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Women with fear of childbirth endure longer labor

June 27, 2012 - Washington

Women who have a fear of childbirth spend 47 minutes longer in labor than their peers who have no such fear, a new research has revealed.

Various factors have been associated with increased prevalence of fear of childbirth, including young maternal age, being a first-time mother, pre-existing psychological problems, lack of social support and a history of abuse or adverse obstetric events.

The Norwegian study, that looked at 2206 women with a singleton pregnancy who wanted normal delivery, is one of the first to look at the relationship between fear of childbirth and labor duration.

Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ), a validated psychometric instrument designed to measure fear of childbirth.

Women undertook the questionnaire at 32 weeks gestation and fear of childbirth was defined as a score of more than 85. Out of the total number, 165 (7.5 percent) women scored more than 85.

The average age of the participants at delivery was 30.9 years and 50.5 percent (1113 women) were first time mothers.

Average labour duration was 8.22 hours for first-time mothers, and it was 4.91 hours for parous women.

After adjustment for other factors associated with labour duration, such as parity, epidural analgesia, instrumental vaginal delivery and labour induction, the difference was still significant at 47 minutes.

The researchers found that average labour duration was 8 hours for women with fear of childbirth compared to 6.46 hours (which equals 6 hours and 28 minutes) for women without such fear.

The study also found that women with fear of childbirth more often delivered by instrumental vaginal delivery (17.0 percent versus 10.6 percent) or emergency caesarean delivery (10.9 percent versus 6.8 percent) as compared to women without fear of childbirth.

In total, 25.5 percent (42 women) of women with fear of childbirth and 44.4 percent (906 women) of women without fear of childbirth had a normal delivery without any obstetric interventions.

However, despite increased labour duration for women with a fear of childbirth, a large proportion of women achieved a vaginal delivery, which was their intention compared to women with no fear (89.1 percent versus 93.2 percent).

"Fear of childbirth seems to be an increasingly important issue in obstetric care. Our finding of longer duration of labour in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics," Samantha Salvesen Adams, Health Services Research Centre, Akershus University Hospital, University of Oslo, Norway and co-author of the research said.

"We found a link between fear of childbirth and longer duration of labour. Generally, longer labour duration increases the risk of instrumental vaginal delivery and emergency caesarean section. However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery and therefore elective caesarean delivery should not be routinely recommended," she added.

The research was published in BJOG: An International Journal of Obstetrics and Gynaecology.


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