Article

Fear of childbirth; The relation to anxiety and depression

Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway.
Acta Obstetricia Et Gynecologica Scandinavica (Impact Factor: 2.43). 11/2011; 91(2):237-42. DOI: 10.1111/j.1600-0412.2011.01323.x
Source: PubMed

ABSTRACT

To study the associations of anxiety and depression with fear of childbirth.
A cross-sectional questionnaire study.
Prenatal public healthcare in Norway.
Pregnant women (n=1642) recruited during November 2008 until April 2010.
Data were collected by a postal questionnaire at pregnancy week 32. Fear of childbirth was measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ) and by a numeric rating scale. Symptoms of anxiety were measured by the Hopkins Symptom Check List (SCL-25) and symptoms of depression by the Edinburgh Postnatal Depression Scale (EPDS).
Fear of childbirth.
Eight per cent (137 of 1642) of the women had fear of childbirth (W-DEQ≥85), 8.8% (145 of 1642) had anxiety (SCL-anxiety≥18) and 8.9% (146 of 1642) had depression (EPDS≥12). More than half (56.2%) of the women with fear of childbirth did not have anxiety or depression; however, presence of anxiety or depression increased the prevalence of fear of childbirth (odds ratio 2.4, 95% confidence interval 1.1-5.2 and odds ratio 8.4, 95% confidence interval 4.8-14.7, respectively). Women with both anxiety and depression had the highest prevalence of fear of childbirth (odds ratio 11.0, 95% confidence interval 6.6-18.3). Similar associations of anxiety and depression were estimated by using the numerical rating scale for measuring fear of childbirth.
Presence of anxiety and depression increased the prevalence of fear of childbirth; however, the majority of women with fear of childbirth had neither anxiety nor depression.

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    • "All rights reserved. childbirth has also been associated with anxiety and depression (Storksen et al., 2012). In Sweden self-reported symptoms of mental illness especially anxiety and depression are increasing among young people (Socialstyrelsen, 2013). "
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    ABSTRACT: this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors. a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records. data were recruited from antenatal health-care clinics in Halland, Sweden. a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42. five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States. results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy. this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Jun 2015 · Midwifery
    • "Further development of the idea for a simpler scale led to the use of numeric rating scale (NRS) of childbirth fear in a Norwegian cohort of 1642 women [17]. The authors concluded that the use of NRS " may promote high compliance in studies and may, for some purposes, replace the WDEQ- A " [17] p241. Extending this research, a cross cultural study from Australia and Sweden explored the use of a two-item VAS to measure fear of birth [3]. "
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    ABSTRACT: Background: The WDEQ-A is the most widely used measure of childbirth fear in pregnant women; however there is increasing discussion in the literature that simpler, more culturally transferrable tools may offer a better solution to identifying fearful women in clinical practice. Aim: To compare the two item Fear of Birth Scale (FOBS) with the 33 item WDEQ-A in a large cohort of Australian pregnant women. Method: Self-report questionnaires during second trimester including Wijma Delivery Expectancy Questionnaire (WDEQ-A) and Fear of Birth Scale (FOBS). Correlation of FOBS and WDEQ-A was tested using Spearman's correlation coefficients. Receiver operating characteristic (ROC) curve assessed the sensitivity and specificity of possible cut-points on the FOBS against WDEQ-A cut-point of >= 85. Sensitivity, specificity, positive and negative predictive values were determined. Fearful and non-fearful women as classified by both instruments were compared for differences in demographic, psycho-social and obstetric characteristics. Results: 1410 women participated. The correlation between the instruments was strong (Spearman's Rho = 0.66, p<0.001). The area under the ROC was 0.89 indicating high sensitivity with a FOBS cut-point of 54. Sensitivity was 89%, specificity 79% and Youden index 0.68. Positive predictive value was 85% and negative predictive value 79%. Both instruments identified high fear as significantly associated with first time mothers, previous emergency caesarean and women with self-reported anxiety and/or depression. Additionally FOBS identified a significant association between fearful women and preference for caesarean. Conclusion: This study supports the use of the FOBS in clinical practice to identify childbirth fear in pregnant women. Crown Copyright
    No preview · Article · May 2015 · Sexual & reproductive healthcare: official journal of the Swedish Association of Midwives
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    • "It is possible that women, only one day after delivery, are overwhelmed by having a healthy baby and the negative feelings from the delivery may only emerge later. However, such an interpretation is unlikely since an earlier prospective study of women with various types of deliveries showed that lower W-DEQ scores were found at one month than at two days postpartum [30]. The choice of a cut-off at W-DEQ B score 66 p may perhaps also affect our results. "
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    ABSTRACT: Background: Studies have suggested several risk factors for a negative birth experience among primiparas. Factors that are mentioned frequently include labour dystocia, operative intervention such as acute caesarean section or vacuum extraction, or the infant being transferred to neonatal care. Another important factor mentioned is lack of support from the midwife. Methods: A study was made of the deliveries of 446 healthy primiparas in a prospective cohort study performed at Soder Hospital, Stockholm, Sweden. Samples of amniotic fluid were collected at delivery and the levels of amniotic fluid lactate (AFL) were measured to give an indication of the metabolism of the uterine tissue. Obstetrical data were collected from birth records.Postpartum, all the women included in the study were asked to complete the Wijma Delivery Experience Questionnaire (W-DEQ B) that measures the experience of a woman's delivery. The main objective of the project was to study well-known as well as new factors associated with negative experience of childbirth among a group of healthy primiparas. Results: Risk factors for reporting a higher level of negative childbirth experience were shown to be a high level of AFL (AOR 3.1, 95%, CI; 1.1-8.9), a longer latent phase (AOR 1.8, 95%, CI; 1.03-3.1), and a low Apgar score (<7 at 1 min) (AOR 13.3, 95%, CI; 1.6-111.0). Those women who had a negative birth experience wanted the midwife to be present more of the time during labour (p = 0.003). Conclusions: A high AFL level, as a marker of uterine metabolic status, and a longer latent phase are strongly associated with a negative experience of childbirth. A low 1 minute Apgar score of the newborn seems to have the strongest negative influence on the woman's experience of childbirth, even when the infant recovers immediately.
    Full-text · Article · Jun 2014 · BMC Pregnancy and Childbirth
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Questions & Answers about this publication

  • Nurussolehah Yusof asked a question in Pregnancy:
    Why did you use EPDS to measure depression symptoms, instead of using questions that were already included in HSCL-25?
    Why use another questionnaire?
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      [Show abstract] [Hide abstract]
      ABSTRACT: To study the associations of anxiety and depression with fear of childbirth. A cross-sectional questionnaire study. Prenatal public healthcare in Norway. Pregnant women (n=1642) recruited during November 2008 until April 2010. Data were collected by a postal questionnaire at pregnancy week 32. Fear of childbirth was measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ) and by a numeric rating scale. Symptoms of anxiety were measured by the Hopkins Symptom Check List (SCL-25) and symptoms of depression by the Edinburgh Postnatal Depression Scale (EPDS). Fear of childbirth. Eight per cent (137 of 1642) of the women had fear of childbirth (W-DEQ≥85), 8.8% (145 of 1642) had anxiety (SCL-anxiety≥18) and 8.9% (146 of 1642) had depression (EPDS≥12). More than half (56.2%) of the women with fear of childbirth did not have anxiety or depression; however, presence of anxiety or depression increased the prevalence of fear of childbirth (odds ratio 2.4, 95% confidence interval 1.1-5.2 and odds ratio 8.4, 95% confidence interval 4.8-14.7, respectively). Women with both anxiety and depression had the highest prevalence of fear of childbirth (odds ratio 11.0, 95% confidence interval 6.6-18.3). Similar associations of anxiety and depression were estimated by using the numerical rating scale for measuring fear of childbirth. Presence of anxiety and depression increased the prevalence of fear of childbirth; however, the majority of women with fear of childbirth had neither anxiety nor depression.
      Full-text · Article · Nov 2011 · Acta Obstetricia Et Gynecologica Scandinavica