title: Birth experience in women with low, intermediate or high levels of fear: findings from the first baby study.
abstract: BACKGROUND
  Fear of childbirth and mode of delivery are two known factors that affect birth experience. The interactions between these two factors are unknown. The aim of this study was to estimate the effects of different levels of fear of birth and mode of delivery on birth experience 1 month after birth.
  
  
  METHODS
  As part of an ongoing prospective study, we interviewed 3,006 women in their third trimester and 1 month after first childbirth to assess fear of birth and birth experience. Logistic regression was performed to examine the interactions and associations between fear of birth, mode of delivery and birth experience.
  
  
  RESULTS
  Compared with women with low levels of fear of birth, women with intermediate levels of fear, and women with high levels of fear had a more negative birth experience and were more affected by an unplanned cesarean section or instrumental vaginal delivery. Compared with women with low levels of fears with a noninstrumental vaginal delivery, women with high levels of fear who were delivered by unplanned cesarean section had a 12-fold increased risk of reporting a negative birth experience (OR 12.25; 95% CI 7.19-20.86). A noninstrumental vaginal delivery was associated with the most positive birth experience among the women in this study.
  
  
  CONCLUSIONS
  This study shows that both levels of prenatal fear of childbirth and mode of delivery are important for birth experience. Women with low fear of childbirth who had a noninstrumental vaginal delivery reported the most positive birth experience.
authors.affiliation: Department of Medicine, Division of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Elvander
authors.forename: Sven
authors.initials: S
authors.lastname: Cnattingius
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Kjerulff
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000523:psychology* / Q000706:statistics & numerical data; D005239:Fear; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D036801:Parturition / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000523:psychology*; D011446:Prospective Studies; D055815:Young Adult
keywords: birth experience; fear of birth; mode of delivery