Preferred and actual mode of delivery in relation to fear of childbirth. (1st October 2020)

• Record Type: Journal Article
• Authors: Sluijs, Anne-Marie; Wijma, Klaas; Cleiren, Marc P. H. D.; van Lith, Jan M. M.; Wijma, Barbro
• Is Part Of: Journal of psychosomatic obstetrics & gynaecology. Volume 41:Number 4(2020)
• Page Start: 266
• Page End: 274
• Publication Date: 2020-10-01
• Subjects: Fear of childbirth -- mode of delivery -- Cesarean section -- anxiety -- preference; Gynecology -- Periodicals; Medicine, Psychosomatic -- Periodicals; Obstetrics -- Periodicals; 616.08
• DOI: 10.1080/0167482X.2019.1708319
• Languages: English
• ISSNs: 0167-482X

Abstract

Abstract: Purpose: This prospective cohort study aimed to investigate the interrelation between preferred/actual mode of delivery and pre- and postpartum fear of childbirth (FOC). Material and methods: Participants from 13 midwifery practices and four hospitals in Southwest Netherlands filled out questionnaires at 30 weeks' gestation ( n = 561) and two months postpartum ( n = 463), including questions on preferred mode of delivery, the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) and Hospital Anxiety Depression Scale (HADS). Results were related to obstetric data. Results: Both severe FOC (OR 7.0, p < .001) and previous Cesarean section (CS) (OR 16.6, p < .001) predicted preference for CS. Severe prepartum FOC also predicted actual CS. Preferring a vaginal delivery (VD) and actually having a CS predicted higher postpartum W-DEQ scores (partial r = 0.107, p < .05). Other significant predictors for high postpartum W-DEQ scores were high prepartum W-DEQ (partial r = 0.357) and HADS anxiety scores (partial r = 0.143) and the newborn in need of medical assistance (partial r = −0.169). Conclusions: Women preferring a VD but ending up with a CS are at risk for severe FOC postpartum, while the same risk was not demonstrated for women who preferred a CS but had a VD. Prepartum FOC is strongly associated with postpartum FOC, regardless of congruence between preferred and actual mode of delivery.