Pre‐ and postpartum levels of childbirth fear and the relationship to birth outcomes in a cohort of Australian women
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Aim. To investigate pre‐ and postpartum levels of childbirth fear in a cohort of childbearing women and explore the relationship to birth outcomes. Background. While results are mixed, there is evidence that fear of childbirth is associated with mode of birth. Limited theoretical work around childbirth fear has been undertaken with Australian women. Design. A prospective correlation design. Method. Women ( n = 401) completed the Wijma Delivery Expectancy/Experience Questionnaire (W‐DEQ) version A at 36 weeks gestation, with 243 (61%) women also completing version B at six weeks postpartum. Scores were summarised with means and standard deviations. Content analysis of the free statements identified nine issues of concern. Results. Twenty‐six per cent of pregnant women reported low levels of childbirth fear, 48% were moderately fearful and 26% were highly fearful. Fear decreased after birth for those women in the high antenatal fear group, however surgical intervention at birth ( n = 238, anova , F 1,230 = 12·39, p = 0·001) and suspected fetal compromise ( F 1,230 = 4·33, p = 0·039) increased levels of postpartum fear. Univariately, high antenatal fear was associated with emergency caesarean delivery ( n = 324, Wald 5·05, p = 0·025) however after adjustment for nulliparity and fetal compromise the association disappeared. Australian‐born women were more likely to report higher levels of fear and experience higher rates of caesarean section than participants of non‐Australian origin. Conclusions. Results support those from earlier studies in showing that nulliparous women experience more fear than parous women before birth and that there is no difference in levels of postpartum fear between these two groups. Fear levels were higher in Australian women when compared to a Swedish sample. Relevance to clinical practice. The results of this study add to our preliminary understanding of the phenomena of childbirth fear within an Australian context and are particularly useful in profiling women for whom secondary fear of childbirth is more likely to occur.
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Women fearing birth vary with regard to fear acquisition, fear objects, symptom severity, and comorbidity.
“Many other variations exist among women fearing birth with regard to fear acquisition, fear objects, symptom severity, and comorbidity [20-23].”
From Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial (2018) · cites this paper as [20]
The Introduction (page not provided) describes different objects of childbirth fear, and the Results (page not provided) distinguish low, moderate and high fear levels. The paper also discusses how birth experiences can affect later fear, but our copy does not establish variation in psychiatric comorbidity among women fearing birth. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPostpartum levels of FOB have been associated with previous mode of delivery, intervention at birth, or emergency cesarean births, as with more negative birth experiences.
“Furthermore, postpartum levels of FOB have been associated with previous mode of delivery, intervention at birth, or emergency cesarean births [4,13,20], as with more negative birth experiences [4,13].”
From Comparing internet-based cognitive behavioral therapy with standard care for women with fear of birth: Randomized controlled trial (2018) · cites this paper as [20]
The Results and Discussion (page unavailable) report that intervention at birth—specifically caesarean or forceps/vacuum delivery—was associated with higher postpartum fear. They do not establish an association between postpartum fear and a previous mode of delivery or a more negative birth experience. Emergency caesarean is included within the intervention finding, but the paper’s separate emergency-caesarean analysis concerns antenatal fear, not postpartum fear. (LLM, conf=0.84)
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“Furthermore, postpartum levels of FOB have been associated with previous mode of delivery, intervention at birth, or emergency cesarean births [4,13,20], as with more negative birth experiences [4,13].”
BackgroundThe Fear of Childbirth and Social Support in Adolescent Pregnancy
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- Authors
- Fenwick, J., Gamble, J., Nathan, E., Bayes, S., & Hauck, Y.
- Affiliations
- Griffith University (AU)
- Corresponding author
- Fenwick, Jennifer
- Venue
- Journal of Clinical Nursing
- Publisher
- Wiley
- Published
- 2009-02-12
- Volume
- 18
- Issue
- 5
- Pages
- 667-677
- ISSN
- 0962-1067 (ISSN-L)
- 1365-2702
- OpenAlex
- W1497579748
- Cited by
- 280
- References
- 43
- Citations by year
- 2026: 12 · 2025: 12 · 2024: 11 · 2023: 11 · 2022: 19 · 2021: 24 · 2020: 27 · 2019: 9 · 2018: 24 · 2017: 22 · 2016: 22 · 2015: 22 · 2014: 26 · 2013: 17 · 2012: 6
- FWCI
- 8.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Nursing (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Griffith Research Online (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 › Surgery › Anesthesia and Pain Management
- Keywords
- fear of childbirth, birth outcomes, cesarean section, emergency caesarean delivery, fetal compromise, nulliparity, parity, Australian women, Wijma Delivery Expectancy/Experience Questionnaire
- MeSH terms
- Adaptation, Psychological, Adult, Cesarean Section, Emergencies, Factor Analysis, Statistical, Fear, Female, Humans, Parity, Pregnancy, Pregnancy Outcome, Prospective Studies, Surveys and Questionnaires, Western Australia, Cohort Studies, Multivariate Analysis, Confidence Intervals, Odds Ratio, Neonatal Nursing, Qualitative Research, Parturition, Postpartum Period, Young Adult
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