Psychoprophylaxis during labor: associations with labor-related outcomes and experience of childbirth.
OBJECTIVE
To study whether use of psychoprophylaxis during labor affects course of labor and experience of childbirth in nulliparous women.


METHODS
Cohort study.


METHODS
Women were recruited from 15 antenatal clinics in Sweden between October 2005 and January 2007.


METHODS
A total of 857 nulliparous women with a planned vaginal delivery.


METHODS
Using data from a randomized controlled trial of antenatal education where the allocated groups were merged, we compared course of labor and experience of childbirth between women who used psychoprophylaxis during labor and those who did not. Data were collected by questionnaires in mid-pregnancy and three months after birth, and from the Swedish Medical Birth Register. Logistic regression was used to assess associations.


METHODS
Mode of delivery, augmentation of labor, length of labor, Apgar score, pain relief and experience of childbirth as measured by the Wijma Delivery Experience Questionnaire.


RESULTS
Use of psychoprophylaxis during labor was associated with a lower risk of emergency cesarean section (adjusted odds ratio (OR) 0.57; 95% confidence interval (CI) 0.37-0.88), but an increased risk of augmentation of labor (adjusted OR 1.68; 95% CI 1.23-2.28). No statistical differences were found in length of labor (adjusted OR 1.32; 95% CI 0.95-1.83), Apgar score < 7 at five minutes (adjusted OR 0.82; 95% CI 0.33-2.01), epidural analgesia (adjusted OR 1.13; 95% CI 0.84-1.53) or fearful childbirth experience (adjusted OR 1.04; 95% CI 0.62-1.74).


CONCLUSIONS
Psychoprophylaxis may reduce the rate of emergency cesarean section but may not affect the experience of childbirth.
Department of Women's and Children's Health, Karolinska Institutet, Retzius väg 13, Stockholm, Sweden. Malin.Bergstrom@ki.se
Malin
M
Bergström
Helle
H
Kieler
Ulla
U
Waldenström
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000523:psychology* / Q000628:therapy*; D007743:Labor, Obstetric / Q000523:psychology*; D016015:Logistic Models; D026441:Mind-Body Therapies; D010298:Parity; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D055815:Young Adult