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The effects of counseling on fear of childbirth
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
2015 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, no 6, 629-636 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE:

To investigate women's experiences of attending existing counseling programs for childbirth-related fear and the effect of this counseling over time.

DESIGN:

A longitudinal survey.

SETTING:

Three hospitals in the central north of Sweden.

SAMPLE:

A selected sample of 936 women. Of these, 70 received counseling due to fear of childbirth (study-group).

METHODS:

Data were collected with questionnaires 2 months and 1 year after giving birth with background data collected during midpregnancy. Comparisons were made between women with or without counseling. Crude and adjusted odds ratios (OR) were calculated.

MAIN OUTCOME MEASURES:

Self-reported childbirth fear, experience of counseling, birth experience and preferred mode of birth.

RESULTS:

Women in the counseling group reported higher childbirth fear 1 year after giving birth (OR 5.0, 95% confidence interval (95% CI) 2.6-9.3), they had a more negative birth experience that did not change over time (OR 2.1, 95% CI 1.2-3.9) and they preferred cesarean section to a greater extent (OR 12.0, 95% CI 5.1-28.1) in the case of another birth. Also, they were more often delivered by planned cesarean section (OR 4.7, 95% CI 2.4-9.1). However, 80% were satisfied with the given support.

CONCLUSION:

Although women were satisfied with the treatment, this study shows that counseling had a minor effect on fear of childbirth, birth experiences or cesarean section rates. To help women with their fear of childbirth, more effective methods of treatment are needed.

Place, publisher, year, edition, pages
2015. Vol. 94, no 6, 629-636 p.
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-254711DOI: 10.1111/aogs.12634ISI: 000354398300012PubMedID: 25772528OAI: oai:DiVA.org:uu-254711DiVA: diva2:819340
Available from: 2015-06-10 Created: 2015-06-10 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Treatment for childbirth fear with a focus on midwife-led counselling: A national overview, women’s birth preferences and experiences of counselling
Open this publication in new window or tab >>Treatment for childbirth fear with a focus on midwife-led counselling: A national overview, women’s birth preferences and experiences of counselling
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Many women experience childbirth fear to such an extent that it seriously interferes with the woman’s daily life and affects her mental well-being.

Aim: The overall aim was to conduct an overview of the midwife-led counselling for childbirth fear in Sweden, to investigate women’s birth preferences and to describe their experiences of treatment on childbirth fear, with focus on midwife-led counselling.

Methods: Study I is a cross-sectional study where 43 out of 45 maternity clinics responded to a questionnaire regarding midwife-led counselling. Study II is a longitudinal survey where 889 women participated of whom 70 received counselling. Data were collected by questionnaires in mid-pregnancy, two months and finally, one year after birth. Study III is a randomised controlled study with 258 participating women assessed with childbirth fear. It compares Internet-based cognitive behaviour therapy (ICBT) with midwife-led counselling. Data were collected by questionnaires twice during pregnancy and two months after birth. Study IV is a qualitative interview study using thematic analysis, including 27 women who received midwife-led counselling during pregnancy.

Results: Overall, midwife-led counselling was perceived as empowering by the women and increased their confidence when facing birth. The preference for a caesarean section decreased during pregnancy and the majority had a normal vaginal birth but an increase in preference for caesarean section appeared after birth. Half of the women who received treatment for childbirth fear experienced a less than positive birth. Women who had a positive birth experience voiced that the contributing factors were the self-confidence received from counselling and the support from the midwife during birth. Decreased or manageable fear was expressed by the women after counselling and birth, which in turn brought a strengthened confidence for a future pregnancy and birth. Furthermore, major differences exist in counselling for childbirth fear throughout the clinics in Sweden.

Conclusion: Midwife-led counselling improved women’s confidence toward giving birth and fear was perceived as manageable. Continuous support is crucial to experience birth as positive. Although women’s preferences for caesarean section did not change over time, few women gave birth with a caesarean section without medial reason.  

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. 77 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1341
Keyword
Birth experience, caesarean section, childbirth fear, internet-based cognitive behaviour therapy, midwife-led counselling, treatment
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-326007 (URN)978-91-513-0003-0 (ISBN)
Public defence
2017-09-08, Sal IV, Universitetshuset, Biskopsgatan 3, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2017-08-17 Created: 2017-06-29 Last updated: 2017-09-08

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Larsson, BirgittaRubertsson, ChristineHildingsson, Ingegerd

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