 11-items TPDS (TPDS-NA) subscale. The TPDS and TPDS-NA were treated as reference standard to establish the discriminative potential of the FOBS for the presence or absence of antenatal birth-related fear. PARTICIPANTS A sample of 396 Dutch women with uncomplicated pregnancies. RESULTS When compared with the 16-items TPDS, the FOBS showed a higher specificity (95%) than sensitivity (70%) to detect fear of childbirth. The FOBS items had a good predictive ability for fear and worries about the forthcoming birth (79%) and a conclusive ability for negative case-finding (92%). The FOBS showed good accuracy (89%). The FOBS discriminated women who were or were not classified as being fearful according to the TPDS (AUC .86). When compared with the 11 items TPDS-NA subscale, the FOBS validity and accuracy decreased: sensitivity: 51%; specificity 92%; positive predictive ability 65%; negative predictive ability 88%; accuracy 83%; AUC .82. CONCLUSION When compared with the 16-items TPDS, the two-item FOBS shows to be an accurate tool for identifying the presence of antenatal birth-related fear in a sample of Dutch women with uncomplicated pregnancies.
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Affiliation(s)
- Jacoba Kuipers
- Antwerp University, Faculty of Medicine and Health Sciences - Nursing & Midwifery, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Jens Henrichs
- Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Midwifery Science AVAG-Amsterdam Public Health research institute, van der Boechhorststraat 7, 1091 BT Amsterdam, the Netherlands.
| | - Kerry Evans
- University of Nottingham, School of Health Sciences, University Park, Nottingham NG7 2RD, United Kingdom.
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Midwife-led integrated pre-birth training and its impact on the fear of childbirth. A qualitative interview study. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 25:100512. [PMID: 32305869 DOI: 10.1016/j.srhc.2020.100512] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/24/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although most expectant women with severe fear of childbirth take pre-birth training sessions, the available literature does not provide substantial emphirical data on its impacts, especially in developing countries like Kenya. AIM The study aimed at exploring women's experience from midwife-led integrated pre-birth training and its impact on the fear of childbirth. METHOD A qualitative interview was conducted using a thematic analysis. Thirty-three women who had experienced high and severe fear of childbirth, and had completed midwife-led integrated pre-birth training were interviewed one month after giving birth. The interviews were conducted in a maternal and child health clinic in Samburu, Kenya from December 2019 to January 2020. Collected data was analysed based on thematic analysis. RESULTS The general theme 'midwife-led integrated pre-birth training promoted constructive disposition and enhanced trust in the process of giving birth' was validated by the interviewed participants. Their contributions covered three themes: 'the significance of midwife-led pre-birth training', 'the role of efficient communication during pregnancy,' and 'adaptation to procedures for improved childbirth experience'. CONCLUSIONS In this study 85% (n = 29) of the participants revealed that midwife-led integrated pre-birth training enhanced their expectations for birth processes. They demonstrated readiness and preparedness for this process, which would lead to improved childbirth outcomes.
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72
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Onchonga D, MoghaddamHosseini V, Keraka M, Várnagy Á. Prevalence of fear of childbirth in a sample of gravida women in Kenya. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 24:100510. [PMID: 32217359 DOI: 10.1016/j.srhc.2020.100510] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/07/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of the study was to determine the prevalence of fear of childbirth (FOC) using a sample of gravida women in Kenya, a developing country where it is not fully acknowledged. MATERIALS AND METHODS This were a cross-sectional study on gravida women visiting health facilities to receive routine antenatal care. The study applied multistage sampling to enrol eligible expectant women. A researcher-developed questionnaire was used alongside Wijma Delivery Expectancy/Experience Questionnaire (version A) to collect respondents' demographic characteristics and to measure their fear of childbirth levels, respectively. RESULTS Approximately 29.5% had low, 40.4% moderate, 22.1% high, and 8% recorded severe FOC levels. Comparing by parity, the prevalence of severe FOC was higher on primigravida at 13.8% than multigravida, 8.0%. The results revealed a significant relationship between marital status (p = 0.045), parity (p = 0.000), literacy status (p = 0.000), regular check-up of pregnancy at health facilities (p = 0.003), having trust in healthcare providers (p = 0.000), and physical activity for gravida women with fear of childbirth (p = 0.000). CONCLUSION From the findings, special attention on the identified predictors of fear of childbirth during prenatal sessions would help in managing fear of childbirth before they give birth.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary.
| | - Vahideh MoghaddamHosseini
- Department of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran; Non-Communicable Diseases Research Centre, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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73
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Qiu L, Sun N, Shi X, Zhao Y, Feng L, Gong Y, Yin X. Fear of childbirth in nulliparous women: A cross-sectional multicentre study in China. Women Birth 2020; 33:e136-e141. [DOI: 10.1016/j.wombi.2019.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 04/12/2019] [Accepted: 04/13/2019] [Indexed: 02/08/2023]
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74
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Henriksen L, Borgen A, Risløkken J, Lukasse M. Fear of birth: Prevalence, counselling and method of birth at five obstetrical units in Norway. Women Birth 2020; 33:97-104. [DOI: 10.1016/j.wombi.2018.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/13/2018] [Accepted: 11/19/2018] [Indexed: 11/24/2022]
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75
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Malmquist A, Jonsson L, Wikström J, Nieminen K. Minority stress adds an additional layer to fear of childbirth in lesbian and bisexual women, and transgender people. Midwifery 2019; 79:102551. [DOI: 10.1016/j.midw.2019.102551] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 02/08/2023]
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76
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Berg M, Goldkuhl L, Nilsson C, Wijk H, Gyllensten H, Lindahl G, Uvnäs Moberg K, Begley C. Room4Birth - the effect of an adaptable birthing room on labour and birth outcomes for nulliparous women at term with spontaneous labour start: study protocol for a randomised controlled superiority trial in Sweden. Trials 2019; 20:629. [PMID: 31744523 PMCID: PMC6862754 DOI: 10.1186/s13063-019-3765-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 09/28/2019] [Indexed: 12/24/2022] Open
Abstract
Background An important prerequisite for optimal healthcare is a secure, safe and comfortable environment. There is little research on how the physical design of birthing rooms affects labour, birth, childbirth experiences and birthing costs. This protocol outlines the design of a randomised controlled superiority trial (RCT) measuring and comparing effects and experiences of two types of birthing rooms, conducted in one labour ward in Sweden. Methods/design Following ethics approval, a study design was developed and tested for feasibility in a pilot study, which led to some important improvements for conducting the study. The main RCT started January 2019 and includes nulliparous women presenting to the labour ward in active, spontaneous labour and who understand either Swedish, Arabic, Somali or English. Those who consent are randomised on a 1:1 ratio to receive care either in a regular room (control group) or in a newly built birthing room designed with a person-centred approach and physical aspects (such as light, silencer, media installation offering programmed nature scenes with sound, bathtub, birth support tools) that are changeable according to a woman’s wishes (intervention group). The primary efficacy endpoint is a composite score of four outcomes: no use of oxytocin for augmentation of labour; spontaneous vaginal births (i.e. no vaginal instrumental birth or caesarean section); normal postpartum blood loss (i.e. bleeding < 1000 ml); and a positive overall childbirth experience (7–10 on a scale of 1–10). To detect a difference in the composite score of 8% between the groups we need 1274 study participants (power of 80% with significance level 0.05). Secondary outcomes include: the four variables in the primary outcome; other physical outcomes of labour and birth; women’s self-reported experiences (the birthing room, childbirth, fear of childbirth, health-related quality of life); and measurement of costs in relation to the hospital stay for mother and neonate. Additionally, an ethnographic study with participant observations will be conducted in both types of birthing rooms. Discussion The findings aim to guide the design of birthing rooms that contribute to optimal quality of hospital-based maternity care. Trial registration ClinicalTrials.gov NCT03948815. Registered 13 May 2019—retrospectively registered.
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Affiliation(s)
- Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden. .,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, SE-416 50, Gothenburg, Sweden.
| | - Lisa Goldkuhl
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, SE-416 50, Gothenburg, Sweden
| | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, SE-501 90, Borås, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden.,Quality and Patient Safety Unit, Sahlgrenska University Hospital of Gothenburg, SE-413 45, Gothenburg, Sweden.,Centre for Healthcare Architecture , CVA, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
| | - Göran Lindahl
- Centre for Healthcare Architecture , CVA, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden.,Building Design, Architecture and Civil Engineering, Chalmers University of Technology, SE 412 96, Gothenburg, Sweden
| | | | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, 24 D'Olier St, Dublin 2, Ireland
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A known midwife can make a difference for women with fear of childbirth- birth outcome and women’s experiences of intrapartum care. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 21:33-38. [DOI: 10.1016/j.srhc.2019.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/08/2019] [Accepted: 06/14/2019] [Indexed: 11/20/2022]
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78
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Molgora S, Fenaroli V, Cracolici E, Saita E. Antenatal fear of childbirth and emergency cesarean section delivery: a systematic narrative review. J Reprod Infant Psychol 2019; 38:436-454. [PMID: 31271306 DOI: 10.1080/02646838.2019.1636216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Fear of childbirth is a common feeling among expectant mothers. Although it represents a physiological expression of women's concerns, it can become a clinical condition compromising the woman's daily activities as well as her coping strategies during labour and delivery. Research has focused on adverse intrapartum and postpartum outcomes of fear of childbirth. As regards intrapartum outcomes, some studies have investigated the association between fear of childbirth and type of delivery, with contrasting results. OBJECTIVE This study aimed at reviewing the literature on the association between fear of childbirth and emergency caesarean section delivery. METHOD This systematic review was based on an electronic search of English-language published studies through 31 December 2018. Following the search process, 14 studies were included. Studies were analysed specifically considering the sample parity and tools for evaluating fears. RESULTS These studies revealed that both sample characteristics and assessment instruments are not criteria for explaining the different result. CONCLUSIONS The importance of distinguishing between fear and severe fear was highlighted because the effect of fear on the type of delivery was present only for clinical fear. However, the different cut-off values did not make it possible to reach a clear result, making further investigation necessary. ABBREVIATIONS FOC - Fear of Childbirth; ECS - Emergency Cesarean Section.
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Affiliation(s)
- Sara Molgora
- Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
| | - Valentina Fenaroli
- Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
| | - Elisa Cracolici
- Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of the Sacred Heart , Milan, Italy
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79
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Coates D, Homer C, Wilson A, Deady L, Mason E, Foureur M, Henry A. Indications for, and timing of, planned caesarean section: A systematic analysis of clinical guidelines. Women Birth 2019; 33:22-34. [PMID: 31253513 DOI: 10.1016/j.wombi.2019.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND There has been a worldwide rise in planned caesarean sections over recent decades, with significant variations in practice between hospitals and countries. Guidelines are known to influence clinical decision-making and, potentially, unwarranted clinical variation. The aim of this study was to review guidelines for recommendations in relation to the timing and indications for planned caesarean section as well as recommendations around the process of decision-making. METHOD A systematic search of national and international English-language guidelines published between 2008 and 2018 was undertaken. Guidelines were reviewed, assessed in terms of quality and extracted independently by two reviewers. FINDINGS In total, 49 guidelines of varying quality were included. There was consistency between the guidelines in potential indications for caesarean section, although guidelines vary in terms of the level of detail. There was substantial variation in timing of birth, for example recommended timing of caesarean section for women with uncomplicated placenta praevia is between 36 and 39weeks depending on the guideline. Only 11 guidelines provided detailed guidance on shared decision-making. In general, national-level guidelines from Australia, and overseas, received higher quality ratings than regional guidelines. CONCLUSION The majority of guidelines, regardless of their quality, provide very limited information to guide shared decision-making or the timing of planned caesarean section, two of the most vital aspects of guidance. National guidelines were generally of better quality than regional ones, suggesting these should be used as a template where possible and emphasis placed on improving national guidelines and minimising intra-country, regional, variability of guidelines.
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Affiliation(s)
- Dominiek Coates
- University of Technology Sydney, Faculty of Health, Centre for Midwifery and Child and Family Health, NSW, Australia; Maridulu Budyari Gumal, The Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), Australia; School of Women's and Children's Health, UNSW Medicine, UNSW, Australia.
| | - Caroline Homer
- University of Technology Sydney, Faculty of Health, Centre for Midwifery and Child and Family Health, NSW, Australia; Burnet Institute, Victoria, Australia
| | - Alyssa Wilson
- Maridulu Budyari Gumal, The Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), Australia
| | - Louise Deady
- South Eastern Sydney Local Health District, District Offices, Sutherland Hospital Locked Bag 21, Taren Point, NSW 2229, Australia.
| | - Elizabeth Mason
- South Eastern Sydney Local Health District, District Offices, Sutherland Hospital Locked Bag 21, Taren Point, NSW 2229, Australia.
| | - Maralyn Foureur
- Hunter New England Nursing and Midwifery Research Centre, Australia; University of Newcastle, Faculty of Health and Medicine, Australia.
| | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine, UNSW, Australia; Department of Women's and Children's Health, St. George Hospital, Sydney, Australia; The George Institute for Global Health, UNSW Medicine, Australia
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80
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O'Connell MA, O'Neill SM, Dempsey E, Khashan AS, Leahy-Warren P, Smyth RMD, Kenny LC. Interventions for fear of childbirth (tocophobia). THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2019. [DOI: 10.1002/14651858.cd013321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Maeve Anne O'Connell
- P.O. Box 15503; RCSI Bahrain; Adliya Bahrain
- University College Cork; Irish Centre for Fetal and Neonatal Translational Research; Cork Ireland
| | - Sinéad M O'Neill
- Health Information and Quality Authority; Health Technology Assessment Directorate; Unit 1301, City Gate Mahon Cork Munster Ireland T12 Y2XT
| | - Eugene Dempsey
- Cork University Maternity Hospital; Neonatology; Wilton Cork Ireland
| | - Ali S Khashan
- University College Cork; School of Public Health; Cork Ireland
| | - Patricia Leahy-Warren
- University College Cork; School of Nursing and Midwifery; Brookfield Health Sciences Complex Cork Ireland
| | - Rebecca MD Smyth
- The University of Manchester; Division of Nursing Midwifery and Social Work; Jean McFarlane Building Oxford Road Manchester UK M13 9PL
| | - Louise C Kenny
- University of Liverpool; Faculty of Health and Life Sciences; Foundation Building, 765 Brownlow Hill Liverpool Merseyside UK
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81
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O'Connell MA, Leahy-Warren P, Kenny LC, Khashan AS. Pregnancy outcomes in women with severe fear of childbirth. J Psychosom Res 2019; 120:105-109. [PMID: 30929700 DOI: 10.1016/j.jpsychores.2019.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 03/07/2019] [Accepted: 03/10/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare pregnancy outcomes for women with and without severe fear of childbirth (FOC) reported in the second trimester of pregnancy. METHODS In a prospective cohort study, 389 singleton pregnancies were followed up using medical records of participants in a study investigating FOC in Cork, Republic of Ireland. FOC was measured using the Wijma Delivery Experience Questionnaire Part A (W-DEQ A). Severe FOC was defined as W-DEQ A ≥ 85, moderate FOC, W-DEQ-A 66-84 and low FOC, W-DEQ A 0-65. Outcome measures were birthweight, birthweight centile, gestational age, and Apgar scores at 1 min and Apgar at 5 min. Linear regression was used to assess the association between FOC and each outcome measure with adjustment for maternal age, smoking, parity and marital status. RESULTS There was no statistically significant difference in mean birthweight (mean difference = -0.03; [95% CI: -444.69, 315.82]), mean birthweight centile (mean difference = 0.03; [95%CI: -15.97, 23.53]), or mean gestational age (mean difference = -0.06; [95%CI: -11.69, 4.82]) in women with severe FOC (n = 18) compared with women with low FOC (n = 371). In the adjusted models, there was only a slight correlation between severe FOC and Apgar scores at 1 min (mean difference = -0.09 [95%CI: -1.28, 0.32]) and Apgar scores at 5 min (mean difference = -0.18 [95%CI: -1.16, 1.08]). CONCLUSION While a slight association was noted between severe FOC and Apgar scores, overall findings are reassuring and could inform educational interventions which may alleviate FOC. Awareness of FOC for health care professionals is vital to consider women's mental well-being.
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Affiliation(s)
- Maeve A O'Connell
- Irish Centre for Fetal and Neonatal Translational Research (INFANT Centre) & Dept. of Obstetrics & Gynaecology, University College Cork, Cork, Ireland.
| | | | - Louise C Kenny
- Faculty of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - Ali S Khashan
- Irish Centre for Fetal and Neonatal Translational Research (INFANT Centre) & Dept. of Obstetrics & Gynaecology, University College Cork, Cork, Ireland; School of Public Health, University College Cork, Cork, Ireland
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82
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Weeks FH, Sadler M, Stoll K. Preference for caesarean attitudes toward birth in a Chilean sample of young adults. Women Birth 2019; 33:e159-e165. [PMID: 30992177 DOI: 10.1016/j.wombi.2019.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/18/2019] [Accepted: 03/17/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little empirical research exists about what motivates birth mode preferences, and even less about this topic in Latin America, where obstetric interventions and caesareans are some of the highest worldwide. AIM To identify factors associated with caesarean preference among Chilean men and women who plan to have children and to inform childbirth education and informed consent procedures. METHODS An online cross-sectional survey measuring attitudes toward birth was administered to graduate students at a large public university in Chile. Eligible students were under the age of 40 and had no children but intended to have children. Logistic regression modelling was used to determine which sociodemographic factors, knowledge and beliefs were associated with caesarean preference. FINDINGS Among eligible students, 730 responded and 664 provided complete answers to the variables of interest. Respondents had a mean age of 28.8; 38% were male and 62% female. Positive attitude toward technological intervention (Odds Ratio 7.4, 95% Confidence Interval 3.9-14.0), high risk perception of vaginal birth (Odds Ratio 1.8, 95% Confidence Interval 1.1-2.8), family history of caesarean (Odds Ratio 1.9, 95% Confidence Interval 1.0-3.8) and high fear of birth (Odds Ratio 3.7, 95% Confidence Interval 2.0-6.8) were associated with caesarean preference. DISCUSSION Preference for caesarean birth was highly associated with positive attitudes toward technological intervention and may be related to a lack of knowledge about the realities of caesarean and vaginal birth. CONCLUSIONS Patient-centered education on the relative benefits and risks of birth modes has the potential to influence preferences toward vaginal birth.
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Affiliation(s)
- Fiona H Weeks
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health. 1 W. Wilson St., Madison, WI, 53704, United States.
| | - Michelle Sadler
- Department of History and Social Sciences, Faculty of Liberal Arts, Universidad Adolfo Ibáñez, Diagonal Las Torres, Peñalolén, Santiago, 2640, Chile.
| | - Kathrin Stoll
- Birth Place Lab., University of British Columbia, BC Women's Hospital Shaughnessy Building E418 4500 Oak Street, Vancouver, BC V6H 3N1, Canada.
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83
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Dencker A, Nilsson C, Begley C, Jangsten E, Mollberg M, Patel H, Wigert H, Hessman E, Sjöblom H, Sparud-Lundin C. Causes and outcomes in studies of fear of childbirth: A systematic review. Women Birth 2019; 32:99-111. [DOI: 10.1016/j.wombi.2018.07.004] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/30/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
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84
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Slade P, Balling K, Sheen K, Houghton G. Establishing a valid construct of fear of childbirth: findings from in-depth interviews with women and midwives. BMC Pregnancy Childbirth 2019; 19:96. [PMID: 30885153 PMCID: PMC6423809 DOI: 10.1186/s12884-019-2241-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 03/08/2019] [Indexed: 11/10/2022] Open
Abstract
Background Fear of childbirth (FOC) can have a negative impact on a woman’s psychological wellbeing during pregnancy and her experience of birth. It has also been associated with adverse obstetric outcomes and postpartum mental health difficulties. However the FOC construct is itself poorly defined. This study aimed to systematically identify the key elements of FOC as reported by women themselves. Methods Semi-structured interviews with pregnant women (n = 10) who reported to be fearful of childbirth and telephone interviews with consultant midwives (n = 13) who regularly work with women who are fearful of childbirth were conducted. Interviews were analysed using thematic analysis for each group independently to provide two sources of information. Findings were reviewed in conjunction with a third source, a recently published meta-synthesis of existing literature of women’s own accounts of FOC. The key elements of FOC were determined via presence in two out of the three sources at least one of which was from women themselves, i.e. the reports of the women interviewed or the meta-synthesis. Results Seven themes were identified by the women and the consultant midwives: Fear of not knowing and not being able to plan for the unpredictable, Fear of harm or stress to the baby, Fear of inability to cope with the pain, Fear of harm to self in labour and postnatally, Fear of being ‘done to’, Fear of not having a voice in decision making and Fear of being abandoned and alone. One further theme was generated by the women and supported by the reports included the meta-synthesis: Fear about my body’s ability to give birth. Two further themes were generated by the consultant midwives and were present also in the meta-synthesis: Fear of internal loss of control and Terrified of birth and not knowing why. Conclusions Ten key elements in women’s FOC were identified. These can now be used to inform development of measurement tools with verified content validity to identify women experiencing FOC, to support timely access to support during pregnancy. Electronic supplementary material The online version of this article (10.1186/s12884-019-2241-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- P Slade
- Institute of Health and Life Sciences, University of Liverpool, Ground Floor Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK.
| | - K Balling
- Institute of Health and Life Sciences, University of Liverpool, Ground Floor Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK
| | - K Sheen
- Natural Sciences and Psychology, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK
| | - G Houghton
- Liverpool Women's Hospital Foundation Trust, Crown Street, Liverpool, L8 7SS, UK
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85
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Badaoui A, Kassm SA, Naja W. Fear and Anxiety Disorders Related to Childbirth: Epidemiological and Therapeutic Issues. Curr Psychiatry Rep 2019; 21:27. [PMID: 30868272 DOI: 10.1007/s11920-019-1010-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW This paper seeks to identify the risk factors of fear of childbirth (FOC) and posttraumatic stress disorder (PTSD) related to birth and reviews the efficacy of their respective screening tools and therapeutic interventions. RECENT FINDINGS Biofeedback, hypnosis, internet-based cognitive behavioral therapy, and antenatal education are promising treatments for FOC. Training midwives to address traumatic birth experiences could help in preventing PTSD. A shorter more pragmatic screening tool for FOC than the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ) is needed. Women with PTSD attributed a mismatch between the expected mode of delivery (MOD) and the actual MOD as the cause of their trauma. A history of mental health disorders, lack of social support, previous negative birth experiences, and MOD are correlated to FOC and postpartum PTSD. Psycho-education and CBT-based treatments have been found to reduce levels of FOC and PTSD.
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Affiliation(s)
- Alexandra Badaoui
- Faculty of Medical Sciences, Department of Psychiatry, Lebanese University, Beirut, Lebanon.
| | - Sandra Abou Kassm
- Faculty of Medical Sciences, Department of Psychiatry, Lebanese University, Beirut, Lebanon
| | - Wadih Naja
- Faculty of Medical Sciences, Department of Psychiatry, Lebanese University, Beirut, Lebanon
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86
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Rondung E, Ekdahl J, Sundin Ö. Potential mechanisms in fear of birth: The role of pain catastrophizing and intolerance of uncertainty. Birth 2019; 46:61-68. [PMID: 29954044 DOI: 10.1111/birt.12368] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/04/2018] [Accepted: 06/05/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although many pregnant women experience fear, worry, or anxiety relating to the upcoming birth, little is known regarding the psychological mechanisms contributing to these experiences. In this study, we wanted to take a first step in trying to identify mechanisms of potential interest. The objective of this cross-sectional study was thus to investigate pain catastrophizing, intolerance of uncertainty, positive worry beliefs, and cognitive avoidance as potential mechanisms predicting fear of birth among pregnant women. METHODS A sample of 499 pregnant women, recruited in antenatal health care settings in 2 Swedish regions, completed the Fear of Birth Scale, along with measurements of the mechanisms of interest. Linear and logistic hierarchical regression analyses were used to investigate the extent to which pain catastrophizing, intolerance of uncertainty, positive worry beliefs, and cognitive avoidance predicted fear of birth, both as a continuous and a dichotomous measure. RESULTS Logistic regression analysis showed high levels of pain catastrophizing and intolerance of uncertainty to be the best predictors of fear of birth, OR 3.49 (95% CI 2.17-5.61) and OR 3.25 (95% CI 2.00-5.27), respectively. Positive beliefs about worry and cognitive avoidance were both correlated with fear of birth as a continuous measure, but did not contribute to the logistic regression model. CONCLUSIONS Pain catastrophizing and intolerance of uncertainty were the most evident predictors of fear of birth. Although preliminary, the findings suggest that interventions targeting catastrophic cognitions and intolerance of uncertainty might be relevant to psychological treatment for fear, worry, or anxiety relating to giving birth.
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Affiliation(s)
- Elisabet Rondung
- Department of Psychology, Mid Sweden University, Östersund, Sweden
| | - Johanna Ekdahl
- Department of Psychology, Mid Sweden University, Östersund, Sweden
| | - Örjan Sundin
- Department of Psychology, Mid Sweden University, Östersund, Sweden
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87
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Reyes E, Rosenberg K. Maternal motives behind elective cesarean sections. Am J Hum Biol 2019; 31:e23226. [PMID: 30791166 DOI: 10.1002/ajhb.23226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/11/2019] [Accepted: 02/02/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The World Health Organization recommends a target cesarean section rate of 10-15%. In recent years, the US has had a nation-wide rate of 30.3% and some developed countries are even higher. Many factors account for this high rate, but our hypothesis is that women who elect cesarean section do so at least in part because of unallayed fear. METHODS Our sample was comprised of American women of childbearing age who have not given birth but may in the near future. We received 368 online survey responses with a 92% completion rate. Responses were categorical and hypotheses tested with non-parametric statistics. RESULTS Those who reported a preference for cesarean section were significantly more likely to be extremely fearful of birth (43.9%) than those who reported a preference for vaginal delivery (20.6%). 73.2% of the cesarean section group state that fear is what influenced their birth preference, 9.8% said their fear had no influence, while in the vaginal birth group 18.9% said fear influenced their birth preference and 53.7% said it did not. CONCLUSIONS In our sample, women likely to elect cesarean sections are motivated at least in part by fear. They report both more extreme levels of fear than the group anticipating non-surgical delivery and they more often say that this fear influences their birth decision. This study offers productive, non-interventional, and inexpensive ways to address women's fears in the hope of reducing unnecessary cesarean sections.
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Affiliation(s)
- Emaline Reyes
- Department of Anthropology, University of Delaware, Newark, Delaware
| | - Karen Rosenberg
- Department of Anthropology, University of Delaware, Newark, Delaware
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88
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Deliktas A, Kukulu K. Pregnant Women in Turkey Experience Severe Fear of Childbirth: A Systematic Review and Meta-Analysis. J Transcult Nurs 2019; 30:501-511. [DOI: 10.1177/1043659618823905] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Culture is an important factor to determine fear of childbirth which is shaped by social learning processes. The purpose of this study is to determine the level of fear of childbirth among Turkish healthy pregnant women. Method: The researchers reviewed the eight databases considering inclusion criteria and 14 studies were included. The data analysis was conducted using meta-analysis. Results: Pregnant women experienced severe levels of fear, 67.26 ± 4.08, 95% confidence interval [59.26, 75.26], and 21 out of every 100 women experienced clinical level of fear. Between study variance was significant for parity (Qb = 6.40, p = .04) and region (Qb = 19.14, p = .00) moderators. Conclusions: The high level of FOC, particularly in the Eastern region, suggests that some of the cultural factors in the Eastern region in Turkey negatively affect the birth expectations. In a country like Turkey with a multicultural population, the health care professional should provide culturally sensitive care.
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89
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Junge C, von Soest T, Weidner K, Seidler A, Eberhard-Gran M, Garthus-Niegel S. Labor pain in women with and without severe fear of childbirth: A population-based, longitudinal study. Birth 2018; 45:469-477. [PMID: 29630751 DOI: 10.1111/birt.12349] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/19/2018] [Accepted: 02/19/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND This prospective study aims to investigate whether severe fear of childbirth increases pain perceptions during birth and whether co-occurring maternal health and birth factors as well as length and weight of the child explain the association. METHODS The study sample comprised women with a vaginal delivery and was drawn from the Akershus Birth Cohort. Data from the hospital birth's record and questionnaires at weeks 17-19 and 32 of pregnancy and 8 weeks postpartum were used (n = 1649). Analysis of variance and analysis of covariance were conducted to examine whether ratings of labor pain differed significantly between women with and without severe fear of childbirth and which factors explained the difference. RESULTS Women with severe fear of childbirth experienced significantly more labor pain than women without severe fear of childbirth (P < .01). However, when controlling for symptoms of maternal depression and anxiety, use of epidural/spinal anesthetic or nitrous oxide gas, and menstrual pain, this difference was no longer significant (P = .09). DISCUSSION Although the results show that labor pain is related to multiple physiological and psychological factors in a complex manner, symptoms of maternal depression and anxiety seem to play a central role for the experience of labor pain, and should therefore be focused on by health practitioners.
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Affiliation(s)
- Carolin Junge
- Norwegian Institute of Public Health, Oslo, Norway.,Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | | | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Malin Eberhard-Gran
- Norwegian Institute of Public Health, Oslo, Norway.,HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Lørenskog, Norway
| | - Susan Garthus-Niegel
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität Dresden, Dresden, Germany
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90
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Rondung E, Ekdahl J, Hildingsson I, Rubertsson C, Sundin Ö. Heterogeneity in childbirth related fear or anxiety. Scand J Psychol 2018; 59:634-643. [DOI: 10.1111/sjop.12481] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 07/05/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Ingegerd Hildingsson
- Department of Women′s and Children′s Health, Obstetrics and Gynecology; Uppsala University; Sweden
- Department of Nursing; Mid Sweden University; Sweden
| | - Christine Rubertsson
- Department of Women′s and Children′s Health, Obstetrics and Gynecology; Uppsala University; Sweden
- Department of Health Sciences; Faculty of Medicine; Lund University; Sweden
| | - Örjan Sundin
- Department of Psychology; Mid Sweden University; Sweden
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91
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Rondung E, Ternström E, Hildingsson I, Haines HM, Sundin Ö, Ekdahl J, Karlström A, Larsson B, Segeblad B, Baylis R, Rubertsson C. Comparing Internet-Based Cognitive Behavioral Therapy With Standard Care for Women With Fear of Birth: Randomized Controlled Trial. JMIR Ment Health 2018; 5:e10420. [PMID: 30097422 PMCID: PMC6109226 DOI: 10.2196/10420] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/21/2018] [Accepted: 06/06/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although many pregnant women report fear related to the approaching birth, no consensus exists on how fear of birth should be handled in clinical care. OBJECTIVE This randomized controlled trial aimed to compare the efficacy of a guided internet-based self-help program based on cognitive behavioral therapy (guided ICBT) with standard care on the levels of fear of birth in a sample of pregnant women reporting fear of birth. METHODS This nonblinded, multicenter randomized controlled trial with a parallel design was conducted at three study centers (hospitals) in Sweden. Recruitment commenced at the ultrasound screening examination during gestational weeks 17-20. The therapist-guided ICBT intervention was inspired by the Unified protocol for transdiagnostic treatment of emotional disorders and consisted of 8 treatment modules and 1 module for postpartum follow-up. The aim was to help participants observe and understand their fear of birth and find new ways of coping with difficult thoughts and emotions. Standard care was offered in the three different study regions. The primary outcome was self-assessed levels of fear of birth, measured using the Fear of Birth Scale. RESULTS We included 258 pregnant women reporting clinically significant levels of fear of birth (guided ICBT group, 127; standard care group, 131). Of the 127 women randomized to the guided ICBT group, 103 (81%) commenced treatment, 60 (47%) moved on to the second module, and only 13 (10%) finished ≥4 modules. The levels of fear of birth did not differ between the intervention groups postintervention. At 1-year postpartum follow-up, participants in the guided ICBT group exhibited significantly lower levels of fear of birth (U=3674.00, z=-1.97, P=.049, Cohen d=0.28, 95% CI -0.01 to 0.57). Using the linear mixed models analysis, an overall decrease in the levels of fear of birth over time was found (P≤ .001), along with a significant interaction between time and intervention, showing a larger reduction in fear of birth in the guided ICBT group over time (F1,192.538=4.96, P=.03). CONCLUSIONS Fear of birth decreased over time in both intervention groups; while the decrease was slightly larger in the guided ICBT group, the main effect of time alone, regardless of treatment allocation, was most evident. Poor treatment adherence to guided ICBT implies low feasibility and acceptance of this treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT02306434; https://clinicaltrials.gov/ct2/show/NCT02306434 (Archived by WebCite at http://www.webcitation.org/70sj83qat).
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Affiliation(s)
- Elisabet Rondung
- Department of Psycholgy, Mid Sweden University, Östersund, Sweden
| | - Elin Ternström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Ingegerd Hildingsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Helen M Haines
- Department of Rural Health, The University of Melbourne, Victoria, Australia
| | - Örjan Sundin
- Department of Psycholgy, Mid Sweden University, Östersund, Sweden
| | - Johanna Ekdahl
- Department of Psycholgy, Mid Sweden University, Östersund, Sweden
| | | | | | - Birgitta Segeblad
- Department of Obstetrics and Gynecology, Uppsala University Hospital, Uppsala, Sweden
| | - Rebecca Baylis
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christine Rubertsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Health Science, Faculty of Medicine, Lund university, Lund, Sweden
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92
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Toohill J, Fenwick J, Sidebotham M, Gamble J, Creedy DK. Trauma and fear in Australian midwives. Women Birth 2018; 32:64-71. [PMID: 29759933 DOI: 10.1016/j.wombi.2018.04.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 01/25/2018] [Accepted: 04/02/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Relatively little is known about the extent of trauma and birth-related fear in midwives and how this might affect practice. AIM (1) Determine prevalence of birth related trauma and fear in midwives and associations with midwives' confidence to advise women during pregnancy of their birth options and to provide care in labour. (2) Describe midwives' experiences of birth related trauma and/or fear. METHOD A mixed methods design. A convenience sample of midwives (n=249) completed an anonymous online survey. Descriptive and inferential statistics were used to analyse the quantitative data. Latent content analysis was used to extrapolate meaning from the 170 midwives who wrote about their experiences of personal and/or professional trauma. RESULTS The majority of midwives (93.6%) reported professional (n=199, 85.4%) and/or personal (n=97, 41.6%) traumatic birth experiences. Eight percent (n=20) reported being highly fearful of birth. Trauma was not associated with practice concerns but fear was. Midwives categorised as having 'high fear' reported more practice concerns (Med 23.5, n=20) than midwives with 'low fear' (Med 8, n=212) (U=1396, z=-3.79, p<0.001, r=0.24). Reasons for personal trauma included experiencing assault, intervention and stillbirth. Professional trauma related to both witnessing and experiencing disrespectful care and subsequently feeling complicit in the provision of poor care. Feeling unsupported in the workplace and fearing litigation intensified trauma. CONCLUSION High fear was associated with lower confidence to support childbearing women. Fear and trauma in midwives warrants further investigation to better understand the impact on professional practice.
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Affiliation(s)
- J Toohill
- School of Nursing and Midwifery, Griffith University, Australia.
| | - J Fenwick
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Australia; Clinical Chair, Gold Coast University Hospital, Australia.
| | - M Sidebotham
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Australia.
| | - J Gamble
- Menzies Health Institute Queensland, School of Nursing & Midwifery, Griffith University, Australia.
| | - D K Creedy
- Menzies Health Institute Queensland, Griffith University, Australia.
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93
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Larsson B, Hildingsson I, Ternström E, Rubertsson C, Karlström A. Women's experience of midwife-led counselling and its influence on childbirth fear: A qualitative study. Women Birth 2018; 32:e88-e94. [PMID: 29709431 DOI: 10.1016/j.wombi.2018.04.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 03/28/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women's views about counselling for childbirth fear. AIM To explore women's experiences of midwife-led counselling for childbirth fear. METHOD A qualitative interview study using thematic analysis. Twenty-seven women assessed for childbirth fear who had received counselling during pregnancy at three different hospitals in Sweden were interviewed by telephone one to two years after birth. FINDINGS The overarching theme 'Midwife-led counselling brought positive feelings and improved confidence in birth' was identified. This consisted of four themes describing 'the importance of the midwife' and 'a mutual and strengthening dialogue' during pregnancy. 'Coping strategies and support enabled a positive birth' represent women's experiences during birth and 'being prepared for a future birth' were the women's thoughts of a future birth. CONCLUSIONS In this qualitative study, women reported that midwife-led counselling improved their confidence for birth through information and knowledge. The women experienced a greater sense of calm and preparedness, which increased the tolerance for the uncertainty related to the birthing process. This, in turn, positively affected the birth experience. Combined with a feeling of safety, which was linked to the professional support during birth, the women felt empowered. The positive birth experience strengthened the self-confidence for a future birth and the childbirth fear was described as reduced or manageable.
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Affiliation(s)
- Birgitta Larsson
- Department of Women's and Children's Health, Obstetrics and Gynecology, Uppsala University, 751 85 Uppsala, Sweden; Research and Development Centre, Sundsvall Hospital, 846 53 Sundsvall, Sweden.
| | - Ingegerd Hildingsson
- Department of Women's and Children's Health, Obstetrics and Gynecology, Uppsala University, 751 85 Uppsala, Sweden; Department of Nursing Sciences, Mid-Sweden University, 851 70 Sundsvall, Sweden
| | - Elin Ternström
- Department of Women's and Children's Health, Obstetrics and Gynecology, Uppsala University, 751 85 Uppsala, Sweden
| | - Christine Rubertsson
- Department of Women's and Children's Health, Obstetrics and Gynecology, Uppsala University, 751 85 Uppsala, Sweden; Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden
| | - Annika Karlström
- Department of Nursing Sciences, Mid-Sweden University, 851 70 Sundsvall, Sweden
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94
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Psenkova P, Bucko M, Braticak M, Baneszova R, Zahumensky J. Impact of introducing specific measures to reduce the frequency of cesarean delivery for non-obstetric indications. Int J Gynaecol Obstet 2018; 142:23-27. [DOI: 10.1002/ijgo.12496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/19/2018] [Accepted: 03/23/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Petra Psenkova
- 2nd Department of Obstetrics and Gynecology; Faculty of Medicine in Bratislava of the Comenius University in Bratislava; Bratislava Slovak Republic
- University Hospital Bratislava; Bratislava Slovak Republic
| | - Marek Bucko
- Department of Obstetrics and Gynaecology; Trnava University Hospital; Trnava Slovak Republic
| | - Michal Braticak
- Department of Obstetrics and Gynaecology; Trnava University Hospital; Trnava Slovak Republic
| | - Ruth Baneszova
- 2nd Department of Obstetrics and Gynecology; Faculty of Medicine in Bratislava of the Comenius University in Bratislava; Bratislava Slovak Republic
- University Hospital Bratislava; Bratislava Slovak Republic
| | - Jozef Zahumensky
- 2nd Department of Obstetrics and Gynecology; Faculty of Medicine in Bratislava of the Comenius University in Bratislava; Bratislava Slovak Republic
- University Hospital Bratislava; Bratislava Slovak Republic
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95
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Striebich S, Mattern E, Ayerle GM. Support for pregnant women identified with fear of childbirth (FOC)/tokophobia - A systematic review of approaches and interventions. Midwifery 2018; 61:97-115. [PMID: 29579696 DOI: 10.1016/j.midw.2018.02.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/20/2018] [Accepted: 02/13/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND providing appropriate care for pregnant women with high or severe fear of childbirth (FOC) is a challenge in midwifery care today. FOC is associated with predisposing anamnestic factors, various sociodemographic and psychosocial characteristics, and may result in serious healthrelated consequences. It is therefore important to establish which interventions may increase a woman's faith in her own ability to cope with labour and birth. AIM to systematically identify and review studies examining interventions for relief of severe fear of childbirth in pregnancy and their underlying conceptual foundation. METHODS a systematic literature search was performed following Cochrane Collaboration and PRISMA Statement recommendations. Inclusion criteria were: studies including pregnant women diagnosed with high or severe FOC or who requested a caesarean section due to severe FOC, studies (regardless of design) observing the effect of an intervention addressing FOC, and studies published in English. Publications addressing anxiety or stress were excluded. 377 references were screened by title and abstract. The risk of bias was assessed. FINDINGS 19 articles referring to 15 research projects were included in the analysis. The studies show heterogeneity regarding assessment methods, type, conceptualisation and application of interventions. There is evidence that both cognitive therapy sessions and a theory-based group psychoeducation with relaxation are effective interventions. KEY CONCLUSIONS despite methodological limitations, single or group psychoeducation sessions for nulliparous women or therapeutic conversation during pregnancy (in group or individual sessions) have the potential to strengthen women's self-efficacy and decrease the number of caesarean sections due to FOC. The theoretical validation of an intervention deepens the understanding of psychological processes in women coping with severe FOC. IMPLICATIONS FOR PRACTICE theory-based concepts of care for both antenatal and intrapartum support of pregnant women with high or severe FOC should be developed, piloted, tested, evaluated and implemented within the given healthcare system. Midwives need to be competent to address pregnant women's fears regarding labour and birth in antenatal care. The use of a valid assessment tool to identify the level of FOC in women, even if they do not raise the issue, is recommended in routine antenatal care so that appropriate expert support can be offered. A one-on-one conversation may be feasible for those women unwilling to fill in a questionnaire. Cooperative local networks between midwives, psychologists and obstetricians qualified in psychotherapy should be established to ensure timely and effective care for women with high or severe FOC.
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Affiliation(s)
- Sabine Striebich
- Institute for Health and Nursing Sciences, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany.
| | - Elke Mattern
- Department of Applied Health Sciences, University of Applied Sciences, Gesundheitscampus 6-8, 44801 Bochum Germany.
| | - Gertrud M Ayerle
- Institute for Health and Nursing Sciences, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany.
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96
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Stoll K, Swift EM, Fairbrother N, Nethery E, Janssen P. A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth. Birth 2018; 45:7-18. [PMID: 29057487 DOI: 10.1111/birt.12316] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Despite a sharp increase in the number of publications that report on treatment options for pregnancy-specific anxiety and fear of childbirth (PSA/FoB), no systematic review of nonpharmacological prenatal interventions for PSA/FoB has been published. Our team addressed this gap, as an important first step in developing guidelines and recommendations for the treatment of women with PSA/FoB. METHODS Two databases (PubMed and Mendeley) were searched, using a combination of 42 search terms. After removing duplicates, two authors independently assessed 208 abstracts. Sixteen studies met eligibility criteria, ie, the article reported on an intervention, educational component, or treatment regime for PSA/FoB during pregnancy, and included a control group. Independent quality assessments resulted in the retention of seven studies. RESULTS Six of seven included studies were randomized controlled trials (RCTs) and one a quasi-experimental study. Five studies received moderate quality ratings and two strong ratings. Five of seven studies reported significant changes in PSA/FoB, as a result of the intervention. Short individual psychotherapeutic interventions (1.5-5 hours) delivered by midwives or obstetricians were effective for women with elevated childbirth fear. Interventions that were effective for pregnant women with a range of different fear/anxiety levels were childbirth education at the hospital (2 hours), prenatal Hatha yoga (8 weeks), and an 8-week prenatal education course (16 hours). CONCLUSIONS Findings from this review can inform the development of treatment approaches to support pregnant women with PSA/FoB.
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Affiliation(s)
- Kathrin Stoll
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Emma Marie Swift
- Department of Nursing, University of Iceland, Reykjavík, Iceland
| | - Nichole Fairbrother
- Department of Psychiatry, University of British Columbia, Island Medical Program, Victoria, Canada
| | - Elizabeth Nethery
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
| | - Patricia Janssen
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
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97
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Rosenberg KR, Trevathan WR. Evolutionary perspectives on cesarean section. EVOLUTION MEDICINE AND PUBLIC HEALTH 2018. [DOI: 10.1093/emph/eoy006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Karen R Rosenberg
- Department of Anthropology, University of Delaware, Newark, DE 19716, USA
| | - Wenda R Trevathan
- Department of Anthropology, New Mexico State University, Las Cruces, NM 80003, USA
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98
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Stoll K, Fairbrother N, Thordarson DS. Childbirth Fear: Relation to Birth and Care Provider Preferences. J Midwifery Womens Health 2018; 63:58-67. [PMID: 29364575 DOI: 10.1111/jmwh.12675] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/27/2017] [Accepted: 07/02/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purpose of this study was to assess how preferences for place of birth and mode of birth relate to different dimensions of childbirth fear and whether there is an association between Canadian women's prenatal fear of childbirth and the type and quality of prenatal care they received. METHODS A link to an online survey was posted on Canadian pregnancy and birth websites; 409 women completed the survey that included sociodemographic questions, questions about the current pregnancy and previous pregnancy experiences (if applicable), and the Childbirth Fear Questionnaire, a validated 40-item scale that measures 9 dimensions of childbirth fear. RESULTS Women under physician care and those with a preference for cesarean birth were generally more fearful of pain associated with vaginal birth, fear of loss of sexual pleasure and attractiveness, and fear of harm to themselves or their infant. Conversely, women under the care of midwives and women who preferred to give birth vaginally were more fearful of interventions. Women who preferred a cesarean birth were significantly more likely to report that fear of childbirth interfered with daily functioning, compared to women who preferred a vaginal birth. Satisfaction with care was associated with lower scores on the Childbirth Fear Questionnaire full and subscales, especially among midwifery clients. DISCUSSION At present there are no guidelines in Canada or the United States for the treatment and/or referral of pregnant women who suffer from childbirth fear. Until such guidelines are developed, findings from the current study can help maternity care providers identify and address specific fears among women in their care and understand how different fear domains relate to care provider choice, satisfaction with care, and women's preferences for place and mode of birth.
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99
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Nilsson C, Hessman E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, Patel H, Sparud-Lundin C, Wigert H, Begley C. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy Childbirth 2018; 18:28. [PMID: 29329526 PMCID: PMC5766978 DOI: 10.1186/s12884-018-1659-7] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 01/07/2018] [Indexed: 11/22/2022] Open
Abstract
Background Fear of Childbirth (FOC) is a common problem affecting women’s health and wellbeing, and a common reason for requesting caesarean section. The aims of this review were to summarise published research on prevalence of FOC in childbearing women and how it is defined and measured during pregnancy and postpartum, and to search for useful measures of FOC, for research as well as for clinical settings. Methods Five bibliographic databases in March 2015 were searched for published research on FOC, using a protocol agreed a priori. The quality of selected studies was assessed independently by pairs of authors. Prevalence data, definitions and methods of measurement were extracted independently from each included study by pairs of authors. Finally, some of the country rates were combined and compared. Results In total, 12,188 citations were identified and screened by title and abstract; 11,698 were excluded and full-text of 490 assessed for analysis. Of these, 466 were excluded leaving 24 papers included in the review, presenting prevalence of FOC from nine countries in Europe, Australia, Canada and the United States. Various definitions and measurements of FOC were used. The most frequently-used scale was the W-DEQ with various cut-off points describing moderate, severe/intense and extreme/phobic fear. Different 3-, 4-, and 5/6 point scales and visual analogue scales were also used. Country rates (as measured by seven studies using W-DEQ with ≥85 cut-off point) varied from 6.3 to 14.8%, a significant difference (chi-square = 104.44, d.f. = 6, p < 0.0001). Conclusions Rates of severe FOC, measured in the same way, varied in different countries. Reasons why FOC might differ are unknown, and further research is necessary. Future studies on FOC should use the W-DEQ tool with a cut-off point of ≥85, or a more thoroughly tested version of the FOBS scale, or a three-point scale measurement of FOC using a single question as ‘Are you afraid about the birth?’ In this way, valid comparisons in research can be made. Moreover, validation of a clinical tool that is more focussed on FOC alone, and easier than the longer W-DEQ, for women to fill in and clinicians to administer, is required. Electronic supplementary material The online version of this article (10.1186/s12884-018-1659-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90, Borås, Sweden. .,Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden.
| | - E Hessman
- Biomedical Library, Gothenburg University Library at University of Gothenburg, Box 416, -405 30, Gothenburg, SE, Sweden
| | - H Sjöblom
- Biomedical Library, Gothenburg University Library at University of Gothenburg, Box 416, -405 30, Gothenburg, SE, Sweden
| | - A Dencker
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden
| | - E Jangsten
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden
| | - M Mollberg
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden
| | - H Patel
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden
| | - C Sparud-Lundin
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden
| | - H Wigert
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden
| | - C Begley
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Box 457, -405 30, Gothenburg, SE, Sweden.,Chair of Nursing and Midwifery, School of Nursing and Midwifery,Trinity College Dublin, 24, D'Olier St. Dublin 2, Dublin, Ireland
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100
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Eckerdal P, Georgakis MK, Kollia N, Wikström AK, Högberg U, Skalkidou A. Delineating the association between mode of delivery and postpartum depression symptoms: a longitudinal study. Acta Obstet Gynecol Scand 2018; 97:301-311. [DOI: 10.1111/aogs.13275] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/22/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Patricia Eckerdal
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Marios K. Georgakis
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
- Department of Hygiene, Epidemiology and Medical Statistics; School of Medicine; National and Kapodistrian University of Athens; Athens Greece
| | - Natasa Kollia
- Department of Nutrition and Dietetics; School of Health Science and Education; Harokopio University; Athens Greece
| | - Anna-Karin Wikström
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Ulf Högberg
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Alkistis Skalkidou
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
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