Fear of childbirth in nulliparous and multiparous women in Australia
Although maternity care in developed countries is safe, fear of childbirth is a common problem. There is limited research in this area on nulliparous and multiparous women. The aim of this study was to compare fear of childbirth, its risk factors and birth outcomes between Australian nulliparous and multiparous women.
In this prospective cohort study, 141 nulliparous women and 212 multiparous women were recruited from antenatal clinics. Data were collected using standardised questionnaires and analysed.
A third of nulliparous (33%) and multiparous women (31%) feared childbirth. Nulliparous women with high–severe fear were more likely to have a lower family income, attend antenatal education classes, undergo assisted conception and report higher levels of depression, anxiety and stress. They also had greater odds of prelabour cervical ripening, oxytocin for induction or augmentation of labour, instrumental birth, episiotomy and greater volume of blood loss during birth than multiparous women.
To empower and support women with fear of childbirth, their unique needs must be recognised. A assistance in coping with fear and anxiety must be made available to contribute to a positive pregnancy experience and birth outcome.
Pregnancy and birth are described as a transition phase or existential threshold that childbearing women must cross. Childbirth is an experience with multifaceted dimensions and is unique for each woman, as well as being strongly influenced by her psychosocial context. Women's expectations and experiences of pregnancy and birth are both positive and negative in nature, involving feelings of joy and faith but also worries, anxiety and fears (Dencker et al, 2019).
Although maternity care in high-income countries is safe, fear of childbirth is a common problem affecting the health and wellbeing of women before, during and after pregnancy. Fear of childbirth can result in consequences for women's relationships with their baby, partner and family, and often leads to a higher rate of childbirth interventions and requests for caesarean section by women striving for control in an exposed situation (Nilsson et al, 2018). Fear of childbirth has also been shown to be associated with emergency caesarean section, increased risk of dystocia, protracted labour, preterm birth, low birth weight, unsuccessful breastfeeding, extended postnatal hospital stay and a negative childbirth experience (Waldenström et al, 2006; Laursen et al, 2009).
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