Mental health problems common in women with fear of childbirth: Mental health of women with fear of childbirth
Abstract
OBJECTIVE: To investigate whether women with fear of childbirth have more mental health problems than women of childbearing age in general. DESIGN: Register-based retrospective study. SETTING: The maternity clinic of Helsinki University Central Hospital. POPULATION: In all, 2405 women referred for consultation because of fear of childbirth during 1996-2002 and 4676 comparable control women. METHODS: Data were linked to the Medical Birth Register, the Hospital Discharge Register and the Drug Reimbursement Register 5-12 years before and after the initial childbirth (during 1990-2008). MAIN OUTCOME MEASURES: Prevalence of psychiatric care as evidenced by the use of psychotropic medication, and episodes of either psychiatric inpatient or outpatient care in women with fear of childbirth compared with nonfearful controls. RESULTS: Women with fear of childbirth had significantly more often had psychiatric care (54.0% versus 33.6%, P < 0.001) during the study period. Fearful and nonfearful women differed from each other (P < 0.001) regarding psychiatric inpatient care (7.2% versus 3.6%), outpatient care (19.0% versus 9.8%) and the use of psychotropic medication (51.3% versus 31.3%). Mood and anxiety disorders were the most common psychiatric diagnoses in both groups. The major predictors for a need for psychiatric care after the initial childbirth were previous psychiatric care (adjusted odds ratio 4.5; 95% CI 4.0-5.1) and fear of childbirth (adjusted odds ratio 1.9; 95%CI 1.7-2.1). CONCLUSIONS: A remarkable mental morbidity was seen among women of childbearing age. Mental health problems were twice as common among women with a fear of childbirth as in nonfearful controls. Clinical practice on how to evaluate and treat women fearing childbirth should be developed.
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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 [22]
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Molgora, S., Fenaroli, V., & Saita, E. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.10.045 · Cited by 27 · see citing works
Massae, A. F., Larsson, M., Leshabari, S., Mbekenga, C. K., Pembe, A. B., & Svanberg, A. S. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-04169-7 · Cited by 26 · see citing works
Hildingsson, I., & Rubertsson, C. (2019) · Journal of Psychosomatic Obstetrics and Gynaecology · doi:10.1080/0167482x.2019.1634047 · Cited by 22 · see citing works
Turkstra, E., Mihala, G., Scuffham, P., Creedy, D. K., Gamble, J. A., Toohill, J., & Fenwick, J. (2016) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2016.08.003 · Cited by 25 · see citing works
Heterogeneity in childbirth related fear or anxiety.
Rondung, E., Ekdahl, J., Hildingsson, I., Rubertsson, C., & Sundin, Ö. (2018) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12481 · Cited by 25 · see citing works
Sanni, K.-R., Ekholm, E. M. K., Scheinin, N. M., Laura, K., Karlsson, L., & Karlsson, H. (2022) · Archives of Women s Mental Health · doi:10.1007/s00737-022-01212-0 · Cited by 22 · see citing works
Depressed mood, anxiety, and the use of labor analgesia
Pettersson, F. D., Hellgren, C., Nyberg, F., Åkerud, H., & Poromaa, I. S. (2015) · Archives of Women s Mental Health · doi:10.1007/s00737-015-0572-6 · Cited by 21 · see citing works
FACTORS ASSOCIATED WITH CHILDBIRTH - RELATED FEAR AMONG SLOVAK WOMEN
Mazúchová, L., Škodová, Z., Kelčíková, S., & Rabárová, A. (2017) · Central European Journal of Nursing and Midwifery · doi:10.15452/cejnm.2017.08.0027 · Cited by 21 · see citing works
Fear of childbirth in Iran: A systematic review of psychological intervention research
Azizi, M., Kamali, M., Elyasi, F., & Shirzad, M. (2021) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.18502/ijrm.v19i5.9250 · Cited by 20 · see citing works
Malmquist, A., Wikström, J., Jönsson, L., & Nieminen, K. (2020) · Midwifery · doi:10.1016/j.midw.2020.102888 · Cited by 19 · see citing works
Transition to parenthood and positive parenting: Longitudinal and intervention approaches
Salmela‐Aro, K. (2011) · European Journal of Developmental Psychology · doi:10.1080/17405629.2011.607584 · Cited by 19 · see citing works
Self-citationAlizadeh-Dibazari, Z., Maghalian, M., & Mirghafourvand, M. (2025) · BMC Psychology · doi:10.1186/s40359-025-03047-7 · Cited by 18 · see citing works
Ternström, E., Hildingsson, I., Haines, H., Karlström, A., Sundin, Ö., Ekdahl, J., Segeblad, B., Larsson, B., Rondung, E., & Rubertsson, C. (2017) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2017.06.001 · Cited by 17 · see citing works
Women’s experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth
Baylis, R., Ekdahl, J., Haines, H. M., & Rubertsson, C. (2019) · Women and Birth · doi:10.1016/j.wombi.2019.05.006 · Cited by 17 · see citing works
Malmquist, A., & Nieminen, K. (2020) · Women and Birth · doi:10.1016/j.wombi.2020.04.005 · Cited by 20 · see citing works
Anxiety and depressive symptoms in women with fear of birth: A longitudinal cohort study
Hildingsson, I., Nilsson, J., Merio, E., & Larsson, B. (2021) · European Journal of Midwifery · doi:10.18332/ejm/138941 · Cited by 16 · see citing works
Iranian women’s perception on the determinants of birth experience: a qualitative study
Mirghafourvand, M., Meedya, S., Mohammadi, E., Mohammad‐Alizadeh‐Charandabi, S., Jafarabadi, M. A., & Ghanbari-Homaie, S. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-05078-z · Cited by 17 · see citing works
Airo, R., Korja, R., Saisto, T., Rouhe, H., Muotka, J. S., & Salmela‐Aro, K. (2018) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646838.2018.1462477 · Cited by 16 · see citing works
Self-citationBeigi, S. M., Valiani, M., Alavi, M., & Mohamadirizi, S. (2019) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_4_19 · Cited by 16 · see citing works
Factors Affecting Fear of Childbirth Among Urban Women in India: A Qualitative Study
Sharma, B., Jungari, S., & Lawange, A. (2022) · SAGE Open · doi:10.1177/21582440221089485 · Cited by 18 · see citing works
Veringa‐Skiba, I. K., de Bruin, E. I., van Steensel, F. J. A., & Bögels, S. M. (2022) · Birth · doi:10.1111/birt.12571 · Cited by 59 · see citing works
Mei, X., Du, P., Li, Y., Mei, R., Wang, X., Chen, Q., & Ye, Z. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05435-y · Cited by 14 · see citing works
Psychometric properties of the Persian version of delivery fear scale (DFS) in Iran
Shakarami, A., Iravani, M., Mirghafourvand, M., & Jafarabadi, M. A. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-03634-7 · Cited by 14 · see citing works
Fear of childbirth and use of labor analgesia: A nationwide register‐based analysis in Finland
Vaajala, M., Kekki, M., Mattila, V. M., & Kuitunen, I. (2023) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.14781 · Cited by 13 · see citing works
Should women be able to request a caesarean section? No
Rouhe, H. (2011) · BMJ · doi:10.1136/bmj.d7565 · Cited by 13 · see citing works
Self-citationEstrategias de relajación durante el período de gestación. Beneficios para la salud
Bjorn, M. B. N., de Jesús, S. N., & Casado‐Morales, M. I. (2013) · Clínica y Salud · doi:10.5093/cl2013a9 · Cited by 13 · see citing works
Weaver, J. J., Browne, J., Aras-Payne, A., & Magill‐Cuerden, J. (2013) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2013-606 · Cited by 13 · see citing works
Cluster Analysis of Fear of Childbirth, Anxiety, Depression, and Childbirth Self-Efficacy
Hildingsson, I., Nordin-Remberger, C., Wells, M. B., & Johansson, M. (2024) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1016/j.jogn.2024.04.004 · Cited by 12 · see citing works
What to expect when you're expecting? Representations of birth in British newspapers
Maclean, E. (2014) · British Journal of Midwifery · doi:10.12968/bjom.2014.22.8.580 · Cited by 12 · see citing works
Long-Acting Injectable Antipsychotic Treatment during Pregnancy: A Case Series
Eleftheriou, G., Butera, R., Sangiovanni, A., Palumbo, C., & Bondi, E. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043080 · Cited by 12 · see citing works
Möller, L., Josefsson, A., Lilliecreutz, C., Gunnervik, C., Bladh, M., & Sydsjö, G. (2018) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/aogs.13503 · Cited by 12 · see citing works
Veringa‐Skiba, I. K., de Bruin, E. I., Mooren, B., van Steensel, F. J. A., & Bögels, S. M. (2021) · Midwifery · doi:10.1016/j.midw.2021.102969 · Cited by 11 · see citing works
Perceived stress and its predictors in women with threatened preterm labour: A cross‐sectional study
Najjarzadeh, M., Abbasalizadeh, S., Mohammad‐Alizadeh‐Charandabi, S., Jafarabadi, M. A., & Mirghafourvand, M. (2021) · Nursing Open · doi:10.1002/nop2.1055 · Cited by 10 · see citing works
Risk factors for preterm delivery among early onset cancer survivors: A Finnish register‐based study
Melin, J. M., Heinävaara, S. H., Malila, N. K., Tiitinen, A. E., Gissler, M., & Madanat‐Harjuoja, L. M. (2018) · International Journal of Cancer · doi:10.1002/ijc.31938 · Cited by 10 · see citing works
Self-citationFear of childbirth after medical vs surgical abortion. Population‐based register study from Finland
Kemppainen, V., Niinimäki, M. J., Bloigu, A. H., Saisto, T., Rouhe, H., Gissler, M., Heikinheimo, O., & Mentula, M. J. (2021) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14078 · Cited by 10 · see citing works
Self-citationHallström, S., Grundström, H., Malmquist, A., Eklind, M., & Nieminen, K. (2022) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.1080/0167482x.2022.2089555 · Cited by 9 · see citing works
Fear of Childbirth, Fatigue, and Well-being in Pregnant Women
Mortazavi, F., & Borzoee, F. (2019) · Journal of Obstetrics Gynecology and Cancer Research · doi:10.30699/jogcr.4.2.45 · Cited by 6 · see citing works
Choisir la césarienne : une pratique où convergent habitus de classe et intérêts médicaux
Gelly, M., Cristofalo, P., & Gasquet‐Blanchard, C. (2019) · Revue française des affaires sociales · doi:10.3917/rfas.193.0071 · Cited by 8 · see citing works
- Authors
- Rouhe, H., Salmela-Aro, K., Gissler, M., Halmesmäki, E., & Saisto, T.
- Affiliations
- Helsinki University Hospital (FI)
- Finnish Institute for Health and Welfare (FI)
- Corresponding author
- Rouhe, H
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2011-04-13
- Volume
- 118
- Issue
- 9
- Pages
- 1104-1111
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- OpenAlex
- W2161058314
- Cited by
- 159
- References
- 33
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 13 · 2023: 10 · 2022: 9 · 2021: 15 · 2020: 10 · 2019: 15 · 2018: 16 · 2017: 9 · 2016: 12 · 2015: 9 · 2014: 10 · 2013: 7 · 2012: 5
- FWCI
- 8.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- Yrjö Jahnssonin Säätiö
- Emil Aaltosen Säätiö
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- fear of childbirth, mental illness, psychiatric nursing, psychotropic drugs, mood disorders, anxiety disorders, women of reproductive age, perinatal mental health
- MeSH terms
- Adolescent, Adult, Analgesia, Mental Disorders, Cesarean Section, Fear, Female, Finland, Humans, Mental Health Services, Middle Aged, Pregnancy, Psychotropic Drugs, Registries, Retrospective Studies, Case-Control Studies, Parturition, Labor Pain, Young Adult
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