References

Areskog B, Uddenberg N, Kjessler B Fear of childbirth in late pregnancy. Gynecol Obstet Invest. 1981; 12:(5)262-6

Areskog B, Kjessler B, Uddenberg N Identification of women with significant fear of childbirth during late pregnancy. Gynecol Obstet Invest. 1982; 13:(2)98-10

, 4th text revision edition. Washington DC: APA; 2000

Carter MC, Corry M, Delbanco S 2020 vision for a high-quality, high-value maternity care system. Women's Health Issues. 2010; 20:7-17

Cooke A, Cork MJ, Danby S, Lavender T Use of oil for baby skincare: A survey of UK maternity and neonatal units. British Journal of Midwifery. 2011; 19:(6)354-62

Fenwick J, Gamble J, Nathan E Pre- and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women. J Clin Nurs. 2009; 18:(5)667-77

Fan W, Zheng Y Factors affecting response rates of web survey: A systematic review. Computers in Human Behavior. 2010; 26:(2)132-9

Haines H, Pallant JF, Karlström A, Hildingsson I Cross-cultural comparison of levels of childbirth-related fear in an Australian and Swedish sample. Midwifery. 2011; 27:(4)560-7 https://doi.org/10.1016/j.midw.2010.05.004

Hofberg K, Brockington I Tokophobia: an unreasoning dread of childbirth - A series of 26 cases. Br J Psychiatry. 2000; 176::83-5

Hofberg K, Ward MR Fear of childbirth, tocophobia, and mental health in mothers: The obstetric-psychiatric interface. Clin Obstet Gynecol. 2004; 47:(3)527-34

Kjærgaard H, Wijma K, Dykes A, Alehagen S Fear of childbirth in obstetrically low-risk nulliparous women in Sweden and Denmark. Journal of Reproductive & Infant Psychology. 2008; 26:(4)340-50

Laursen M, Hedegaard M, Johansen C Fear of childbirth: predictors and temporal changes among nulliparous women in the Danish National Birth Cohort. BJOG. 2008; 115:(3)354-60

Light HK, Fenster C Maternal concerns during pregnancy. Am J Obstet Gynecol. 1974; 118:(1)46-50

Madge C, O'Connor H Online methods in geography educational research. Journal of Geography in Higher Education. 2004; 1:(28)143-52

Ethical decision-making and Internet Research: Recommendations from the AoIR Ethics Working Committee. 2012. http://aoir.org/reports/ethics2.pdf (accessed 29 June 2015)

McMunn V, Bedwell C, Neilson J, Jones A, Dowswell T, Lavender T A National survey of the use of TENS in labour. British Journal of Midwifery. 2009; 18:(8)492-5

Antenatal and postnatal mental health: Clinical management and service guidance.London: NICE; 2007

Caesarean Section Guidelines.London: NICE; 2011

National Institute of Health and Care Excellence. Quality statement 3 Maternal request for Caesarean section: maternal anxiety. 2013. http://publications.nice.org.uk/quality-standard-for-caesarean-section-qs32/quality-statement-3-maternal-request-for-a-caesarean-section-maternal-anxiety (accessed 26 June 2015)

Nieminen K, Stephansson O, Ryding EL Women's fear of childbirth and preference for caesarean section - a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand. 2009; 88:(7)807-13 https://doi.org/10.1080/00016340902998436

Nulty DD The adequacy of response rates to online and paper surveys: what can be done?. Assessment and Evaluation in Higher Education. 2008; 33:(3)301-4

Nursing and Midwifery Council. Midwives rules and standards. 2012. http://www.nmc-uk.org/Publications/Standards/ (accessed 26 June 2015)

Pleshette N, Asch SS, Chase J A study of anxieties during pregnancy, labor, the early and later pueperium. Bull N Y Acad Med. 1956; 32:(6)436-55

Saisto T, Halmesmäki E Fear of childbirth: A neglected dilemma. Acta Obstet Gynecol Scand. 2003; 82:(3)201-8

Sandall J, Soltani H, Gates S, Shennan A, Devane D Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2013; 8 https://doi.org/10.1002/14651858.CD004667.pub3

Searle J Fearing the worst - Why do pregnant women feel ‘at risk’?. Aust N Z J Obstet Gynaecol. 1996; 36:(3)279-86

Størksen HT, Garthus-Niegel S, Vangen S, Eberhard-Gran M The impact of previous birth experiences on maternal fear of birth. Acta Obstet Gynecol Scand. 2013; 92:(3)318-24 https://doi.org/10.1111/aogs.12072

Wiklund I, Edman G, Andolf E Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers. Acta Obstet Gynecol Scand. 2007; 86:(4)451-6

A national online survey of UK maternity unit service provision for women with fear of birth

02 August 2015
11 min read
Volume 23 · Issue 8

Abstract

In the UK, fear of birth (FoB) is considered a valid reason to request an elective caesarean section, and the National Institute for Health and Care Excellence (NICE, 2011) provided guidance in respect of women with a FoB requesting operative delivery. However, it was not clear how many maternity units in the UK offered support for women in line with this guidance. Consequently, a national online audit survey was undertaken to determine current service provision in maternity units. Hence in 2013, 202 maternity units were surveyed over 9 weeks; there was a 63% (n=128) response rate.

It was evident that 47.3% (n=52) of all units did not offer specialist support for women with FoB. However, where support was available, this varied from the benchmark recommendation for referral to a consultant obstetrician (NICE, 2001) to specialist midwifery clinics and psychological support services. Overall, the survey revealed that care pathways for FoB had not been widely implemented in the UK.

There is no agreed definition on what fear of birth (FoB) is, largely due to the differences in its diagnostic testing (Haines et al, 2011). However, Areskog (1982: 263) defined severe FoB in women who ‘expressed a strong anxiety which had impacted their daily functions and wellbeing’.

The evidence for a true prevalence of FoB is scarce; however, between 7 and 26% of women in high income countries fear childbirth (Hofberg and Ward, 2004; Laursen et al, 2008; Kjærgaard et al, 2008; Fenwick et al, 2009) with 6% reporting the fear as ‘disabling’ (Searle, 1996).

A FoB was documented as early as 1858 by French psychiatrist, Marcé (Hofberg and Brockington, 2000: 83):

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month