The impact of previous birth experiences on maternal fear of childbirth

Objectives This study aimed to assess the relation between fear of childbirth and previous birth experiences. Design A prospective study of pregnant women. Setting Akershus University Hospital, Norway. Population Parous women (n=1357) scheduled to give birth at Akershus University Hospital in Norway during 20092011. Methods Data were collected using two self-completed questionnaires at pregnancy weeks 17 and 32. Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire. Previous overall birth experience was measured using a numeric rating scale, and previous obstetric complications were assessed using an index of seven obstetric complications: emergency cesarean section, instrumental vaginal delivery, extensive blood loss, retained placenta, serious maternal infection during labor, thrombosis, and anal sphincter tears. Main outcome measure Fear of childbirth. Results The odds ratio of fear of childbirth was 4.8 (95% confidence interval (CI) 2.88.3) for a previous negative overall birth experience, 1.9 (95% CI 1.23.1) for one obstetric complication and 2.6 (95% CI 1.25.5) for two or more complications. The estimates were adjusted for mental health, labor pain, time since last delivery, age, and education. Almost 80% of women who experienced obstetric complications neither considered the birth a negative overall experience nor developed a fear of childbirth. Conclusions The association between a previous subjectively negative birth experience and fear of childbirth was high and was greater than the association between previous obstetric complications and fear of childbirth.