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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 11 Feb 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Why focus on ‘fear of childbirth’? Editorial. J Psychosom Obstet Gynecol 2003;24:141-143.

Author(s) :

Wijma K.

Year of publication :


URL(s) :

Résumé (français)  :

Abstract (English)  :

Fear of childbirth (FOC) is a common phenomenon in pregnant women. From a psychometrical point-of-view FOC can be seen as a continuum, from almost no fear to extreme fear to give birth. In the latter case, FOC can be so intense that it qualifies for diagnostic terms like ‘clinical FOC’, i.e. a disabling fear that interferes with occupational or academic functioning, with domestic and social activities or with relationships. The fear may even meet the criteria for a specific phobia according to DSM IV. In some women the fear is specific, and only concerns the event of childbirth. In others, FOC exists in parallel with other types of anxiety problems.

In the clinic, a tempting, but often questionable answer on women’s fear during labor is pain relief. A study in 1982 found that fear of physical pain was not a dominating contributing factor to fear of labor and stated that ‘an augmented service for obstetrical analgesia will not suffice to curtail the problem of FOC’. The study concluded that ‘instead, FOC, if present, must be promptly identified and correctly evaluated to be adequately treated’. Nevertheless, the same authors, 20 years later reported that women with a higher level of fear during labor had more pain relief, even if their pain was the same as in women with less fear. However, scientifically valid data about treatment of childbirth related anxiety is almost non-existent. Clinical practice of how to handle and treat FOC is consequently based on knowledge of treatment of similar problems, clinical experience, and common sense. One of the essential challenges for the near future is therefore controlled treatment research. More basic knowledge of childbirth related anxiety is essential to develop adequate methods of treatment. In its clinical form, childbirth related anxiety could have important consequences for the health of the woman, for her role as a mother, as well as for the interpersonal balance in the family and in the partner relationship. Enough data exists that shows many women experience great distress related to childbirth, which might have long lasting consequences for their mental health. Sensitive screening methods, well-performed valid diagnostics followed by adequate therapies for FOC could probably prevent, or at least lessen such suffering. This is expensive, but it is, if truth be told, amazing how much money is afforded for biological diagnostic and therapeutic procedures in relation to pregnancy and delivery, both regarding research funding and by means of clinical interventions. In contrast, financial support to the management of women’s mental health is often marginalized and mental problems related to childbirth clinically handled in an amateurish manner.

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Argument (English):

Argumento (português):

Keywords :

➡ c-section/caesarean ; depression, anxiety ; traumatism ; psychology ; instrumental delivery

Author of this record :

Cécile Loup — 11 Feb 2004

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