Seeking answers to treat the fear of childbirth
One of five Norwegian women suffers from a fear of childbirth. This fear increases health risks to mother and child, results in more planned and emergency Caesarean sections and consumes substantial resources at hospitals. Now researchers are looking for the causes.
A few women are so afraid of giving birth that they avoid becoming pregnant or seek an abortion, even though they want to have children. This fear is related to several serious conditions such as prolonged labour, a greater need for pain relief during labour and an increased risk of an emergency C-section. In some cases, the fear of childbirth is so serious that it can be classified as a specific phobia, such as a fear of dentists or a fear of heights, and leads to avoidance behaviour.
In Oslo, 5-10 per cent of all pregnant women are treated for fear of childbirth. It is the reason underlying about 20 per cent of all planned C-sections. This trend is on the rise, which is unfortunate since C-sections pose a greater risk to the mother and child than a vaginal delivery.
World’s largest study of the fear of childbirth
There is very little research-based knowledge about the actual causes of the fear of childbirth.
“The studies conducted up until now have been limited and have had a low response rate. They have also lacked good psychometric measuring instruments for gauging the mental health of the participants,” says Malin Eberhard-Gran, a senior researcher at the Norwegian Institute for Public Health. She is the project manager of an extensive study investigating the causal relationships between the risk factors for fear of childbirth and how this fear affects delivery and the child. The “Fear of childbirth: causes and consequences” project is funded in part by the Research Council of Norway’s funding scheme for independent projects (FRIPRO).
“This group of pregnant women costs society considerable sums, but as of today we do not know whether we are giving them the proper treatment and follow-up. In addition to the societal perspective, there is also the personal suffering of the women themselves, their families and not least the child to take into consideration.”
“This study will enable us to gain more insight into what we are treating as well as how we are treating it,” says Dr Eberhard-Gran, who emphasises that a large percentage of women with a fear of childbirth are well functioning in terms of mental health.
“Currently many women who suffer from a fear of childbirth are treated as if they have a classic phobia, but this is wrong. It is not an illness to feel fear. It is actually completely normal to be afraid of giving birth,” explains Dr Eberhard-Gran, who wrote her doctoral thesis on post-partum depression.
“We got an extremely high response rate to our study,” says the researcher. “More than 80 per cent of all of the women who gave birth at one of the large hospitals in the Oslo area in the period from 2009 to 2011 took part in the study – that is almost 4,000 women.”
“We believe so many women decided to participate because they wanted to help to enhance the quality of pregnancy checkups and post-partum follow-up in general.”
The researchers have collected large amounts of valuable data that shed light on and document numerous problems related to pregnancy and health.
“So far we have authored nine articles that have either been published in, submitted to or are being assessed for publication by international scientific journals. Three have already been published online,” says Dr Eberhard-Gran. The project will be followed up by a study of the respondents two years after giving birth.
|About the study|
The study is a collaborative project between Kvinneklinikken (a women’s health clinic at Akershus University Hospital in Oslo), Forskningssenteret (HØKH) (a health research centre at Akershus University Hospital in Oslo) and the Norwegian Institute of Public Health.
The Research Council of Norway has allocated research funding to the project. Akershus University Hospital has also provided funding for one research fellowship.
The study has been approved by the privacy ombudsman of the National Committee for Medical and Health Research Ethics.
Malin Eberhard-Gran is a senior researcher at the Norwegian Institute of Public Health and serves as project manager for the study. She has a background as a general practitioner and has conducted research for many years. She holds professor-level qualifications in health services research and will soon complete a speciality in community medicine.
Dr Eberhard-Gran has taken active part in the efforts to draw up guidelines for pregnancy care, for the diagnosis and treatment of adults with depression in the primary and specialist health services, and for the Medical Products Agency of Sweden. She has also co-authored a number of reports on health-promoting and prevention measures focusing on pregnancy and childbirth. Her doctoral thesis addressed the topic of post-partum depression.
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