title: Fear of childbirth before, during, and after childbirth.
abstract: BACKGROUND
  Only scanty research exists about the relationship between women's expectations during pregnancy and their experiences as reported during the actual process of labor and afterwards. The aims of the present study were: (1) to investigate the associations between fear of childbirth during pregnancy and postpartum and fear and pain during early active labor (phase 1: cervix dilatation 3-5 cm), and (2) to explore possible differences regarding fear of childbirth during pregnancy and postpartum between women who did or did not receive epidural analgesia during labor. Methods. Fear of childbirth was measured in 47 nulliparous women during gestation weeks 37-39 by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ version A). During early active labor we measured women's fear (Delivery Fear Scale) and their experiences of pain (a pain intensity scale). Finally, fear after childbirth (W-DEQ version B) was measured two hours, two days, and five weeks after delivery.
  
  
  RESULTS
  A positive correlation appeared between fear of childbirth during pregnancy, postpartum, and early active labor. There were no differences in fear of childbirth during late pregnancy between women who received epidural analgesia and those who did not. Postpartum fear was higher in the women who had received epidural analgesia.
  
  
  CONCLUSIONS
  Pregnant women who fear childbirth are prone to report fear during the actual labor and postpartum. The administration of epidural analgesia is not a sufficient response to women's fear during the process of labor.
authors.affiliation: Division of Nursing, Department of Medicine and Care, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden. siw.alehagen@imv.liu.se
authors.forename: Siw
authors.initials: S
authors.lastname: Alehagen
authors.forename: Barbro
authors.initials: B
authors.lastname: Wijma
authors.forename: Klaas
authors.initials: K
authors.lastname: Wijma
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical; D005239:Fear; D005260:Female; D006801:Humans; D007745:Labor Onset / Q000523:psychology*; D036801:Parturition / Q000523:psychology*; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy / Q000523:psychology; D011446:Prospective Studies; D011795:Surveys and Questionnaires