Hanna Rouhe

Fear of childbirth according to parity, gestational age, and obstetric history

Objective  To examine fear of childbirth according to parity, gestational age, and obstetric history.

Obstetric outcome after intervention for severe fear of childbirth in nulliparous women – randomised trial

Objective  To compare the numbers of vaginal deliveries and delivery satisfaction among women with fear of childbirth randomised to either psychoeducation or conventional surveillance during pregnancy.

Mental health problems common in women with fear of childbirth

Please cite this paper as: Rouhe H, Salmela‐Aro K, Gissler M, Halmesmäki E, Saisto T. Mental health problems common in women with fear of childbirth. BJOG 2011;118:1104–1111.

Promoting positive motherhood among nulliparous pregnant women with an intense fear of childbirth: RCT intervention

This RCT intervention among nulliparous pregnant women with an intense fear of childbirth sought to promote preparedness for childbirth and to enhance positive parenting. Pregnant women (n = 8,611) filled in a ‘fear of childbirth’ questionnaire. Nulliparous women with severe fear of childbirth (n = 355) were randomized into intervention (n = 131; 41 refused) and control (n = 224) groups. They rated themselves on a preparedness scale in middle and late pregnancy, and on a motherhood scale three months after childbirth. The intervention included six psycho-education group sessions during pregnancy and one after childbirth. This intervention increased the mothers’ preparedness for childbirth, which predicted an increase in positive motherhood.

Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience – a randomised controlled trial

Abstract Background: Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother–infant relationship. Methods: Three hundred and seventy-one nulliparous women out of 4575 scored ≥100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. Results: Postnatal maternal adjustment (MAMA mean score 38.1 ± 4.3 versus 35.7 ± 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 ± 29 versus 73.7 ± 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 ± 5.4 versus 8.0 ± 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. Conclusions: In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care.

Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance.

Fear of childbirth is a common reason for seeking cesarean section. It is important to consider outcomes and costs associated with alternative treatment and delivery mode. We compared well‐being and costs of group psychoeducation and conventional care for fear of childbirth.

Fear of childbirth according to parity, gestational age and obstetric history: Correspondence

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