A randomized controlled trial of intervention in fear of childbirth☆
Section snippets
Materials and methods
Between August 1996 and July 1999, a total of 176 obstetrically low-risk and physically healthy pregnant women were referred to the outpatient clinic of the Department of Obstetrics and Gynecology in Helsinki University Central Hospital because of fear of vaginal delivery, as diagnosed by a specific questionnaire10, 11 (Table 1). The cut-off point for diagnosis of fear of childbirth was five or more affirmative answers or request for cesarean. The only exclusion criterion was a
Results
In total, 112 women (64%) completed all three questionnaires (participants); percentages were distributed similarly in both groups (Table 2). All the women were of Finnish background, spoke Finnish, were middle or upper social class, and from the urban capital area of Helsinki. In logistic regression analysis, those who did not complete the questionnaires (nonparticipants) were characterized by older age (adjusted OR 0.93 [95% CI 0.87, 1.00], P = .045), fewer appointments (adjusted OR 2.03 [95%
Discussion
The question as to the right to choose a cesarean without a medical indication is of the utmost relevance: on the one hand, because of universally growing cesarean rates, and on the other, because of the fundamental medical principle of not to harm but to benefit the patient.18, 19 The main goal of this study was to evaluate the possibility of reducing requests for cesareans by helping women choose vaginal delivery without fear. We found this possible by personal cognitive therapy.
Conversely,
References (30)
- et al.
The association between prenatal stress and infant birth weight and gestation age at birthA prospective investigation
Am J Obstet Gynecol
(1993) - et al.
Depression and anxiety in early pregnancy and risk for preeclampsia
Obstet Gynecol
(2000) - et al.
Maternal mortality and mode of delivery
Lancet
(1999) How do adolescents see their future? A review of the development of future orientation and planning
Dev Rev
(1991)Choosing caesarean section
Lancet
(2000)- et al.
Psychosocial characteristics of couples fearing vaginal childbirth
Br J Obstet Gynaecol
(2001) - et al.
Posttraumatic stress disorder after childbirthA cross sectional study
J Anxiety Disord
(1997) - et al.
Factors associated with fear of delivery in second pregnancies
Obstet Gynecol
(1999) - et al.
Subsequent obstetric performance related to primary mode of delivery
Br J Obstet Gynaecol
(1999) - et al.
Psychosocial predictors of low birthweight
Br J Obstet Gynaecol
(1999)
Possible determinants, correlates and consequences of high levels of anxiety in primiparous mothers
Psychol Med
Fear of childbirth during pregnancy may increase the risk of emergency cesarean section
Acta Obstet Gynecol Scand
Individual coping style and psychological attitudes during pregnancy predict depression levels during pregnancy and during postpartum
Acta Psychiatr Scand
Postpartum depressionIdentification of women at risk
Br J Obstet Gynaecol
Psychosocial predictors of disappointment with delivery and puerperal depressionA longitudinal study
Acta Obstet Gynecol Scand
Cited by (0)
- ☆
This study was supported by the Signe and Ane Gyllenberg Foundation, the Emil Aaltonen Foundation, Helsinki University Central Hospital, and the Academy of Finland.