Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;48(2):230-241.
doi: 10.1111/birt.12532. Epub 2021 Mar 17.

Mental health problems and fear of childbirth: A cohort study of women in an inner-city maternity service

Selina Nath  1 , Lucy N Lewis  1 , Debra Bick  2 , Jill Demilew  3 , Louise M Howard  1
Affiliations

Mental health problems and fear of childbirth: A cohort study of women in an inner-city maternity service

Selina Nath et al. Birth. 2021 Jun.

Abstract

Objectives: To estimate the population prevalence of severe fear of childbirth (FOC) during pregnancy and investigate its association with: (a) antenatal common mental disorders (depression and anxiety disorder) and (b) elective cesarean birth.

Methods: 545 participants from an inner-city London maternity population were interviewed soon after their first antenatal appointment (mean gestation: 14 weeks). Current mental disorders were assessed using the Structured Clinical Interview DSM-IV. FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A) at approximately 28 weeks gestation (n = 377), with severe FOC defined using a cutoff of WDEQ-A ≥ 85. Birth mode information was collected at 3 months post-delivery using an adapted Adult Service Use Schedule. Linear regressions were used to model associations, adjusting for the effects of covariates (age, parity, relationship status, education, and planned pregnancy). Sampling weights were used to adjust for bias introduced by the stratified sampling. We also accounted for missing data within the analysis.

Results: The estimated population prevalence of severe FOC was 3% (95% CI: 2%-6%) (n = 377). Depression and anxiety were significantly associated with severe FOC after adjustment for covariates (45% vs 11%; coefficient: 15.75, 95% CI: 8.08-23.42, P < .001). There was a weak association between severe FOC and elective cesarean birth.

Conclusions: Severe FOC occurs in around 3% of the population. Depression and anxiety are associated with FOC. Pregnant people with depression and anxiety may be at increased risk of experiencing severe FOC. Attitudes toward childbirth should be assessed as part of routine clinical assessment of pregnant people in contact with mental health services.

Keywords: anxiety; depression; fear of childbirth; mental disorders; pregnancy.

PubMed Disclaimer

References

REFERENCES

    1. Wijma K. Why focus on ‘fear of childbirth'? J Psychosomatic Obstetr Gynecol. 2003;24(3):141-143.
    1. Nilsson C, Hessman E, Sjöblom H, et al. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Preg Childbirth. 2018;18(1):28.
    1. Wijma K, Wijma B. A woman afraid to deliver: how to manage childbirth anxiety. In: Paarlberg KM, van de Wiel HBM, (Eds.). Bio-Psycho-Social Obstetrics and Gynecology. Switzerland: Springer; 2017:3-31.
    1. Ayers S. Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care. Midwifery. 2014;30(2):145-148.
    1. Rondung E, Thomtén J, Sundin Ö. Psychological perspectives on fear of childbirth. J Anxiety Disord. 2016;44:80-91.

Publication types

LinkOut - more resources