Many expectant women can experience fearful thoughts or anxiety before giving birth. Studies from the Nordic countries have shown that between 8-23% of women experience some level of fear before giving birth. This wide estimate is caused in part by how the question is asked and which measuring instrument or scale is used. It is generally accepted though that around 20% or every fifth woman experiences a fear of childbirth. Severe fear of childbirth occurs in about 6-10% of all women and about 2% have something called Tokophobia: a pathological fear of childbirth (FOC)The occurrence and cause of the fear depends on many factors.
Fear of childbirth is divided into four grades: Light, moderate, difficult and phobic.
Mild fear of childbirth implies a worry that the woman can cope with herself, while moderate is a stronger degree that the woman may have difficulty dealing with alone. The difficult grade of fear of childbirth is a strong concern that affects the woman in her everyday life and can in some cases mean that she avoids a pregnancy or wants to give birth with the help of a caesarean section instead of vaginally. The phobic fear is an extreme fear that can result in the woman never getting pregnant despite the longing for children.
Primary or secondary fear
In addition to the four grades, fear of childbirth is also divided into primary or secondary fear. A primary fear of childbirth is when the woman has not previously given birth and can arise during adolescence or earlier in life. A secondary fear of childbirth is when the woman experiences fear due to a previous childbirth experience that was difficult or traumatic. This does not mean that the birth itself must have been complicated or traumatic, but that the woman's experience was such.
Common causes of fear of childbirth
The most common cause of fear of childbirth is anxiety about losing control, pain, risk of stretch marks associated with childbirth or complications that may occur for mother or child. Other reasons that women state before giving birth are anxiety about not being seen, lack of trust in the staff and lack confidence in their body and ability to give birth.
Treatment available
At the midwife clinic, as a pregnant woman, you will be asked by your midwife how you view the birth and what feelings you have before the birth. If you express any kind of anxiety or fear, your midwife will ask more questions and rate the degree of fear of childbirth that exists in order for you to receive the right help and treatment. At the midwife clinic you will have the opportunity to get extra appointments to ask questions, talk more about your feelings before the birth and receive extended information. For many women, it can help to create a birth plan which might include the type of pain relief you want and for what period of time. For example, it can be easier to know that there is a possibility of an early epidural or to get a date when the birth is started. You can also formulate a plan that includes the type of support that would facilitate, for example, the continuous presence of a midwife or other support person in the room. The purpose of the treatment is for you to gain increased security and knowledge to strengthen your belief in yourself and your ability to give birth and to ultimately have a positive experience of the birth, regardless of the method of delivery.
Can you request a caesarean section due to fear of childbirth?
Women who are afraid of childbirth often seek this type of care with a desire to have a caesarean section. Today, as a prospective parent, it is not possible to choose which way you want to give birth, but the treatment that is available aims for you to have a positive experience of giving birth, regardless of how the baby is delivered. It can be difficult to have to go through these conversations when you know deep down that a caesarean section would facilitate and remove these difficult feelings. Some women also feel that the medical risks of a caesarean section are lower compared to a vaginal birth.
The risks of medical complications are generally lower in a vaginal birth compared to a caesarean section and in cases where the anxiety is great, information and increased knowledge can contribute to a lower level of fear and increased security before giving birth. Sometimes the fear cannot be treated and in these cases a planned caesarean section may be necessary. This decision is always made by an obstetrician and should be made in consultation with the expectant mother.