title: Mental health problems common in women with fear of childbirth.
abstract: OBJECTIVE
  To investigate whether women with fear of childbirth have more mental health problems than women of childbearing age in general.
  
  
  METHODS
  Register-based retrospective study.
  
  
  METHODS
  The maternity clinic of Helsinki University Central Hospital.
  
  
  METHODS
  In all, 2405 women referred for consultation because of fear of childbirth during 1996-2002 and 4676 comparable control women.
  
  
  METHODS
  Data were linked to the Medical Birth Register, the Hospital Discharge Register and the Drug Reimbursement Register 5-12 years before and after the initial childbirth (during 1990-2008).
  
  
  METHODS
  Prevalence of psychiatric care as evidenced by the use of psychotropic medication, and episodes of either psychiatric inpatient or outpatient care in women with fear of childbirth compared with nonfearful controls.
  
  
  RESULTS
  Women with fear of childbirth had significantly more often had psychiatric care (54.0% versus 33.6%, P < 0.001) during the study period. Fearful and nonfearful women differed from each other (P < 0.001) regarding psychiatric inpatient care (7.2% versus 3.6%), outpatient care (19.0% versus 9.8%) and the use of psychotropic medication (51.3% versus 31.3%). Mood and anxiety disorders were the most common psychiatric diagnoses in both groups. The major predictors for a need for psychiatric care after the initial childbirth were previous psychiatric care (adjusted odds ratio 4.5; 95% CI 4.0-5.1) and fear of childbirth (adjusted odds ratio 1.9; 95%CI 1.7-2.1).
  
  
  CONCLUSIONS
  A remarkable mental morbidity was seen among women of childbearing age. Mental health problems were twice as common among women with a fear of childbirth as in nonfearful controls. Clinical practice on how to evaluate and treat women fearing childbirth should be developed.
authors.affiliation: Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland. hanna.rouhe@helsinki.fi
authors.forename: H
authors.initials: H
authors.lastname: Rouhe
authors.forename: K
authors.initials: K
authors.lastname: Salmela-Aro
authors.forename: M
authors.initials: M
authors.lastname: Gissler
authors.forename: E
authors.initials: E
authors.lastname: Halmesmäki
authors.forename: T
authors.initials: T
authors.lastname: Saisto
mesh_terms: D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D005239:Fear / Q000523:psychology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012042:Registries; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs