Prevalence and course of fear of childbirth during pregnancy and need
for help in nulliparous women, HEAR study: a cohort study
Abstract
Objective To determine the prevalence and course of fear of
childbirth (FoC) according to gestational age and to identify risk
factors for FoC, the influence of FoC on preferred mode of delivery and
self-reported need for help. Study Design Cross-sectional and
cohort study Setting Urban hospital, midwifery practices,
social media, maternity websites. Population Nulliparous
pregnant women May 2020-January 2021. Methods Participants
completed an online survey. Women who completed the survey in the first
or second trimester(T0) were approached again in their third
trimester(T1). Questionnaires indexing FoC, social support, anxiety,
depressive symptoms, self-reported need for help, and preferred mode of
delivery were included. Main outcome measures Fear of
childbirth, defined as W-DEQ A score ≥ 85 Results In total, 364
women were enrolled at T0, and 118 women were included in the
longitudinal analysis. Cross-sectional analysis showed a prevalence of
FoC of 18.4% with no significant difference between trimesters. In the
longitudinal sample, prevalence of FoC decreased from 18.6%(T0) to
11.0%(T1), P=0.004. W-DEQ A mean scores decreased significantly,
P<0.001, although 41 (34.7%) women showed an increase
in scores. FoC was associated with elevated anxiety, less family
support, prenatal care of the obstetrician by choice, preference for a
cesarean section, and for pain relief. Women with FoC were more likely
to actively seek for help compared to women without FoC.
Conclusions While FoC is common, prevalence decreases over the
course of pregnancy. Because women with FoC are actively seeking for
help, this problem should be addressed better, and help should be
offered.