Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
Rural Remote Health. 2021 Nov;21(4):6974. doi: 10.22605/RRH6974. Epub 2021 Nov 8.
There is a growing interest in fear of childbirth. The prevalence, reasons and treatment have been investigated, but the development of fear of birth during and after pregnancy in a sample of women from a rural area is less studied. The aim of this study was to explore the trajectories of fear of birth and associated factors in a sample of women living in a rural area of Sweden.
A longitudinal cohort study of women were recruited to a continuity-of-care project in mid-pregnancy and followed up 2 months after birth. Data were collected by two questionnaires. Fear of birth was assessed using the Fear of Birth Scale (FOBS) in mid-pregnancy, in retrospect after birth and looking forward to a possible future birth.
The questionnaire was completed by 280 women in mid-pregnancy and by 236 women after giving birth. The mean FOBS fluctuated over time: it was highest in pregnancy, lower after birth and then increased once more when women were thinking about a future birth. Factors associated with developing fear after birth were mainly related to having had an emergency caesarean section, epidural, augmentation, or neonatal care that resulted in a less positive birth experience. Reduction of fear was associated with antenatal support. For some women, the levels of fear did not change, and these women were characterised with worse self-rated health but also more negative experiences of having given birth.
Fear of birth seemed to change over time and was associated with women's emotional wellbeing, circumstances accompanying the actual birth and the whole birth experience. Support during pregnancy could change the trajectory of fear of birth. Women whose levels of fear were high rated their health lower and had a more negative birth experience. More research is needed into how best to help women overcome their fear of birth.
人们对生育恐惧的兴趣日益浓厚。已经研究了其流行程度、原因和治疗方法，但对农村地区女性样本中生育恐惧在怀孕期间和产后的发展研究较少。本研究旨在探讨瑞典农村地区女性样本中生育恐惧的轨迹及其相关因素。
对参加连续性护理项目的孕妇进行纵向队列研究，并在产后 2 个月进行随访。通过两份问卷收集数据。在妊娠中期使用生育恐惧量表（FOBS）评估生育恐惧，在产后回顾时以及对未来可能的生育时进行前瞻性评估。
在妊娠中期，280 名妇女完成了问卷，产后有 236 名妇女完成了问卷。FOBS 的平均值随时间波动：妊娠中期最高，产后较低，然后在妇女考虑未来生育时再次增加。与产后出现恐惧相关的因素主要与紧急剖宫产、硬膜外麻醉、引产或新生儿护理有关，这些因素导致了生育体验不那么积极。减少恐惧与产前支持有关。对于一些女性，恐惧水平没有变化，这些女性的自我健康评估较差，但分娩体验也更消极。
生育恐惧似乎随时间而变化，与女性的情绪健康、伴随实际分娩的情况以及整个分娩体验有关。怀孕期间的支持可以改变生育恐惧的轨迹。恐惧水平较高的女性自评健康状况较差，分娩体验更消极。需要进一步研究如何最好地帮助女性克服生育恐惧。
