The impact of previous birth experiences on maternal fear of childbirth

Abstract

Objectives: This study aimed to assess the relation between fear of childbirth and previous birth experiences.

Design: A prospective study of pregnant women.

Setting: Akershus University Hospital, Norway.

Population: Parous women (n = 1357) scheduled to give birth at Akershus University Hospital in Norway during 2009-2011.

Methods: Data were collected using two self-completed questionnaires at pregnancy weeks 17 and 32. Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire. Previous overall birth experience was measured using a numeric rating scale, and previous obstetric complications were assessed using an index of seven obstetric complications: emergency cesarean section, instrumental vaginal delivery, extensive blood loss, retained placenta, serious maternal infection during labor, thrombosis, and anal sphincter tears.

Main outcome measure: Fear of childbirth.

Results: The odds ratio of fear of childbirth was 4.8 (95% confidence interval (CI) 2.8-8.3) for a previous negative overall birth experience, 1.9 (95% CI 1.2-3.1) for one obstetric complication and 2.6 (95% CI 1.2-5.5) for two or more complications. The estimates were adjusted for mental health, labor pain, time since last delivery, age, and education. Almost 80% of women who experienced obstetric complications neither considered the birth a negative overall experience nor developed a fear of childbirth.

Conclusions: The association between a previous subjectively negative birth experience and fear of childbirth was high and was greater than the association between previous obstetric complications and fear of childbirth.