• 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.

    @aaronecarroll

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    • New dad here. From our childbirth classes, we learned that fear or anxiety during labor stimulates the release of adrenaline, which has the opposite effect of the oxytocin being produced to bring on contractions.

    • Really. You can’t imagine why one might tense up when anticipating pain? Aren’t there studies about that?
      As someone who has given birth, let me tell you that relaxing and letting everything open, is fairly important.
      And if it doesn’t open, then everything slows down and takes longer.
      This seems a little like those studies showing people with no money are hungrier than richer people or people with no health care get worse medical care. Which is to say, a little obvious.

    • Every pregnant woman I know has looked at her body, her husband and talked to her mother. The most worried were petite, narrow-hipped women married to big-boned guys and women whose mothers had difficulty during birth. The women least likely to worry were wide-hipped women married to smaller men. My guess is that women who fear labor more are more likely to have good reasons to worry and those reasons, not the fear, cause longer labor.

    • Dr. Grantley Dick-Read did this research and the results are in his book Childbirth Without Fear, original copyright date 1944. I am not confident that there is new information in this study (I have not yet read the actual study) based on the excerpts I have seen.