Article
Needs of pregnant women with severe fear of childbirth – Empirical foundation for women-centred maternity care
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Authors
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Sabine Striebich
- Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Institut für Gesundheits- und Pflegewissenschaft, Deutschland
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Gertrud M. Ayerle
- Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Institut für Gesundheits- und Pflegewissenschaft, Deutschland
| Published: | February 11, 2020 |
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Outline
Text
Background: Pregnant women with severe fear of childbirth are a vulnerable group of users in the maternity care system [1], [2]. Knowledge is required regarding experiences in maternity care in this country typical to pregnant women with severe fear of childbirth [3].
Aim/Research Question: What kind of experiences in the personal context and in antenatal care are significant for pregant women with FOC regarding to their fear? What coping strategies do they use?
Method: A systematic review was initially performed to identify interventions which could contribute towards overcoming fears and simultaneously increasing the self-efficacy of pregnant women and how these interventions are theoretically funded. In the subsequent empiric section, problem-centered interviews were conducted individually with twelve pregnant women who stated to be under mental strain because of their fear of childbirth. Collective frames of orientation and patterns of action orientation were reconstructed with the Documentary Method. A basic typology of ‘pregnant women with severe fear of childbirth’ was condensed, based on their collective orientations identified in the interviewees regarding the development of fear of childbirth in pregnancy, antenatal care, and birth preparation, the orientation towards birth and three types of coping mechanisms [4], [5].
Results: The interviewees lack the opportunity to talk about labour and birth in an affirming way in either the private or professional setting. They wish for a physiological birth and need the care of a skilled midwife in a trusting relationship, who addresses fear of birth early in pregnancy and offers support. Single or group psychoeducation with relaxation and complementary therapeutic conversation are effective interventions for pregnant women with severe fear of childbirth. Evidence-based information about labour and birth and care in hospital, about coping with pain and methods of pain relief, quality assured birth preparation with breathing and relaxation exercises and one-to-one care by a trusted midwife during labour and birth, have the potential to contribute to a positive birth experience.
Relevance: This phd study informs midwives, obstetricians and health policy stakeholders about the specific needs of pregant women with FOC.
Recommendation/Conclusion: Midwives need specific knowledge and skills to provide an appropriate and didactically effective care for pregnant women with severe fear of childbirth. This dissertation established the fundamental principles to be considered when developing a concept of care for severe fear of childbirth during pregnancy.
Ethics and conflicts of interest: A vote on ethics was obtained. The research was supported by external funding. There are no conflicts of interest.
References
- 1.
- Nilsson C, Hessman E, Sjoblom H, Dencker A, Jangsten E, Mollberg M, et al. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy and Childbirth. 2018; 18(1):28. DOI: 10.1186/s12884-018-1659-7
- 2.
- Kennedy HP, Yoshida S, Costello A, Declercq E, Dias MA, Duff E, et al. Asking different questions: research priorities to improve the quality of care for every woman, every child. The Lancet Global Health. 2016; 4(11):e777-e9. DOI: org/10.1016/S2214-109X(16)30183-8
- 3.
- Fisher C, Hauck Y, Fenwick J. How social context impacts on women’s fears of childbirth: a Western Australian example. Social Science & Medicine. 2006; 63(1):64-75. DOI: 10.1016/j.socscimed.2005.11.065
- 4.
- Striebich S, Ayerle GM. Große Angst vor der Geburt bei schwangeren Frauen in Deutschland: Erfahrungen und Orientierungen in Bezug auf die Schwangerenbetreuung und die Geburtsvorbereitung – eine rekonstruktive Studie. Zeitschrift für Hebammenwissenschaft. 2019; 7(1):35-43.
- 5.
- Striebich S, Ayerle GM. Fear of childbirth (FOC): pregnant women’s perceptions towards the impending hospital birth and coping resources – a reconstructive study. J Psychosom Obstet Gynaecol. 2019. DOI: 10.1080/0167482X.2019.1657822
