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Birth Experience in Women with Low, Intermediate or High Levels of Fear: Findings from the First Baby Study

Authors

  • Charlotte Elvander CNM,

    Certified Nurse-Midwife and a doctoral student
    1. Department of Medicine, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
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  • Sven Cnattingius MD, PhD,

    Senior Professor
    1. Department of Medicine, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden
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  • Kristen H. Kjerulff PhD

    Professor
    1. Departments of Public Health Sciences and Obstetrics and Gynecology, College of Medicine, Penn State University, Hershey, Pennsylvania
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  • This article reports a study which was supported by grant (R01-HD052990) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA. Charlotte Elvander is supported by the National Doctoral School in Health Care Sciences, Sweden.

Address correspondence to Charlotte Elvander, Department of Medicine, Division of Clinical Epidemiology, T2, Karolinska Universitetssjukhuset, 171 76 Stockholm, Sweden.

Abstract

Background

Fear of childbirth and mode of delivery are two known factors that affect birth experience. The interactions between these two factors are unknown. The aim of this study was to estimate the effects of different levels of fear of birth and mode of delivery on birth experience 1 month after birth.

Methods

As part of an ongoing prospective study, we interviewed 3,006 women in their third trimester and 1 month after first childbirth to assess fear of birth and birth experience. Logistic regression was performed to examine the interactions and associations between fear of birth, mode of delivery and birth experience.

Results

Compared with women with low levels of fear of birth, women with intermediate levels of fear, and women with high levels of fear had a more negative birth experience and were more affected by an unplanned cesarean section or instrumental vaginal delivery. Compared with women with low levels of fears with a noninstrumental vaginal delivery, women with high levels of fear who were delivered by unplanned cesarean section had a 12-fold increased risk of reporting a negative birth experience (OR 12.25; 95% CI 7.19–20.86). A noninstrumental vaginal delivery was associated with the most positive birth experience among the women in this study.

Conclusions

This study shows that both levels of prenatal fear of childbirth and mode of delivery are important for birth experience. Women with low fear of childbirth who had a noninstrumental vaginal delivery reported the most positive birth experience.

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