Women with a fear of childbirth endure a longer labor: research

June 26, 2012

Women who have a fear of childbirth spend longer in labour than women who have no such fear, suggests new research published today (27 June) in BJOG: An International Journal of Obstetrics and Gynaecology.

Between 5 and 20% of pregnant women have a fear of childbirth. Various factors have been associated with increased prevalence of fear of childbirth, including young , being a first-time mother, pre-existing , lack of social support and a history of abuse or adverse obstetric events.

This Norwegian study looked at 2206 women with a pregnancy who intended to deliver vaginally.

Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ), a validated psychometric instrument designed to measure fear of childbirth. Women undertook the questionnaire at 32 weeks gestation and fear of childbirth was defined as a score of more than 85. Out of the total number, 165 (7.5%) women scored more than 85.

Labour duration was defined as 3-4 centimetres cervical dilatation and 3 uterine contractions per 10 minutes, until delivery of the child.

The average age of the participants at delivery was 30.9 years and 50.5% (1113 women) were first time mothers. Average labour duration was 8.22 hours for first-time mothers, and it was 4.91 hours for parous women.

The researchers found that women with a fear of childbirth spent one hour and 32 minutes longer in labour than women with no such fear. After adjustment for other factors associated with labour duration, such as parity, epidural analgesia, instrumental and labour induction, the difference was still significant at 47 minutes.

Average labour duration was 8 hours for women with fear of childbirth compared to 6.46 hours (which equals 6 hours and 28 minutes) for women without fear.

The study also found that women with fear of childbirth more often delivered by instrumental vaginal delivery (17.0% versus 10.6%) or emergency caesarean delivery (10.9% versus 6.8%) as compared to women without fear of childbirth.

In total, 25.5% (42 women) of women with fear of childbirth and 44.4% (906 women) of women without fear of childbirth had a vaginal delivery without any obstetric interventions.

However, despite increased labour duration for women with a fear of childbirth, a large proportion of women achieved a vaginal delivery which was their intention compared to women with no fear (89.1% versus 93.2%).

Samantha Salvesen Adams, Health Services Research Centre, Akershus University Hospital, University of Oslo, Norway and co-author of the research said:

"Fear of childbirth seems to be an increasingly important issue in obstetric care. Our finding of longer duration of labour in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics.

"We found a link between fear of childbirth and longer duration of labour. Generally, longer labour duration increases the risk of instrumental vaginal delivery and emergency caesarean section. However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery and therefore elective caesarean delivery should not be routinely recommended."

John Thorp, BJOG Deputy-Editor-in-Chief added:

"There are a number of reasons why women may develop a fear of childbirth. This research shows that with of are more likely to need obstetric intervention and this needs to be explored further so that obstetricians and midwives can provide the appropriate support and advice."

Explore further: Fear of childbirth increases likelihood of C-section

More information: Adams S, Eberhard-Gran M, Eskild A. Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. BJOG 2012; DOI: 10.1111/j.1471-0528.2012.03433.x

Related Stories

Fear of childbirth increases likelihood of C-section

September 21, 2011
A new study published in the international journal Acta Obstetricia et Gynecologica Scandinavica (AOGS) reveals that fear of childbirth is a predisposing factor for emergency and elective cesarean sections, even after psychological ...

Incontinence 20 years after child birth three times more common after vaginal delivery

March 26, 2012
Women are nearly three times more likely to experience urinary incontinence for more than 10 years following a vaginal delivery rather than a caesarean section, finds new research at the Sahlgrenska Academy at the University ...

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.

Recommended for you

Population health impact of infants born small for gestational age in low- and middle-income countries

August 18, 2017
In low-and middle-income countries, it is common for babies to be born of low birth weight, due to either inadequate growth in utero (fetal growth restriction) and/or preterm birth, (birth before 37 weeks gestation). Maternal ...

Hormone from fat tissue can give protection against polycystic ovary syndrome

August 10, 2017
Obesity and reduced insulin sensitivity are common in polycystic ovary syndrome, PCOS. New research based on animal studies, and to be published in the journal PNAS, reveals that the hormone adiponectin can protect against ...

Study in mice may reveal insights into causes of miscarriages for some women

August 9, 2017
Researchers at St. Michael's Hospital have identified how natural killer cells in the mouse placenta can cause a fetus to fail to grow in the womb or cause miscarriages.

Insomnia, sleep apnea nearly double the risk of preterm delivery before 34 weeks

August 9, 2017
Pregnant women who are diagnosed with sleep disorders such as sleep apnea and insomnia appear to be at risk of delivering their babies before reaching full term, according to an analysis of California births by researchers ...

Elective freezing of IVF embryos linked to higher pregnancy rates in some cases

August 1, 2017
A delay in transferring embryos to the mother improves the success of in vitro fertilization in certain cases, according to a study by scientists at the Stanford University School of Medicine, Celmatix Inc. and several other ...

Negative birth outcomes linked to air pollution exposure early in pregnancy, study finds

July 27, 2017
Exposure to air pollution early in a pregnancy could increase risk for preterm birth and low birth weight, according to a study led by researchers at NYU School of Medicine, and published on July 27 in Environmental Health ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

packrat
not rated yet Jun 26, 2012
That's not particularly surprising. The women that fear it are more tense and simply can't relax enough for nature to do it's job.

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.