Making bad worse for expectant mothers

June 22, 2012

Some Norwegian women with birth anxiety face additional trauma in their meeting with the country's health service, according to research carried out in Stavanger.

The Cesarean section rate is rising in most developed countries and many pregnant women around the world suffer from a fear of childbirth. In , birth affects one in five and can prompt some to demand a Caesarean delivery. But the question is how afraid a woman must be before her wishes are heard.

Unlike many other countries, Norway does not give women an automatic right to a Caesarean – although their wishes are meant to be taken into account in the assessment.

"A number find their anxieties are not taken seriously," says postdoctoral researcher Ellen Ramvi at the University of Stavanger (UiS). "This has a big effect on the way they experience the birth and its aftermath."

The case histories of five women who gave birth vaginally after requesting a Caesarean were studied by Ramvi and midwife Margrethe Tangerud at Stavanger University Hospital.

They wanted to identify how these expectant mothers experienced their reception by health personnel when they asked for the operation.

Their research shows that the process of reaching a decision on how the baby is to be delivered is difficult both for the women themselves and for the midwives and doctors.

Legitimate the fear

The women covered by the study reported they had difficulties feeling secure about and about their relationship with the medical personnel.

"We interpreted our interviews to suggest that some women 'deserved' to get help and understanding for their birth anxiety," explains Tangerud.

"That applied to those expectant mothers whose fears could be explained and understood by the health personnel. When the latter could find no obvious reason for the birth anxiety, the women experienced little understanding of their wish for a Caesarean."

In other words, the women felt that they had to legitimate their fear of giving birth in order to be met with any respect by midwives and doctors.

"Every woman has the right to have her anxieties taken seriously," says Ramvi. "That also applies to the ones who can't explain or don't understand the reasons for their own fears."

"The most important job of midwives and doctors is to take account of the woman's anxieties, not to attempt to treat these concerns."

Inhumane decisions

One of the women in the study reported that her anxiety was so great that she felt prepared to sacrifice the baby to avoid a vaginal delivery.

"Being told that I'd have to give birth that way was awful," she said. "I thought I was going to die. The doctor looked so stern. I felt he was cross. I think you can become so afraid of giving birth that the child becomes unwanted."

Another of the subjects said: "Nobody listened when I tried to explain my position. I was quite simply not given a choice. It was an inhuman decision."

Three of the women in the study had a difficult time with their child after the birth, and had substantial problems in bonding with it.

Ramvi and Tangerud believe that health personnel must help women with birth anxiety to break out of a vicious circle where they fight their fear before, during and after birth. The anxiety often carries over to a subsequent pregnancy.

"Midwives and doctors mustn't make a bad position worse," says Tangerud. "They must respond with an active and open dialogue and by respecting the feelings these women are suffering from."

"Health personnel must be aware that have the right to participate in the decision on Caesarean or vaginal delivery," agrees Ramvi. "Expectant mothers must feel that their voice is heard on the way to reaching this decision."

Explore further: Local efforts can stem the increasing unnecessary cesarean sections

Related Stories

Local efforts can stem the increasing unnecessary cesarean sections

July 26, 2011
Caesarean section rates are steadily increasing globally. Requiring two doctors to agree that a Caesarean section is the best way to deliver a baby, rather than just needing one opinion, providing internal feedback to doctors ...

Study researches birth satisfaction for first time mothers

September 16, 2011
A pilot University of Otago study investigating factors that contribute to birth satisfaction for first time New Zealand mothers has led to a bigger nationwide study examining how birth preparation impacts on birth satisfaction.

Mode of childbirth following cesarean section: Informing women's decision-making

March 27, 2012
In this week's PLoS Medicine, the PLoS Medicine editors discuss new research studies on the risks associated with mode of childbirth following caesarean section.

Reduced baby risk from another cesarean

March 13, 2012
A major study led by the University of Adelaide has found that women who have had one prior cesarean can lower the risk of death and serious complications for their next baby - and themselves - by electing to have another ...

International study shows Caesareans not as 'posh' as commonly believed

June 14, 2011
(Medical Xpress) -- A ground-breaking study of women who have given birth in New Zealand, Scotland and England, has found the strongest evidence yet that having caesarean sections does not always protect women from the common ...

Recommended for you

Female researchers pay more attention to sex and gender in medicine

November 7, 2017
When women participate in a medical research paper, that research is more likely to take into account the differences between the way men and women react to diseases and treatments, according to a new study by Stanford researchers.

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

Mindano Iha
not rated yet Jun 23, 2012
Having lived in several countries and now in Norway my conclusion is that in Norway one should always be subjected to as much pain as possible.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.