Pre- and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women

Aim. To investigate pre- and postpartum levels of childbirth fear in a cohort of childbearing women and explore the relationshipto birth outcomes.Background. While results are mixed, there is evidence that fear of childbirth is associated with mode of birth. Limitedtheoretical work around childbirth fear has been undertaken with Australian women.Design. A prospective correlation design.Method. Women (n = 401) completed the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) version A at 36weeks gestation, with 243 (61%) women also completing version B at six weeks postpartum. Scores were summarised withmeans and standard deviations. Content analysis of the free statements identified nine issues of concern.Results. Twenty-six per cent of pregnant women reported low levels of childbirth fear, 48% were moderately fearful and 26%were highly fearful. Fear decreased after birth for those women in the high antenatal fear group, however surgical interventionat birth (n = 238, ANOVA, F1,230 = 12Æ39, p = 0Æ001) and suspected fetal compromise (F1,230 = 4Æ33, p = 0Æ039) increased levelsof postpartum fear. Univariately, high antenatal fear was associated with emergency caesarean delivery (n = 324, Wald 5Æ05,p = 0Æ025) however after adjustment for nulliparity and fetal compromise the association disappeared. Australian-born womenwere more likely to report higher levels of fear and experience higher rates of caesarean section than participants of non-Australian origin.Conclusions. Results support those from earlier studies in showing that nulliparous women experience more fear than parouswomen before birth and that there is no difference in levels of postpartum fear between these two groups. Fear levels werehigher in Australian women when compared to a Swedish sample.Relevance to clinical practice. The results of this study add to our preliminary understanding of the phenomena of childbirthfear within an Australian context and are particularly useful in profiling women for whom secondary fear of childbirth is morelikely to occur.