Women who fear labor spend more time in it

Anecdotally, I’ve found that women who have a harder time getting pregnant seem to have easier pregnancies and delivery. I have no real data on that, though, so I keep it to myself for the most part. But this study is interesting:

Objective  To assess the association between fear of childbirth and duration of labour.

Design  A prospective study of women from 32 weeks of gestation through to delivery.

Setting  Akershus University Hospital, Norway.

Population  A total of 2206 pregnant women with a singleton pregnancy and intended vaginal delivery during the period 2008–10.

Methods  Fear of childbirth was assessed by the Wijma Delivery Expectancy Questionnaire (W-DEQ) version A at 32 weeks of gestation, and defined as a W-DEQ sum score ≥ 85. Information on labour duration, use of epidural analgesia and mode of delivery was obtained from the maternal ward electronic birth records.

Main outcome measures   Labour duration in hours: from 3–4 cm cervical dilatation and three uterine contractions per 10 minutes lasting ≥1 minute, until delivery of the child.

The authors got more than 2200 women to fill out a questionnaire assessing how much they feared childbirth.  About 7.5% of women had a score which qualified them as having “fear”. In an unadjusted analysis, women who feared childbirth got to “enjoy” it for an extra 92 minutes. This could have been because of other factors that were associated with fear. So the researchers performed another analysis where they adjusted for “parity, counselling for pregnancy concern, epidural analgesia, labour induction, labour augmentation, emergency caesarean delivery, instrumental vaginal delivery, offspring birthweight and maternal age”. They found that even after all of this, women who feared childbirth endured it for an extra 47 minutes.

Additionally, women who feared childbirth were more likely to have a vaginal delivery that required the use of instruments, or an emergency caesarean.

I’m not sure why this is so, nor do the researchers. It may be that women who fear childbirth psych themselves out into a more painful labor. It may be a more complicated relationship between psychology and obstetrics. Regardless, the link appears real, and may be worth further investigation.


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