The effects of counseling on fear of childbirth
Open accessAbstract
Objective: To investigate women's experiences of attending existing counseling programs for childbirth‐related fear and the effect of this counseling over time. Design: A longitudinal survey. Setting: Three hospitals in the central north of Sweden. Sample: A selected sample of 936 women. Of these, 70 received counseling due to fear of childbirth (study‐group). Methods: Data were collected with questionnaires 2 months and 1 year after giving birth with background data collected during midpregnancy. Comparisons were made between women with or without counseling. Crude and adjusted odds ratios ( OR ) were calculated. Main outcome measures: Self‐reported childbirth fear, experience of counseling, birth experience and preferred mode of birth. Results: Women in the counseling group reported higher childbirth fear 1 year after giving birth ( OR 5.0, 95% confidence interval (95% CI ) 2.6–9.3), they had a more negative birth experience that did not change over time ( OR 2.1, 95% CI 1.2–3.9) and they preferred cesarean section to a greater extent ( OR 12.0, 95% CI 5.1–28.1) in the case of another birth. Also, they were more often delivered by planned cesarean section ( OR 4.7, 95% CI 2.4–9.1). However, 80% were satisfied with the given support. Conclusion: Although women were satisfied with the treatment, this study shows that counseling had a minor effect on fear of childbirth, birth experiences or cesarean section rates. To help women with their fear of childbirth, more effective methods of treatment are needed.
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Fear of birth has been associated with negative birth experiences.
“FOB has repeatedly been associated with measures of both anxiety and depression [1-3], as with obstetric complications [4], negative birth experiences [4,5], and requests for cesarean births [6,7].”
From Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial (2018) · cites this paper as [5]
Previous research suggests that FOB during pregnancy might be positively correlated with the experience of pain during childbirth, longer birth duration, and a more negative rating of the overall birth experience.
“Although findings are not coherent [62], previous research suggests that FOB during pregnancy might be positively correlated with the experience of pain during childbirth [63,64], longer birth duration [65-67], and a more negative rating of the overall birth experience [4,5].”
From Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial (2018) · cites this paper as [5]
Counselling may be ineffective in reducing fear of childbirth in the long-term, as at one-year follow-up some women still experienced a 'great deal' of fear of childbirth.
“counselling may be ineffective in reducing FOC in the long-term, as at one-year follow-up some women (n = 24/59) still experienced a ‘great deal’ of FOC.”
From The feasibility and acceptability of a single-session Acceptance and Commitment Therapy (ACT) intervention to support women self-reporting fear of childbirth in a first pregnancy. (2023) · cites this paper as Larsson et al., 2015
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Dweik, D., & Sluijs, A. (2015) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.12692 · Cited by 8 · see citing works
“(7) listed the most important measures in the process of counseling.”
BackgroundInfluentialAfrakoti, N. B., Alipour, A., Pourasghar, M., & Shirvani, M. A. (2018) · Health Care For Women International · doi:10.1080/07399332.2018.1428804 · Cited by 7 · see citing works
“groups, the findings of some researchers were not consistent with this (Fenwick et al., 2015; Larsson et al., 2015; Saisto et al., 2001).”
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Han, Q., Min, G., Ren, F., Duan, D., & Xu, X. (2020) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2020.9011 · Cited by 7 · see citing works
“In the included studies, midwife-supported psychoeducation counselling was administered by 12 studies (19,32,52,57-61,63-66).”
InfluentialZhou, J., Zhu, Z., Li, R., Guo, X., & Li, D. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1530311 · Cited by 10 · see citing works
“Although its effectiveness in reducing FOC is well-documented, some studies report limited impacts on FOC, childbirth experiences, and cesarean rates (Larsson et al., 2015).”
Ghaffari, S. F., Elyasi, F., Mousavinasab, S. N., & Shahhosseini, Z. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04638-7 · Cited by 6 · see citing works
“When necessary, they were referred to obstetricians, psychologists, social workers, and psychiatrists [38].”
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Nordin-Remberger, C., Wells, M. B., Woodford, J., Lindelöf, K. S., & Johansson, M. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06580-2 · Cited by 5 · see citing works
Health, obstetric outcomes and reproduction in women with vulvar pain or primary fear of childbirth
Möller, L. (2019) · Linköping University medical dissertations · doi:10.3384/diss.diva-156622 · Cited by 5 · see citing works
Rondung, E., Lier, E., & Ternström, E. (2024) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2024.2415106 · Cited by 3 · see citing works
“While this intervention has not been evaluated in any controlled trial, women have generally been satisfied with this support (Larsson et al., 2015; Ryding et al., 2003).”
DOĞUM KORKUSUNUN NEDENLERİ VE BAŞ ETME
Demirsoy, G., & Aksu, H. (2016) · DergiPark (Istanbul University) · Cited by 3 · see citing works
Continuity of care vs standard counselling for fear of birth: a Swedish comparative study
Hildingsson, I., Nääs, K. L., Wiklund, I. E., & Johansson, M. (2025) · British Journal of Midwifery · doi:10.12968/bjom.2025.0057 · Cited by 2 · see citing works
“However, women are usually satisfied overall with the services (Larsson et al, 2015; 2018).”
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“[9] Larsson B, Karlström A, Rubertsson C, Hildingsson I.”
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Norwegian midwiveś experiences of encounter and support women with fear of childbirth during birth
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“Previous studies have shown the need for treatment options to be available for women with FOC during pregnancy and birth [11,12].”
Fear of Childbirth and Its Contributing Factor – An Exploratory Study at a Tertiary Care Hospital
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Fear levels of the childbirth of primiparaous women applying to emergency obstetric unit
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TOCOPHOBIA – SHORT REVIEW OF CURRENT LITERATURE
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Clinical aspects of childbirth-related anxiety
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“This was also seen in a study evaluating the effect of interventions in the ordinary obstetric care, suggesting that more effective methods are needed (Larsson et al. 2015).”
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Fear of Childbirth during Pregnancy and Birth PlanningPreprint
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“On the other hand, interventions provided by mid-wives have been shown to reduce cesarean birth rates and increase the preference for vaginal delivery in future pregnancies [10, 11].”
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Nordin-Remberger, C., Wells, M. B., Woodford, J., Lindelöf, K. S., & Johansson, M. (2024) · Figshare · doi:10.6084/m9.figshare.26725622
Nordin-Remberger, C., Wells, M. B., Woodford, J., Lindelöf, K. S., & Johansson, M. (2024) · Figshare · doi:10.6084/m9.figshare.26725625
Is The Fear Of Childbirth The Pregnant Woman's Or The Health Professional's
Gezer, A., & Yarıcı, F. (2025) · Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi · doi:10.56061/fbujohs.1521477
Navigating fear of birth: women's desire for relational midwifery continuity of care
Larsson, B., Johansson, M., Eld, D., Hirsch, L., & Fahlbeck, H. (2026) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2026.2715724
“Women in Sweden have generally been satisfied with midwife-led counseling [8], as it showed to increase their confidence in giving birth.”
Self-citation
- Authors
- Larsson, B., Karlström, A., Rubertsson, C., & Hildingsson, I.
- Affiliations
- Uppsala University (SE)
- Mid Sweden University (SE)
- Corresponding author
- Larsson, Birgitta
- Venue
- Acta Obstetricia et Gynecologica Scandinavica
- Publisher
- Wiley
- Published
- 2015-03-30
- Volume
- 94
- Issue
- 6
- Pages
- 629-636
- ISSN
- 0001-6349 (ISSN-L)
- 1600-0412
- OpenAlex
- W2121694051
- Cited by
- 81
- References
- 32
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 15 · 2021: 4 · 2020: 5 · 2019: 9 · 2018: 15 · 2017: 9 · 2016: 5 · 2015: 2
- FWCI
- 11.76
- Type
- journal article
- Language
- en
- Open access
- green
- urn.kb.se
- Licence
- Locations
- Acta Obstetricia Et Gynecologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
- Keywords
- fear of childbirth, childbirth experience, cesarean section, elective cesarean section, postpartum women, maternal satisfaction
- MeSH terms
- Adult, Attitude to Health, Counseling, Fear, Female, Humans, Longitudinal Studies, Mothers, Pregnancy, Surveys and Questionnaires, Sweden, Treatment Outcome, Parturition, Delivery, Obstetric
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