title: Fear of childbirth during pregnancy may increase the risk of emergency cesarean section.
abstract: BACKGROUND
  The purpose of our study was to elucidate the association between fear of childbirth, general anxiety, and stress coping during the third trimester of pregnancy, and a subsequent delivery by emergency cesarean section.
  
  
  METHODS
  In a case-control study, 1,981 Swedish-speaking women completed three self-assessment questionnaires at 32 weeks' gestation. Ninety-seven of these women were delivered by emergency cesarean section. Fear of childbirth, general anxiety and the stress coping ability of these 97 cases were compared with the same features in 194 controls, matched for age and parity.
  
  
  RESULTS
  Women, subsequently delivered by emergency cesarean section, reported a greater anxiety and a poorer stress coping ability, and, most obviously, a greater fear of childbirth at 32 weeks' gestation. After elimination of possible confounders, the odds ratio for emergency cesarean section was examined for women whose scores were above various cut-off points according to the fear of childbirth measuring instrument. For women with a serious fear of childbirth the odds ratio was 3.0 (95% confidence interval 1.4 to 6.6), and the population attributable risk 0.167.
  
  
  CONCLUSIONS
  Fear of childbirth during the third trimester of pregnancy may increase the risk of subsequent emergency cesarean section.
authors.affiliation: Department of Obstetrics and Gynecology, Central Hospital, Helsingborg, Sweden.
authors.forename: E L
authors.initials: EL
authors.lastname: Ryding
authors.forename: B
authors.initials: B
authors.lastname: Wijma
authors.forename: K
authors.initials: K
authors.lastname: Wijma
authors.forename: H
authors.initials: H
authors.lastname: Rydhström
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety; D016022:Case-Control Studies; D002585:Cesarean Section / Q000523:psychology* / Q000706:statistics & numerical data; D015986:Confounding Factors, Epidemiologic; D004630:Emergencies; D005239:Fear; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000523:psychology*; D016017:Odds Ratio; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000523:psychology*; D011581:Psychological Tests; D013312:Stress, Physiological; D011795:Surveys and Questionnaires