Fear of Birth and Modern Maternity Systems of Care

  • Geraldine Butcher
  • Clare WillocksEmail author


This chapter will examine the lived experience of maternity systems and how this shapes practice for obstetricians and midwives. In searching deeper into the care systems we will discover the way women present with anxiety and fear, how this is managed within maternity settings. Why recognising that pregnancy and birth leading to motherhood is more than a physiological event; the best care ensures that women’s psychological wellbeing is nurtured too. Who are these women and what can we learn from them in developing our services to support them. Using an example from a consultant midwife’s clinical setting some of these answers will be revealed.


Attitudes Hypnobirthing Sexual abuse Fearful 


  1. Adams S, Eberhard-Gran M, Eskild A (2012) Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. BJOG 119(10):1238–1246. Scholar
  2. Bakshi R, Mehta A, Mehta A, Sharma B (2007) Tokophobia: fear of pregnancy and childbirth. Internet J Gynecol Obstet 10(1):9–11Google Scholar
  3. Beck C, Driscoll J, Watson S (2013) Traumatic childbirth. Routledge London Accessed 15 Mar 2019
  4. Best Start (2017) The best start: a five-year forward plan for maternity and neonatal care in Scotland Scottish government.
  5. Birthplace Study (2011) Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ 343:d7400 (this is by National Perinatal Epidemiology Unit but not used in the BMJ reference)CrossRefGoogle Scholar
  6. Buckley S (2011) Undisturbed birth. AIMS J 23(4)Google Scholar
  7. Cook K, Lomas C (2012) The impact of choice and control on women’s childbirth experiences. J Perinat Educ 21(3):158–168CrossRefGoogle Scholar
  8. Dick-Read G, (2004) Childbirth without fear pinter and Martin EnglandGoogle Scholar
  9. Downe S, Finlayson K, Melvin C, Spiby H, Ali S, Diggle P, Gyte G, Hinder S, Miller V, Slade P, Trepel D, Weeks A, Whorwell P, Williamson M (2015) Self-hypnosis for intrapartum pain management (SHIP) in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG 122:1226–1234CrossRefGoogle Scholar
  10. England and Wales (2012) NICE guidance CG132 (updated April 2019) caesarean section.
  11. Fenwick J, Toohill J, Gamble J, Creedy D, Buist A, Turkstra E, Sneddon A, Scuffham P, Ryding E (2015) Effects of a midwife psycho-education intervention to reduce childbirth fear on women’s birth outcomes and postpartum psychological wellbeing. BMC Pregnancy Childbirth 15:284CrossRefGoogle Scholar
  12. Fyfe A, Burns D, Butcher G, Deery R (2012) Connecting body and birth through hypnobirthing: a small scale evaluation. MIDIRS Midwifery Digest 22:415Google Scholar
  13. Gagnon AJ, Sandall J (2007) Individual or group antenatal education for childbirth or parenthood, or both. Cochrane Database Syst Rev (3):CD002869.
  14. Garrat L (2011) Survivors of childhood sexual abuse and midwifery practice. Radcliffe, OxfordGoogle Scholar
  15. Haines H, Rubbertsson C, Pallant J, Hildingsson I (2012) The influence of women’s fear, attitudes and beliefs of childbirth on mode and experience of birth. BMC Pregnancy Childbirth 12:55CrossRefGoogle Scholar
  16. Hildingsson I, Rubertsson C, Karlström A, Haines H (2018) Caseload midwifery for women with fear of birth is a feasible option. Sex Reprod Healthc 16:50–55CrossRefGoogle Scholar
  17. Howell M (2012) Lie back listen and relax. Pract Midwife 15(5):12–14–6PubMedGoogle Scholar
  18. Isbir G, Inci F, Onal H, Yildiz P (2016) The efficacy 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 32:227–292CrossRefGoogle Scholar
  19. Larsson B, Hildingsson I, Ternstrom E, Rubertsson C, Karlstrom A (2019) Women’s experience of midwife led counselling and its influence on childbirth fear: a qualitative study. Low income women ‘poorly served’ by midwifery services.
  20. Luce A, Cash M, Hundley V, Cheyne H, Van Teijlingen E, Angell C (2016) “Is it realistic?” the portrayal of pregnancy and childbirth in the media. BMC Pregnancy Childbirth 16(1):40CrossRefGoogle Scholar
  21. Madden K, Middleton P, Cyna AM, Matthewson M, Jones L (2016) Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev (5):CD009356.
  22. Morris Z, Wooding S, Grant J (2011) The answer is 17 years, what is the question: understanding time lags in translational research. J R Soc Med 104:510–520CrossRefGoogle Scholar
  23. Plested M, Kirkham M (2016) Risk and fear in the lived experience of birth without a midwife. Midwifery 38:29–34CrossRefGoogle Scholar
  24. Poggi L, Goutaudier N, Sejourne N, Chabroi H (2018) When fear of childbirth is pathological: the fear continuum. Matern Child Health J 22(5):772–778CrossRefGoogle Scholar
  25. Ryding E, Lukasse M, Parys AS, Wangel AM, Karro H, Kristjansdottir H, Schroll AM, Schei B, Bidens Group (2015) Fear of childbirth and risk of cesarean delivery: a cohort study in six European countries. Birth 42(1):48–55CrossRefGoogle Scholar
  26. Saisto T, Ylikorkala O, Halmesmäki E (1999) Factor associated with a fear of childbirth in second pregnancies. Obstet Gynecol 94:679–682PubMedGoogle Scholar
  27. Scottish Government (2015) Having a baby in Scotland maternity care survey.
  28. Scottish Government (2017) The best start: a five-year forward plan for maternity and neonatal care in Scotland.
  29. Sheen K, Spiby H, Slade P (2015) Exposure to traumatic perinatal experiences and posttraumatic stress symptoms in midwives: prevalence and association with burnout. Int J Nurs Stud 52(2):578–587CrossRefGoogle Scholar
  30. Sheen K, Spiby H, Slade P (2016) What are the characteristics of perinatal events perceived to be traumatic by midwives? Midwifery 40:55–61CrossRefGoogle Scholar
  31. Stoll K, Hall W, Janssen P, Carty E (2014) Why are young Canadians afraid of birth? A survey study of childbirth fear and birth preferences among Canadian University students. Midwifery 30:220–226CrossRefGoogle Scholar
  32. Storksen H, Eberhard-Gran M, Garthus-Niegel S, Eskild A (2012) Fear of childbirth; the relation to anxiety and depression. Acta Obstet Gynecol Scand 91:237–242CrossRefGoogle Scholar
  33. Storksen H, Garthuse-Neigel S, Adams S, Vangen S, Eberhard-Gran M (2015) Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth 15:221CrossRefGoogle Scholar
  34. Toohill J, Fenwick J, Gamble J, Creedy D, Buist A, Turkstra E, Ryding E (2014) A randomized controlled trial of a psycho‐education intervention by midwives in reducing childbirth fear in pregnant women Birth 41:4Google Scholar
  35. Turienzo F, Roe Y, Rayment-Jonesa H, Kennedy A, Forsterd D, Homer C, McLachlane H, Sandall J (2016) Implementation of midwifery continuity of care models for indigenous women in Australia: perspectives and reflections for the United Kingdom. Midwifery 69:110–112CrossRefGoogle Scholar
  36. Uvnas-Moberg K (2011) The oxytocin factor: tapping the hormone of calm, love and healing, 2nd edn. Pinter & Martin Ltd, LondonGoogle Scholar
  37. van Dinter-Douma EE, de Vries NE, Aarts-Greven M, Stramrood CA, van Pampus MG (2018) Screening for trauma and anxiety recognition: knowledge, management and attitudes amongst gynecologists regarding women with fear of childbirth and postpartum posttraumatic stress disorder. J Matern Fetal Neonatal Med 18:1–281Google Scholar
  38. Wosu AC, Gelaye B, Williams MA (2015) Maternal history of childhood sexual abuse and preterm birth: an epidemiologic review. BMC Pregnancy Childbirth 15:174CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Ayrshire Maternity UnitNHS Ayrshire and ArranAyrshireScotland
  2. 2.Wishaw General Hospital, NHS LanarkshireLanarkshireScotland

Personalised recommendations