title: Women's fear of childbirth and preference for cesarean section--a cross-sectional study at various stages of pregnancy in Sweden.
abstract: OBJECTIVE
  To investigate Swedish women's level of antenatal fear of childbirth at various gestational ages, and factors associated with intense fear and with preference for cesarean section.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  All antenatal clinics in four geographical areas.
  
  
  METHODS
  Thousand six hundred and thirty-five pregnant women at various gestational ages recruited during September-October 2006.
  
  
  METHODS
  A questionnaire completed at the antenatal clinic. The women reported their appraisal of the approaching delivery according to the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ).
  
  
  METHODS
  The level of fear of childbirth and preferred mode of delivery.
  
  
  RESULTS
  Mean W-DEQ score was 62.8. The prevalence of intense fear of childbirth (W-DEQ score > or =85) was 15.8% and very intense fear (tocophobia) (W-DEQ score > or =100) 5.7%. Nulliparous women had a higher mean score than parous women, but more parous women reported an intense fear. Preference for cesarean section was associated with fear of childbirth (OR 11.79, 6.1-22.59 for nulliparous and OR 8.32, 4.36-15.85 for parous women) and for parous women also with a previous cesarean section (OR 18.54, 9.55-35.97), or an instrumental vaginal delivery (OR 2.34, 1.02-5.34). The level of fear of childbirth was not associated with the gestational age.
  
  
  CONCLUSIONS
  When a woman requests a cesarean section, both primary fear of birth and traumatic childbirth experiences need to be considered and dealt with. The W-DEQ can be used at any time during pregnancy in order to identify pregnant women who suffer from intense fear of childbirth.
authors.affiliation: Department of Obstetrics and Gynaecology, Motala Hospital, Motala, Sweden. katri.nieminen@lio.se
authors.forename: Katri
authors.initials: K
authors.lastname: Nieminen
authors.forename: Olof
authors.initials: O
authors.lastname: Stephansson
authors.forename: Elsa Lena
authors.initials: EL
authors.lastname: Ryding
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002585:Cesarean Section / Q000523:psychology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005239:Fear; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology