title: Self reported fear of childbirth and its association with women's birth experience and mode of delivery: a longitudinal population-based study.
abstract: OBJECTIVE
  To explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery.
  
  
  METHODS
  A longitudinal population-based study.
  
  
  METHODS
  Pregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden.
  
  
  METHODS
  Differences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used.
  
  
  RESULTS
  FOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5-10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2-5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1-20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4-11.7), emergency caesarean section (RR 2.4, CI 1.2-4.5) and primiparity (RR 1.9, CI 1.2-3.1).
  
  
  CONCLUSIONS
  FOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women's perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women's experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required.
authors.affiliation: School of Health Sciences, University of Borås, S-501 90 Borås, Sweden; Linnaeus University, S-351 95 Växjö, Sweden. christina.nilsson@hb.se
authors.forename: Christina
authors.initials: C
authors.lastname: Nilsson
authors.forename: Ingela
authors.initials: I
authors.lastname: Lundgren
authors.forename: Annika
authors.initials: A
authors.lastname: Karlström
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Hildingsson
mesh_terms: D000328:Adult; D001294:Attitude to Health; D036861:Delivery, Obstetric / Q000379:methods* / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010298:Parity; D036801:Parturition / Q000523:psychology*; D011159:Population Surveillance; D011247:Pregnancy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology