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Fear of childbirth? More frequent choice for cesarean section

Fear of childbirth? More frequent choice for cesarean section

Many women dread their childbirth experience. For 10 to 15% of women, this fear is so severe that it affects their daily lives and even the childbirth itself. Additionally, these women have a higher risk of mental health issues after childbirth. Midwife Anne-Marie Sluijs therefore advocates for more attention to be given to anxiety early in pregnancy. She wrote in 2021 a dissertation on this topic at Leiden University Medical Center. An article with a few personal remarks from me.

Fear of childbirth

Anne-Marie Sluijs has worked as a midwife for 26 years and has witnessed many childbirths. “Almost every woman dreads her childbirth when you ask her about it. But if women are preoccupied with it day in and day out, and it affects their functioning, there is often more going on,” says Sluijs.

In her research, Sluijs looked at the influence of fear of childbirth on the choices women make. For example, whether they want to give birth in the hospital or at home, and via cesarean section or vaginally. “We see that women who have a lot of fear of childbirth more frequently request cesarean sections and pain relief. Additionally, they are more likely to choose to give birth in the hospital.”

Fear after childbirth

Furthermore, a referral to secondary care during childbirth, to a medical specialist, increases the likelihood of more fear after childbirth. During the study, it was found that this applies to women who give birth at home, as well as to women who are already in the hospital with their midwife at the time of referral. Women who undergo emergency cesarean sections while a vaginal delivery was planned also have a higher risk of fear after childbirth.

In my practice, I see that this affects doubts about having a second or third child.

Negative spiral

Fear of childbirth is a vicious circle, according to Sluijs. “If women are anxious about childbirth, they are also more likely to perceive childbirth as negative. This can lead to depression or even post-traumatic stress disorder. This, in turn, leads to fear of another pregnancy.” Therefore, it is important to address this issue.

Sluijs advocates for more attention to anxiety early in pregnancy. “At LUMC, we now routinely inquire about anxiety during intake and ask thorough follow-up questions. Additionally, as a midwifery care provider, you should be vigilant for signs that may indicate anxiety, such as unexplained physical complaints and requests for cesarean sections.”

Positive childbirth experience

Sluijs also believes that there should be more attention to this issue during training. “You only have a certain amount of time to overcome fear of childbirth. If this is recognized and treated in time, it can prevent a lot of suffering. Women with less anxiety have a more positive childbirth experience and therefore a lower risk of problems afterwards.”

I completely agree with her. The fact that you had doubts can also have its influence. Midwives should be more aware of this. My experience during my first pregnancy was not the best…

Photo: Pexels – grijstinten-foto-van-een-zwangere-vrouw-3737150/ – pexels-photo-3737150.jpeg – My English is not very good, so I’m translating this with the help of Google Translate and ChatGPT.