Antenatal fear of childbirth and emergency cesarean section delivery: a systematic narrative review

BACKGROUND: Fear of childbirth is a common feeling among expectant mothers. Although it represents a physiological expression of women's concerns, it can become a clinical condition compromising the woman's daily activities as well as her coping strategies during labour and delivery. Research has focused on adverse intrapartum and postpartum outcomes of fear of childbirth. As regards intrapartum outcomes, some studies have investigated the association between fear of childbirth and type of delivery, with contrasting results. OBJECTIVE: This study aimed at reviewing the literature on the association between fear of childbirth and emergency caesarean section delivery. METHOD: This systematic review was based on an electronic search of English-language published studies through 31 December 2018. Following the search process, 14 studies were included. Studies were analysed specifically considering the sample parity and tools for evaluating fears. RESULTS: These studies revealed that both sample characteristics and assessment instruments are not criteria for explaining the different result. CONCLUSIONS: The importance of distinguishing between fear and severe fear was highlighted because the effect of fear on the type of delivery was present only for clinical fear. However, the different cut-off values did not make it possible to reach a clear result, making further investigation necessary. ABBREVIATIONS: FOC - Fear of Childbirth; ECS - Emergency Cesarean Section.