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Personality, fear of childbirth and birth outcomes in nulliparous women

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

This study was aimed at investigating the delivery continuum starting from constant personality variables and their association with Fear of childbirth (FOC) pre-partum, following the association of FOC pre-partum with the delivery process (as measured by birth outcome variables and subjective experience) and the effect of all of these variables over FOC post-partum.

Methods

In this prospective questionnaire study, 101 nulliparous, singleton pregnancy, healthy parturients were randomly recruited during 2011. Questionnaires were administered on admittance to the delivery ward (FOC, anxiety-sensitivity index, demographic information) and 2 days post-partum (FOC, Big five inventory and a question regarding the birth experience). Medical Variables were taken from medical records.

Results

FOC pre- and post-partum were associated with neuroticism (p < 0.05; p < 0.01) and anxiety sensitivity (p < 0.01). FOC pre-partum was correlated with mode of delivery, higher FOC pre-partum associated with instrumental delivery and emergency CS (p < 0.01). FOC post-partum was associated with both mode of delivery and length of the second phase of delivery (p < 0.05). Hierarchical regression analysis showed FOC pre-partum (β = 0.35, p < 0.01), anxiety sensitivity (β = 0.38, p < 0.01), mode of delivery (β = 0.19, p < 0.05) and birth experience (β = −0.17, p < 0.05) as major predictors for high FOC post-partum explaining 61 % of variance (F (7,84) = 16.82; p < 0.001).

Conclusions

The difference between FOC levels pre- and post-partum was associated with personality variables and birth outcomes resulting in a model describing the variance in FOC post-partum by all of the above mentioned variables. As the implications of FOC over delivery outcomes are evident, women suffering from FOC pre-partum should be screened routinely before delivery and offered proper care.

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References

  1. Rouhe H, Salmela-Aro K, Halmesma¨ki E, Saisto T (2009) Fear of childbirth according to parity, gestational age, and obstetric history. Br J Obstet Gynaecol 116:67–73

    Article  CAS  Google Scholar 

  2. Spice K, Jones SL, Hadjistavropoulos HD, Kowalyk K, Stewart SH (2009) Prenatal fear of birth and anxiety sensitivity. J Psychosom Obstet Gynaecol 30(3):168–174

    Article  PubMed  Google Scholar 

  3. Zar M, Wijma K, Wijma B (2002) Relation between anxiety disorders and fear of childbirth during late pregnancy. Clin Psychol Psychother 9:122–130

    Article  Google Scholar 

  4. Waldenstrom U, Hildingsson I, Ryding EL (2006) Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. Br J Obstet Gynaecol 113:638–646

    Article  CAS  Google Scholar 

  5. Grant KA, McMahon C, Austin MP (2008) Maternal anxiety during the transition to parenthood: a prospective study. J Affect Disord 108(1):101–111

    Article  PubMed  Google Scholar 

  6. Johnston RG, Brown AE (2013) Maternal trait personality and childbirth: the role of extraversion and neuroticism. Midwifery 29:1244–1250. doi:10.1016/j.midw.2012.08.005

    Article  CAS  PubMed  Google Scholar 

  7. Ryding E, Wirfelt E, Wängborg I, Sjögren B, Edman G (2007) Personality and fear of childbirth. Acta Obstet Gynecol Scand 86(7):814–820

    Article  PubMed  Google Scholar 

  8. Saisto T (2001) Obstetrics, psychosocial, and pain related background of childbirth. Academic dissertation, Department of Obstetrics and Gynecology, University of Helsinki, Finland

  9. Nordeng H, Hansen C, Garthus-Niegel S, Eberhard-GranArch M (2012) Fear of childbirth, mental health, and medication use during pregnancy. Arch Womens Ment Health 15:203–209. doi:10.1007/s00737-012-0278-

    Article  PubMed  Google Scholar 

  10. Rouhe H, Salmela-Aro K, Gissler M, Halmesmaki E, Saisto T (2011) Mental health problems common in women with fear of childbirth. Br J Obstet Gynaecol 118:1104–1111

    Article  CAS  Google Scholar 

  11. Storksen HT, Eberhard-Gran M, Garthus-Niegel S, Eskild A (2012) Fear of childbirth; the relation to anxiety and depression. Acta Obstet Gynecol Scand 91(2):237–242. doi:10.1111/j.1600-0412.2011.01323.x

    Article  PubMed  Google Scholar 

  12. Jokic-Begic N, Zigic L, Nakic Radoš S (2014) Anxiety and anxiety sensitivity as predictors of fear of childbirth: different patterns for nulliparous and parous women. J Psychosom Obstet Gynaecol 35(1):22–28

    Article  PubMed  Google Scholar 

  13. John OP, Donahue EM, Kentle RL (1991) The big five inventory—version 4a and 54. University of California, Institute of Personality and Social Research, Berkeley

    Google Scholar 

  14. John OP, Naumann LP, Soto CJ (2008) Paradigm shift to the integrative big-five trait taxonomy: history, measurement, and conceptual issues. Handb Personal Theory Res 3:114–158

    Google Scholar 

  15. Adams S, Eberhard-Gran M, Eskild A (2012) Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. Br J Obstet Gynaecol 119(10):1238–1246. doi:10.1111/j.1471-0528.2012.03433.x

    Article  CAS  Google Scholar 

  16. Laursen M, Johansen C, Hedegaard M (2009) Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort. BJOG 116(10):1350–1355

    Article  CAS  PubMed  Google Scholar 

  17. Lowe NK (2007) A review of factors associated with dystocia and cesarean section in nulliparous women. J Midwifery Womens Health 52:216–228

    Article  PubMed  Google Scholar 

  18. Sluijs AM, Cleiren MPHD, Scherjon SA, Wijma K (2012) No relationship between fear of childbirth and pregnancy-/delivery-outcome in a low-risk Dutch pregnancy cohort delivering at home or in hospital. J Psychosom Obstet Gynaecol 33(3):99–105. doi:10.3109/0167482X.2012.685905

    Article  PubMed  Google Scholar 

  19. Ryding EL, Wijma B, Wijma K, Rydhstrom H (1998) Fear of childbirth during pregnancy may increase the risk of emergency caesarean section. Acta Obstet Gynecol Scand 77:542–547

    Article  CAS  PubMed  Google Scholar 

  20. Sydsjo G, Sydsjo A, Gunnervik C, Bladh M, Josefsson A (2011) Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy. Acta Obstet Gynecol Scand 91(1):44–49. doi:10.1111/j.1600-0412.2011.01242.x

    Article  PubMed  Google Scholar 

  21. Elvander C, Cnattingius S, Kjerulff KH (2013) Birth experience in women with low, intermediate or high levels of fear: findings from the first baby study. Birth 40(4):289–296

    Article  PubMed  Google Scholar 

  22. Heimstad R, Dahloe R, Laache I, Skogvoll E, Schei B (2006) Fear of childbirth and history of abuse: implications for pregnancy and delivery. Acta Obstet Gynecol Scand 85:435–440

    Article  PubMed  Google Scholar 

  23. Johnson R, Slade P (2002) Does fear of childbirth during pregnancy predict emergency caesarean section? Br J Obstet Gynaecol 109:1213–1221

    Article  Google Scholar 

  24. Handelzalts JE, Fisher S, Lurie S, Shalev A, Golan A, Sadan O (2012) Personality, fear of childbirth and cesarean delivery on demand. Acta Obstet Gynecol Scand 91:16–21. doi:10.1111/j.1600-0412.2011.01287.x

    Article  PubMed  Google Scholar 

  25. Karlstrom A, Lindgren H, Hildingsson I (2013) Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish case–control study. Br J Obstet Gynaecol 120(4):479–486. doi:10.1111/1471-0528.12129

    Article  CAS  Google Scholar 

  26. Nilsson C, Lundgren I, Karlstrom A, Hildingsson I (2012) Self reported fear of childbirth and its association with women’s birth experience and mode of delivery: a longitudinal population-based study. Women Birth 25:114–121

    Article  PubMed  Google Scholar 

  27. Størksen HT, Garthus-Niegel S, Vangen S, Eberhard-Gran M (2013) The impact of previous birth experiences on maternal fear of childbirth. Acta Obstet Gynecol Scand 92:318–324. doi:10.1111/aogs.12072

    Article  PubMed  Google Scholar 

  28. Reiss S, Peterson RA, Gursky DM, McNally RJ (1986) Anxiety sensitivity, anxiety frequency, and prediction of fearfulness. Behav Res Ther 24:1–8

    Article  CAS  PubMed  Google Scholar 

  29. Lang AJ, Sorell JT, Rodgers CS, Lebeck MM (2006) Anxiety sensitivity as predictor of labor pain. Eur J Pain 10:263–270

    Article  PubMed  Google Scholar 

  30. Cohen J (1977) Statistical power analysis for the behavioral sciences, revised edn. Lawrence Erlbaum Associates Inc., Hillsdale

    Google Scholar 

  31. Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191

    Article  PubMed  Google Scholar 

  32. Kotov R, Gamez W, Schmidt F, Watson D (2010) Linking “big” personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychol Bull 136:768–821. doi:10.1037/a0020327

    Article  PubMed  Google Scholar 

  33. Connor-Smith JK, Flachsbart C (2007) Relations between personality and coping: a meta-analysis. J Pers Soc Psychol 93(6):1080–1107

    Article  PubMed  Google Scholar 

  34. Alehagen S, Wijma B, Wijma K (2006) Fear of childbirth before, during, and after childbirth. Acta Obstet Gynecol Scand 85:56–62

    Article  PubMed  Google Scholar 

  35. Elvander C, Cnattingius S, Kjerulff KH (2013) Birth experience in women with low, intermediate or high levels of fear: findings from the first baby study. Birth 40(4):289–296

    Article  PubMed  Google Scholar 

  36. Nunnally JC, Bernstein IH (1994) Psychometric theory, 3rd edn. McGraw Hill, New York

    Google Scholar 

  37. Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmaki E, Saisto T (2013) Obstetric outcome after intervention for severe fear of childbirth in nulliparous women—randomized trial. Br J Obstet Gynaecol 120:75–84. doi:10.1111/1471-0528.12011

    Article  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest, have had full control of all primary data and they agree to allow the journal to review their data if requested.

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Authors and Affiliations

  1. Department of Psychology, The Academic College of Tel Aviv-Jaffa, 14 Rabenu Yeruham st., P.O. Box 8401, 68114, Tel-Aviv, Israel

    Jonathan E. Handelzalts & Marie-Paule Ahren

  2. Department of Psychology, The Center for Academic Studies, Or Yehuda, Israel

    Gideon Becker

  3. Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel

    Samuel Lurie, Nili Raz, Ziva Tamir & Oscar Sadan

Authors
  1. Jonathan E. Handelzalts
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  2. Gideon Becker
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  3. Marie-Paule Ahren
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  4. Samuel Lurie
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  5. Nili Raz
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  6. Ziva Tamir
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  7. Oscar Sadan
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Correspondence to Jonathan E. Handelzalts.

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Handelzalts, J.E., Becker, G., Ahren, MP. et al. Personality, fear of childbirth and birth outcomes in nulliparous women. Arch Gynecol Obstet 291, 1055–1062 (2015). https://doi.org/10.1007/s00404-014-3532-x

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  • DOI: https://doi.org/10.1007/s00404-014-3532-x

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