The 'no worries' approach fails to identify Australian women with childbirth fear

Having a fear of birth has a negative impact on women's pregnancy and birth. In recently published research from a collaboration of The University of Melbourne, Australia, and Uppsala University, Sweden, doctoral student Helen Haines draws the conclusion that the 'no worries'approach to this issue in Australia has underestimated the needs of a considerable number of pregnant women.

Fear of birth and its relationship to has been recognised in Sweden for some time and there are special clinics for women with fear of birth. The mounting interest in the subject from countries outside of Scandinavia has been situated very much within the discourse on the growing rates of caesarean in general and 'caesarean on demand' in particular. Sweden has half the rate of caesarean birth compared to Australia.

In her doctoral thesis, consisting of several published papers, Helen Haines investigates the prevalence and impact of fear on birthing outcomes in two cohorts of from Australia and Sweden to explore the birth attitudes and beliefs of these women.

Her studies have shown that fear was as much of a reality for the Australian women studied as it was for the Swedish women. High levels of fear were found in 30 percent of Swedish and Australian women.

Helen Haines and her colleagues identified three profiles among the Australian and Swedish women in the study; Self determiners, Take it as it comes and Fearful . Belonging to the Fearful profile had the most negative outcomes for women including higher rates of elective caesarean, more about pregnancy and parenting.

In her research Helen Haines has also seen that a key attitude influencing preference for mode of birth is the belief that birth is a natural event. The cross-cultural comparison showed that the Australian women were less likely than the Swedish women to hold this belief. This may be an important indicator of the wider ecological influences in the Australian society and system of care that contributes to the higher overall rates of caesarean birth when compared to Sweden.

"Reconstructing birth as a natural event, rather than a medical event, is an essential belief for midwives and doctors to promote. It appears to be a very important belief in respect to elective caesarean" says Helen Haines.

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