Advertisement

Fear and Anxiety Disorders Related to Childbirth: Epidemiological and Therapeutic Issues

  • Alexandra BadaouiEmail author
  • Sandra Abou Kassm
  • Wadih Naja
Anxiety Disorders (A Pelissolo, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Anxiety Disorders

Abstract

Purpose of Review

This paper seeks to identify the risk factors of fear of childbirth (FOC) and posttraumatic stress disorder (PTSD) related to birth and reviews the efficacy of their respective screening tools and therapeutic interventions.

Recent Findings

Biofeedback, hypnosis, internet-based cognitive behavioral therapy, and antenatal education are promising treatments for FOC. Training midwives to address traumatic birth experiences could help in preventing PTSD. A shorter more pragmatic screening tool for FOC than the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ) is needed. Women with PTSD attributed a mismatch between the expected mode of delivery (MOD) and the actual MOD as the cause of their trauma.

Summary

A history of mental health disorders, lack of social support, previous negative birth experiences, and MOD are correlated to FOC and postpartum PTSD. Psycho-education and CBT-based treatments have been found to reduce levels of FOC and PTSD.

Keywords

Fear of childbirth Postpartum PTSD Tokophobia Pregnancy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    O’Connell MA, Leahy-Warren P, Khashan AS, Kenny LC, O’Neill SM. Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2017;96(8):907–20.PubMedGoogle Scholar
  2. 2.
    Hofberg K, Brockington I. Tokophobia: an unreasoning dread of childbirth. A series of 26 cases. Br J Psychiatry J Ment Sci. 2000;176:83–5.Google Scholar
  3. 3.
    Sheen K, Slade P. Examining the content and moderators of women’s fears for giving birth: a meta-synthesis. J Clin Nurs. 2018;27(13–14):2523–35.PubMedGoogle Scholar
  4. 4.
    Demšar K, Svetina M, Verdenik I, Tul N, Blickstein I, Globevnik Velikonja V. Tokophobia (fear of childbirth): prevalence and risk factors. J Perinat Med. 2018;46(2):151–4.PubMedGoogle Scholar
  5. 5.
    Shahhosseini Z, Pourasghar M, Khalilian A, Salehi F. A review of the effects of anxiety during pregnancy on children’s health. Mater Sociomed. 2015;27(3):200–2.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Pazzagli C, Laghezza L, Capurso M, Sommella C, Lelli F, Mazzeschi C. Antecedents and consequences of fear of childbirth in nulliparous and parous women. Infant Ment Health J. 2015;36(1):62–74.PubMedGoogle Scholar
  7. 7.
    O’Donovan C, O’Donovan J. Why do women request an elective cesarean delivery for non-medical reasons? A systematic review of the qualitative literature. Birth. 2018;45(2):109–19.PubMedGoogle Scholar
  8. 8.
    Jha P, Larsson M, Christensson K, Svanberg AS. Fear of childbirth and depressive symptoms among postnatal women: a cross-sectional survey from Chhattisgarh, India. Women Birth. 2018;31(2):e122–33.PubMedGoogle Scholar
  9. 9.
    Rondung E, Ekdahl J, Hildingsson I, Rubertsson C, Sundin Ö. Heterogeneity in childbirth related fear or anxiety. Scand J Psychol. 2018;59(6):634–43.PubMedGoogle Scholar
  10. 10.
    Sitras V, Šaltytė Benth J, Eberhard-Gran M. Obstetric and psychological characteristics of women choosing epidural analgesia during labour: a cohort study. PLoS One. 2017;12(10):e0186564.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Fear of childbirth predicts postpartum depression: a population-based analysis of 511 422 singleton births in Finland. BMJ Open. 2013;3(11):e004047.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Poggi L, Goutaudier N, Séjourné N, Chabrol H. When fear of childbirth is pathological: the fear continuum. Matern Child Health J. 2018;22(5):772–8.PubMedGoogle Scholar
  13. 13.
    Molgora S, Fenaroli V, Prino LE, Rollè L, Sechi C, Trovato A, et al. Fear of childbirth in primiparous Italian pregnant women: the role of anxiety, depression, and couple adjustment. Women Birth. 2018;31(2):117–23.PubMedGoogle Scholar
  14. 14.
    Nieminen K, Wijma K, Johansson S, Kinberger EK, Ryding E-L, Andersson G, et al. Severe fear of childbirth indicates high perinatal costs for Swedish women giving birth to their first child. Acta Obstet Gynecol Scand. 2017;96(4):438–46.PubMedGoogle Scholar
  15. 15.
    Dikmen-Yildiz P, Ayers S, Phillips L. Factors associated with post-traumatic stress symptoms (PTSS) 4–6 weeks and 6 months after birth: a longitudinal population-based study. J Affect Disord. 2017;221:238–45.PubMedGoogle Scholar
  16. 16.
    Çapik A, Durmaz H. Fear of childbirth, postpartum depression, and birth-related variables as predictors of posttraumatic stress disorder after childbirth. Worldviews Evid-Based Nurs. 2018;15:455–63.PubMedGoogle Scholar
  17. 17.
    Dencker A, Nilsson C, Begley C, Jangsten E, Mollberg M, Patel H, et al. Causes and outcomes in studies of fear of childbirth: a systematic review. Women Birth. 2018.  https://doi.org/10.1016/j.wombi.2018.07.004.
  18. 18.
    •• Richens Y, Smith DM, Lavender DT. Fear of birth in clinical practice: a structured review of current measurement tools. Sex Reprod Healthc. 2018;16:98–112 Recent structured literature review assessing the efficacy of screening tools for FOC. PubMedGoogle Scholar
  19. 19.
    Nilsson C, Hessman E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, et al. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy Childbirth. 2018;18(1):28.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol. 1998;19(2):84–97.PubMedGoogle Scholar
  21. 21.
    Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Saisto T. Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance. Acta Obstet Gynecol Scand. 2015;94(5):527–33.PubMedGoogle Scholar
  22. 22.
    Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Ryding E-L, et al. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience—a randomised controlled trial. J Psychosom Obstet Gynaecol. 2015;36(1):1–9.PubMedGoogle Scholar
  23. 23.
    • Toohill J, Creedy DK, Gamble J, Fenwick J. A cross-sectional study to determine utility of childbirth fear screening in maternity practice—an Australian perspective. Women Birth. 2015;28(4):310–6 This study suggests that a WDEQ-A cut off score of 66 should be used when screening for FOC to not miss women in need of further assessment. PubMedGoogle Scholar
  24. 24.
    Rouhe H, Salmela-Aro K, Halmesmäki E, Saisto T. Fear of childbirth according to parity, gestational age, and obstetric history. BJOG Int J Obstet Gynaecol. 2009;116(1):67–73.Google Scholar
  25. 25.
    Haines H, Pallant JF, Karlström A, Hildingsson I. Cross-cultural comparison of levels of childbirth-related fear in an Australian and Swedish sample. Midwifery. 2011;27(4):560–7.PubMedGoogle Scholar
  26. 26.
    • Haines HM, Pallant JF, Fenwick J, Gamble J, Creedy DK, Toohill J, et al. Identifying women who are afraid of giving birth: a comparison of the fear of birth scale with the WDEQ-A in a large Australian cohort. Sex Reprod Healthc. 2015;6(4):204–10 This study highlights the promise of the two item FOBS as a shorter more clinically pragmatic tool than the WDEQ-A for initial FOC screening. PubMedGoogle Scholar
  27. 27.
    • Hollander MH, van Hastenberg E, van Dillen J, van Pampus MG, de Miranda E, Stramrood CAI. Preventing traumatic childbirth experiences: 2192 women’s perceptions and views. Arch Womens Ment Health. 2017;20(4):515–23 This retrospective survey study assessed the different attributions women gave to their traumatic births and found that hypnobirthing classes lead to a mismatch between expectations and reality resulting in the attribution of their trauma to this discrepancy. PubMedPubMedCentralGoogle Scholar
  28. 28.
    Areskog B, Kjessler B, Uddenberg N. Identification of women with significant fear of childbirth during late pregnancy. Gynecol Obstet Investig. 1982;13(2):98–107.Google Scholar
  29. 29.
    Ayers S, Wright DB, Thornton A. Development of a measure of postpartum PTSD: the city birth trauma scale. Front Psych. 2018;9:409.Google Scholar
  30. 30.
    Devilly GJ, Gullo MJ, Alcorn KL, O’Donovan A. Subjective appraisal of threat (criterion A2) as a predictor of distress in childbearing women. J Nerv Ment Dis. 2014;202(12):877–82.PubMedGoogle Scholar
  31. 31.
    Boorman RJ, Devilly GJ, Gamble J, Creedy DK, Fenwick J. Childbirth and criteria for traumatic events. Midwifery. 2014;30(2):255–61.PubMedGoogle Scholar
  32. 32.
    •• Geller PA, Stasko EC. Effect of previous posttraumatic stress in the perinatal period. J Obstet Gynecol Neonatal Nurs. 2017;46(6):912–22 This recent literature review shows that most studies on postpartum PTSD do not control for previous PTSD unrelated to birth. PubMedGoogle Scholar
  33. 33.
    Lukasse M, Schei B, Ryding EL, Bidens Study Group. Prevalence and associated factors of fear of childbirth in six European countries. Sex Reprod Healthc. 2014;5(3):99–106.PubMedGoogle Scholar
  34. 34.
    Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997-2010. BJOG Int J Obstet Gynaecol. 2014;121(8):965–70.Google Scholar
  35. 35.
    • Fairbrother N, Thordarson DS, Stoll K. Fine tuning fear of childbirth: the relationship between Childbirth Fear Questionnaire subscales and demographic and reproductive variables. J Reprod Infant Psychol. 2018;36(1):15–29 This recent study assesses the validity of the multidimensional Childbirth Fear Questionnaire that aims to be used for clinical diagnosis and to measure symptom severity. Important finding is those with previous negative birth experience are at high risk of developing FOC. PubMedGoogle Scholar
  36. 36.
    Salomonsson B, Gullberg MT, Alehagen S, Wijma K. Self-efficacy beliefs and fear of childbirth in nulliparous women. J Psychosom Obstet Gynaecol. 2013;34(3):116–21.PubMedGoogle Scholar
  37. 37.
    Gao L-L, Liu XJ, Fu BL, Xie W. Predictors of childbirth fear among pregnant Chinese women: a cross-sectional questionnaire survey. Midwifery. 2015;31(9):865–70.PubMedGoogle Scholar
  38. 38.
    Khwepeya M, Lee GT, Chen S-R, Kuo S-Y. Childbirth fear and related factors among pregnant and postpartum women in Malawi. BMC Pregnancy Childbirth. 2018;18(1):391.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Størksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth. 2015;15:221.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Toohill J, Callander E, Fox H, Lindsay D, Gamble J, Creedy D, et al. Socioeconomic differences in access to care in Australia for women fearful of birth. Aust Health Rev. 2018.  https://doi.org/10.1071/AH17271.
  41. 41.
    Toohill J, Fenwick J, Gamble J, Creedy DK. Prevalence of childbirth fear in an Australian sample of pregnant women. BMC Pregnancy Childbirth. 2014;14:275.PubMedPubMedCentralGoogle Scholar
  42. 42.
    Okumus F, Sahin N. Fear of childbirth in urban and rural regions of Turkey: comparison of two resident populations. North Clin Istanb. 2017;4(3):247–56.PubMedPubMedCentralGoogle Scholar
  43. 43.
    Ternström E, Hildingsson I, Haines H, Rubertsson C. Higher prevalence of childbirth related fear in foreign born pregnant women—findings from a community sample in Sweden. Midwifery. 2015;31(4):445–50.PubMedGoogle Scholar
  44. 44.
    Hildingsson I, Haines H, Karlström A, Nystedt A. Presence and process of fear of birth during pregnancy—findings from a longitudinal cohort study. Women Birth. 2017;30(5):e242–7.PubMedGoogle Scholar
  45. 45.
    Handelzalts JE, Becker G, Ahren M-P, Lurie S, Raz N, Tamir Z, et al. Personality, fear of childbirth and birth outcomes in nulliparous women. Arch Gynecol Obstet. 2015;291(5):1055–62.PubMedGoogle Scholar
  46. 46.
    Jokić-Begić N, Zigić L, Nakić Radoš S. Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women. J Psychosom Obstet Gynaecol. 2014;35(1):22–8.PubMedGoogle Scholar
  47. 47.
    Elvander C, Cnattingius S, Kjerulff KH. Birth experience in women with low, intermediate or high levels of fear: findings from the first baby study. Birth. 2013;40(4):289–96.PubMedGoogle Scholar
  48. 48.
    Sioma-Markowska U, Żur A, Skrzypulec-Plinta V, Machura M, Czajkowska M. Causes and frequency of tocophobia—own experiences. Ginekol Pol. 2017;88(5):239–43.PubMedGoogle Scholar
  49. 49.
    Anderson CA, Gill M. Childbirth related fears and psychological birth trauma in younger and older age adolescents. Appl Nurs Res. 2014;27(4):242–8.PubMedGoogle Scholar
  50. 50.
    Soltani F, Eskandari Z, Khodakarami B, Parsa P, Roshanaei G. Factors contributing to fear of childbirth among pregnant women in Hamadan (Iran) in 2016. Electron Physician. 2017;9(7):4725–31.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Aksoy M, Aksoy AN, Dostbil A, Celik MG, Ince I. The relationship between fear of childbirth and women’s knowledge about painless childbirth. Obstet Gynecol Int. 2014;2014:274303.PubMedPubMedCentralGoogle Scholar
  52. 52.
    Ryding EL, Lukasse M, Parys A-SV, Wangel A-M, Karro H, Kristjansdottir H, et al. Fear of childbirth and risk of cesarean delivery: a cohort study in six European countries. Birth. 2015;42(1):48–55.PubMedGoogle Scholar
  53. 53.
    Jespersen C, Hegaard HK, Schroll A-M, Rosthøj S, Kjærgaard H. Fear of childbirth and emergency caesarean section in low-risk nulliparous women: a prospective cohort study. J Psychosom Obstet Gynaecol. 2014;35(4):109–15.PubMedGoogle Scholar
  54. 54.
    •• Dikmen-Yildiz P, Ayers S, Phillips L. Longitudinal trajectories of post-traumatic stress disorder (PTSD) after birth and associated risk factors. J Affect Disord. 2018;229:377–85 This recent study is the first to identify four trajectories of post partum PTSD and the associated risk factors of each. PubMedGoogle Scholar
  55. 55.
    Jaju S, Al Kharusi L, Gowri V. Antenatal prevalence of fear associated with childbirth and depressed mood in primigravid women. Indian J Psychiatry. 2015;57(2):158–61.PubMedPubMedCentralGoogle Scholar
  56. 56.
    Rubertsson C, Hellström J, Cross M, Sydsjö G. Anxiety in early pregnancy: prevalence and contributing factors. Arch Womens Ment Health. 2014;17(3):221–8.PubMedGoogle Scholar
  57. 57.
    Martini J, Asselmann E, Einsle F, Strehle J, Wittchen H-U. A prospective-longitudinal study on the association of anxiety disorders prior to pregnancy and pregnancy- and child-related fears. J Anxiety Disord. 2016;40:58–66.PubMedGoogle Scholar
  58. 58.
    Shlomi Polachek I, Huller Harari L, Baum M, Strous RD. Postpartum anxiety in a cohort of women from the general population: risk factors and association with depression during last week of pregnancy, postpartum depression and postpartum PTSD. Isr J Psychiatry Relat Sci. 2014;51(2):128–34.PubMedGoogle Scholar
  59. 59.
    Turner K, Piazzini A, Franza A, Canger R, Canevini MP, Marconi AM. Do women with epilepsy have more fear of childbirth during pregnancy compared with women without epilepsy? A case-control study. Birth. 2008;35(2):147–52.PubMedGoogle Scholar
  60. 60.
    Henningsgaard JM, Arnau RC. Relationships between religiosity, spirituality, and personality: a multivariate analysis. Personal Individ Differ. 2008;45(8):703–8.Google Scholar
  61. 61.
    Abdollahpour S, Khosravi A. Relationship between spiritual intelligence with happiness and fear of childbirth in Iranian pregnant women. Iran J Nurs Midwifery Res. 2018;23(1):45–50.PubMedPubMedCentralGoogle Scholar
  62. 62.
    van Heumen MA, Hollander MH, van Pampus MG, van Dillen J, Stramrood CAI. Psychosocial predictors of postpartum posttraumatic stress disorder in women with a traumatic childbirth experience. Front Psych. 2018;9:348.Google Scholar
  63. 63.
    Srkalović Imširagić A, Begić D, Šimičević L, Bajić Ž. Prediction of posttraumatic stress disorder symptomatology after childbirth—a Croatian longitudinal study. Women Birth. 2017;30(1):e17–23.PubMedGoogle Scholar
  64. 64.
    Haagen JFG, Moerbeek M, Olde E, van der Hart O, Kleber RJ. PTSD after childbirth: a predictive ethological model for symptom development. J Affect Disord. 2015;185:135–43.PubMedGoogle Scholar
  65. 65.
    •• Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychol Med. 2016;46(6):1121–34 This meta-analysis examines the risk factors of birth-related PTSD before birth, during birth, and after birth, which contributes to the diathesis stress model of postpartum PTSD and can inform clinicians for screening, prevention, and intervention. PubMedGoogle Scholar
  66. 66.
    Garthus-Niegel S, von Soest T, Knoph C, Simonsen TB, Torgersen L, Eberhard-Gran M. The influence of women’s preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study. BMC Pregnancy Childbirth. 2014;14:191.PubMedPubMedCentralGoogle Scholar
  67. 67.
    •• Olieman RM, Siemonsma F, Bartens MA, Garthus-Niegel S, Scheele F, Honig A. The effect of an elective cesarean section on maternal request on peripartum anxiety and depression in women with childbirth fear: a systematic review. BMC Pregnancy Childbirth. 2017;17(1):195 Recent systematic review proposing that a mismatch between preferred MOD and actual MOD is one of the causes of birth-related PTSD. PubMedPubMedCentralGoogle Scholar
  68. 68.
    Ghorbani M, Dolatian M, Shams J, Alavi-Majd H. Anxiety, post-traumatic stress disorder and social supports among parents of premature and full-term infants. Iran Red Crescent Med J. 2014;16(3):e13461.PubMedPubMedCentralGoogle Scholar
  69. 69.
    Misund AR, Nerdrum P, Diseth TH. Mental health in women experiencing preterm birth. BMC Pregnancy Childbirth. 2014;14:263.PubMedPubMedCentralGoogle Scholar
  70. 70.
    Goutaudier N, Bertoli C, Séjourné N, Chabrol H. Childbirth as a forthcoming traumatic event: pretraumatic stress disorder during pregnancy and its psychological correlates. J Reprod Infant Psychol. 2018;10:1–12.Google Scholar
  71. 71.
    Agius A, Xuereb RB, Carrick-Sen D, Sultana R, Rankin J. The co-existence of depression, anxiety and post-traumatic stress symptoms in the perinatal period: a systematic review. Midwifery. 2016;36:70–9.PubMedGoogle Scholar
  72. 72.
    Dikmen-Yildiz P, Ayers S, Phillips L. Depression, anxiety, PTSD and comorbidity in perinatal women in Turkey: a longitudinal population-based study. Midwifery. 2017;55:29–37.PubMedGoogle Scholar
  73. 73.
    O’Donovan A, Alcorn KL, Patrick JC, Creedy DK, Dawe S, Devilly GJ. Predicting posttraumatic stress disorder after childbirth. Midwifery. 2014;30(8):935–41.PubMedGoogle Scholar
  74. 74.
    de Oliveira AGES, Reichenheim ME, Moraes CL, Howard LM, Lobato G. Childhood sexual abuse, intimate partner violence during pregnancy, and posttraumatic stress symptoms following childbirth: a path analysis. Arch Womens Ment Health. 2017;20(2):297–309.PubMedGoogle Scholar
  75. 75.
    Shlomi Polachek I, Dulitzky M, Margolis-Dorfman L, Simchen MJ. A simple model for prediction postpartum PTSD in high-risk pregnancies. Arch Womens Ment Health. 2016;19(3):483–90.PubMedGoogle Scholar
  76. 76.
    Striebich S, Mattern E, Ayerle GM. Support for pregnant women identified with fear of childbirth (FOC)/tokophobia - a systematic review of approaches and interventions. Midwifery. 2018;61:97–115.PubMedGoogle Scholar
  77. 77.
    • Rondung E, Ternström E, Hildingsson I, Haines HM, Sundin Ö, Ekdahl J, et al. Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: randomized controlled trial. JMIR Ment Health. 2018;5(3):e10420 This recent RCT found that adherence rates for ICBT were very low; however, those who completed the intervention had lower FOC at 1 year post partum. PubMedPubMedCentralGoogle Scholar
  78. 78.
    Larsson B, Karlström A, Rubertsson C, Ternström E, Ekdahl J, Segebladh B, et al. Birth preference in women undergoing treatment for childbirth fear: a randomised controlled trial. Women Birth. 2017;30(6):460–7.PubMedGoogle Scholar
  79. 79.
    Uçar T, Golbasi Z. Effect of an educational program based on cognitive behavioral techniques on fear of childbirth and the birth process. J Psychosom Obstet Gynaecol. 2018;27:1–10.Google Scholar
  80. 80.
    Stoll K, Swift EM, Fairbrother N, Nethery E, Janssen P. A systematic review of nonpharmacological prenatal interventions for pregnancy-specific anxiety and fear of childbirth. Birth. 2018;45(1):7–18.PubMedGoogle Scholar
  81. 81.
    Sydsjö G, Bladh M, Lilliecreutz C, Persson A-M, Vyöni H, Josefsson A. Obstetric outcomes for nulliparous women who received routine individualized treatment for severe fear of childbirth—a retrospective case control study. BMC Pregnancy Childbirth. 2014;14:126.PubMedPubMedCentralGoogle Scholar
  82. 82.
    Toohill J, Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E, et al. A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women. Birth. 2014;41(4):384–94.PubMedGoogle Scholar
  83. 83.
    Andaroon N, Kordi M, Kimiaei SA, Esmaeily H. The effect of individual counseling program by a midwife on fear of childbirth in primiparous women. J Educ Health Promot. 2017;6:97.PubMedPubMedCentralGoogle Scholar
  84. 84.
    Gamble J, Creedy DK. A counselling model for postpartum women after distressing birth experiences. Midwifery. 2009;25(2):e21–30.PubMedGoogle Scholar
  85. 85.
    Larsson B, Karlström A, Rubertsson C, Hildingsson I. The effects of counseling on fear of childbirth. Acta Obstet Gynecol Scand. 2015;94(6):629–36.PubMedGoogle Scholar
  86. 86.
    Airo Toivanen R, Korja R, Saisto T, Rouhe H, Muotka J, Salmela-Aro K. Changes in emotions and personal goals in primiparous pregnant women during group intervention for fear of childbirth. J Reprod Infant Psychol. 2018;36(4):363–80.PubMedGoogle Scholar
  87. 87.
    Fenwick J, Toohill J, Gamble J, Creedy DK, Buist A, Turkstra E, et al. Effects of a midwife psycho-education intervention to reduce childbirth fear on women’s birth outcomes and postpartum psychological wellbeing. BMC Pregnancy Childbirth. 2015;15:284.PubMedPubMedCentralGoogle Scholar
  88. 88.
    Toohill J, Callander E, Gamble J, Creedy DK, Fenwick J. A cost effectiveness analysis of midwife psycho-education for fearful pregnant women—a health system perspective for the antenatal period. BMC Pregnancy Childbirth. 2017;17(1):217.PubMedPubMedCentralGoogle Scholar
  89. 89.
    Turkstra E, Mihala G, Scuffham PA, Creedy DK, Gamble J, Toohill J, et al. An economic evaluation alongside a randomised controlled trial on psycho-education counselling intervention offered by midwives to address women’s fear of childbirth in Australia. Sex Reprod Healthc. 2017;11:1–6.PubMedGoogle Scholar
  90. 90.
    Haapio S, Kaunonen M, Arffman M, Åstedt-Kurki P. Effects of extended childbirth education by midwives on the childbirth fear of first-time mothers: an RCT. Scand J Caring Sci. 2017;31(2):293–301.PubMedGoogle Scholar
  91. 91.
    Kızılırmak A, Başer M. The effect of education given to primigravida women on fear of childbirth. Appl Nurs Res. 2016;29:19–24.PubMedGoogle Scholar
  92. 92.
    Serçekuş P, Başkale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery. 2016;34:166–72.PubMedGoogle Scholar
  93. 93.
    Gökçe İsbir G, İnci F, Önal H, Yıldız PD. The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study. Appl Nurs Res. 2016;32:227–32.PubMedGoogle Scholar
  94. 94.
    Karabulut Ö, Coşkuner Potur D, Doğan Merih Y, Cebeci Mutlu S, Demirci N. Does antenatal education reduce fear of childbirth? Int Nurs Rev. 2016;63(1):60–7.PubMedGoogle Scholar
  95. 95.
    Navaee M, Abedian Z. Effect of role play education on primiparous women’s fear of natural delivery and their decision on the mode of delivery. Iran J Nurs Midwifery Res. 2015;20(1):40–6.PubMedPubMedCentralGoogle Scholar
  96. 96.
    Stoll K, Fairbrother N, Thordarson DS. Childbirth fear: relation to birth and care provider preferences. J Midwifery Womens Health. 2018;63(1):58–67.PubMedGoogle Scholar
  97. 97.
    • Moghaddam Hosseini V, Nazarzadeh M, Jahanfar S. Interventions for reducing fear of childbirth: a systematic review and meta-analysis of clinical trials. Women Birth. 2018;31(4):254–62 This systematic review found that both education sessions and self-hypnosis were efficacious in reducing FOC, though education sessions were twice as effective. PubMedGoogle Scholar
  98. 98.
    • Narita Y, Shinohara H, Kodama H. Resting heart rate variability and the effects of biofeedback intervention in women with low-risk pregnancy and prenatal childbirth fear. Appl Psychophysiol Biofeedback. 2018;43(2):113–21 This study showed promise for biofeedback on heart rate variability as a therapeutic intervention for FOC. PubMedGoogle Scholar
  99. 99.
    Klabbers GA, Wijma K, Paarlberg KM, Emons WHM, Vingerhoets AJJM. Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial. J Psychosom Obstet Gynaecol. 2017;20:1–10.Google Scholar
  100. 100.
    Guszkowska M. The effect of exercise and childbirth classes on fear of childbirth and locus of labor pain control. Anxiety Stress Coping. 2014;27(2):176–89.PubMedGoogle Scholar
  101. 101.
    Newham JJ, Wittkowski A, Hurley J, Aplin JD, Westwood M. Effects of antenatal yoga on maternal anxiety and depression: a randomized controlled trial. Depress Anxiety. 2014;31(8):631–40.PubMedGoogle Scholar
  102. 102.
    Nieminen K, Berg I, Frankenstein K, Viita L, Larsson K, Persson U, et al. Internet-provided cognitive behaviour therapy of posttraumatic stress symptoms following childbirth—a randomized controlled trial. Cogn Behav Ther. 2016;45(4):287–306.PubMedGoogle Scholar
  103. 103.
    Shaw RJ, St John N, Lilo EA, Jo B, Benitz W, Stevenson DK, et al. Prevention of traumatic stress in mothers with preterm infants: a randomized controlled trial. Pediatrics. 2013;132(4):e886–94.PubMedPubMedCentralGoogle Scholar
  104. 104.
    Bastos MH, Furuta M, Small R, McKenzie-McHarg K, Bick D. Debriefing interventions for the prevention of psychological trauma in women following childbirth. Cochrane Database Syst Rev. 2015;4:CD007194.Google Scholar
  105. 105.
    Baxter JD, McCourt C, Jarrett PM. What is current practice in offering debriefing services to post partum women and what are the perceptions of women in accessing these services: a critical review of the literature. Midwifery. 2014;30(2):194–219.PubMedGoogle Scholar
  106. 106.
    Borg Cunen N, McNeill J, Murray K. A systematic review of midwife-led interventions to address post partum post-traumatic stress. Midwifery. 2014;30(2):170–84.PubMedGoogle Scholar
  107. 107.
    • Simpson M, Catling C. Understanding psychological traumatic birth experiences: a literature review. Women Birth. 2016;29(3):203–7 This review investigated the efficacy of birth-related PTSD interventions and found that midwives were often not trained well enough to address traumatic births. PubMedGoogle Scholar
  108. 108.
    McKenzie-McHarg K, Crockett M, Olander EK, Ayers S. Think pink! A sticker alert system for psychological distress or vulnerability during pregnancy. Br J Midwifery. 2014;22(8):590–5.Google Scholar
  109. 109.
    Fenwick J, Gamble J, Creedy D, Barclay L, Buist A, Ryding EL. Women’s perceptions of emotional support following childbirth: a qualitative investigation. Midwifery. 2013;29(3):217–24.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Alexandra Badaoui
    • 1
    Email author
  • Sandra Abou Kassm
    • 1
  • Wadih Naja
    • 1
  1. 1.Faculty of Medical Sciences, Department of PsychiatryLebanese UniversityBeirutLebanon

Personalised recommendations