Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort

Objectives  To examine the associations between fear of childbirth and emergency caesarean section and between fear of childbirth and dystocia or protracted labour and fetal distress.

Design  Prospective cohort study.

Setting  Danish National Birth Cohort.

Population  A total of 25 297 healthy nulliparous women in spontaneous labour with a single fetus in cephalic presentation at term following an uncomplicated pregnancy.

Methods  Data were collected during 1997–2003 from computer-assisted telephone interviews twice in pregnancy linked with national health registers.

Main outcome measures  Risk for emergency caesarean section of women who feared childbirth; risk for dystocia/protracted labour or fetal distress of women who feared childbirth.

Results  Fear of childbirth in early (16 weeks, 6 ± 29 days) and late (31 weeks, 4 ± 21 days) pregnancy was associated with emergency caesarean section: OR, 1.23 (1.05–1.47) and 1.32 (1.13–1.55), respectively. When fear of childbirth was expressed at both interviews, the OR was 1.43 (1.13–1.80). Women who feared childbirth had an increased risk for dystocia or protracted labour (OR, 1.33; 1.15–1.54), but not for fetal distress (OR, 0.94; 0.72–1.23).

Conclusions  Fear of childbirth during pregnancy was associated with dystocia and emergency caesarean section but not with fetal distress.