Fear of childbirth and postnatal post-traumatic stress disorder after childbirth in Belgium

Background: Pregnancy and childbirth are normal physiological processes which have a significant impact on the life of the mother and those surrounding her. However, some women can be very fearful towards birth or it can be a... [ view full abstract ]

Background:
Pregnancy and childbirth are normal physiological processes which have a significant impact on the life of the mother and those surrounding her. However, some women can be very fearful towards birth or it can be a potentially traumatic experience. Additionally women who are fearful of childbirth show a greater risk of developing post-traumatic stress disorder (PTSD) after birth. In Belgium, the prevalence and risk factors of fear of childbirth and PTSD after childbirth have never been explored.
Aim and objectives of the study
The aim was to explore the current situation about PTSD after childbirth and childbirth related fear in Flanders, Belgium. Secondly the prevalence and risk factors were examined.
Method
This abstract concludes two parts of research. The first study was a prospective cohort study in 13 hospitals. Data collection was performed twice in the postpartum (week one and six). In the second study participants were recruited through private practices of obstetricians in Antwerp, Belgium. Ethical approval for both studies was obtained.
Findings
The first and second sample of the first study consisted of 340 and 229 postnatal women respectively. The prevalence of PTSD symptoms after childbirth ranged from 0.3% to 5.7% in the first week and from 0% to 4% at six weeks follow-up. Multiple regression analysis showed that PTSD was associated with a traumatic childbirth experience, lower socio-economic status, a history of psychological/psychiatric problems and a complicated delivery. Maternity team care and the opportunity to ask questions, as well as experiencing a normal physiological delivery were protective factors.
In the second study a sample of 349 pregnant women was achieved. 12.5 percent of the participants showed severe fear of childbirth. Risk factors associated with fear of childbirth appeared to be an unplanned pregnancy, lower family income, primipara, percentage of employment and number of family members.
Conclusions and Implications
Fear of childbirth and PTSD requires more attention by caregivers. Further research in this field is needed.