Personality disorder, psychiatric of childbirth among childbearing symptoms and experience women in Sweden

Objective: to investigate the importance of having a personality disorder or psychiatric symptoms during pregnancy for women's experience of childbirth. Design: a prospective study of women consecutively recruited during mid-pregnancy. On study entry, the women completed setf-rating scales for personality disorders, global functioning level and psychiatric symptoms. Two weeks after the birth, the women completed a questionnaire about their childbirth experiences. Obstetric and neonatal data were collected from maternity ward records. Multivariate logistic regression was used to estimate the likelihood for negative birth experiences. Setting: antenatal clinics in Stockholm, Sweden. Participants: 625 primiparous women. Findings: 40 out of 624 (6.4%) women fulfilled the criteria for personality disorder, and 28 out of 625 (4.5%) women were defined as psychiatric cases. No significant differences were found between women with personality disorders, or defined as psychiatric cases, and women without any mental problems regarding their global experience of birth. Women defined as psychiatric cases were more anxious (z = -2.5, p = 0.04) during Labour than women without mental problems. The strongest predictors of having had a negative global experience of birth were instrumental vaginal delivery (OR 3.2, 95% Cl 2.1-5.1) and epidural analgesia (OR 2.4, 95% Cl 1.5-3.9). Key conclusions and implications for practice: obstetric factors, such as instrumental delivery, seem to be more important than mental problems during pregnancy for women's global experience of birth. Women with psychiatric symptoms during pregnancy need extra support during tabour. (C) 2006 Elsevier Ltd. ALL rights reserved.