Fear of childbirth: predictors and temporal changes among nulliparous women in the Danish National Birth Cohort

Abstract

Objectives: To describe the association between fear of childbirth and social, demographic and psychological factors in a cohort of 30 480 healthy nulliparous women with uncomplicated singleton pregnancies.

Design: Nationwide population-based study.

Setting: The Danish National Birth Cohort.

Population: Healthy nulliparous women (n= 30 480) with singleton pregnancies.

Methods: Data from computer-assisted telephone interviews twice in pregnancy linked with national health registers.

Main outcome measures: Characteristics of women with fear of childbirth in early (mean, 16 weeks) and late pregnancy (mean, 32 weeks) and changes in fear of childbirth between 1997 and 2003.

Results: Low educational level, lack of a social network, young age and unemployment were associated with fear of childbirth, as were being a smoker and having low self-rated health. The odds ratio for fear of childbirth among women with anxiety symptoms was 4.8 (4.1-5.7) after adjustment for socio-demographic, lifestyle, fertility and depression variables. During the study period, the prevalence of fear of childbirth was stable. Fear of childbirth was reported by 7.6% in early pregnancy and 7.4% in late pregnancy. Only 3.2% of the women expressed fear of childbirth in both interviews.

Conclusions: The prevalence of fear of childbirth among healthy nulliparous women with singleton pregnancies did not increase during the study period. Fear of childbirth among nulliparous women was most often seen in individuals with few social and psychological resources. Testing the women twice, we found the same prevalence of fear in early and late pregnancy, but found that half the women who expressed fear during early pregnancy had no fear later in pregnancy, an effect that was counterbalanced by a similar number of women who became fearful between the two interviews.