Fear of childbirth and history of abuse: implications for pregnancy and delivery

BACKGROUND: The aim of this study was to assess the prevalence of fear of childbirth, and to find possible associations to selected sociodemographic factors and important life events. A secondary aim was to explore the relationship between these factors and pregnancy outcome. METHODS: Questionnaire booklets were sent to 2680 women at 18 weeks of gestation, of whom 1452 women (54%) responded. The questionnaire included background factors (marital status, education, history of abuse, current pregnancy), W-DEQ (measurement of fear of childbirth), and STAI (measurement of subjective anxiety). Pregnancy outcome information was recorded. RESULTS: The prevalence of serious fear of childbirth (W-DEQ > 100) was 5.5%. The W-DEQ and STAI scores were positively correlated (r = 0.44, p < 0.001). Among the anxious women, a trend towards more frequent operative vaginal delivery (12.1% versus 6.9%, p = 0.07) was noted, but not for emergency cesarean section (10.6% versus 7.6%, p = 0.34). Women who reported being exposed to physical or sexual abuse in childhood had a higher W-DEQ score (71, SD 31 and 69, SD 27) than did the non-abused (61, SD 23, p < 0.01). Only half of women sexually or physically abused in childhood (54% and 57% respectively) had uncomplicated vaginal delivery at term versus 75% among non-abused (p < 0.001). CONCLUSION: The prevalence of serious fear of childbirth was 5.5%. Fear of childbirth was not associated with mode of delivery, whereas sexual or physical abuse in childhood influenced negatively mode of delivery.