Can a simple assessment of fear of childbirth in pregnant women predict requests and use of non-urgent obstetric interventions during labour?

Irena K Veringa-Skiba; Esther I de Bruin; Bennie Mooren; Francisca J A van Steensel; Susan M Bögels

doi:10.1016/j.midw.2021.102969

Can a simple assessment of fear of childbirth in pregnant women predict requests and use of non-urgent obstetric interventions during labour?

Midwifery. 2021 Jun:97:102969. doi: 10.1016/j.midw.2021.102969. Epub 2021 Feb 27.

Authors

Irena K Veringa-Skiba¹, Esther I de Bruin², Bennie Mooren³, Francisca J A van Steensel⁴, Susan M Bögels⁴

Affiliations

¹ University of Amsterdam, Research Institute of Child Development and Education (RICDE), Research Priority Area Yield, Nieuwe Achtergracht 127, Amsterdam, WS 1018, the Netherlands. Electronic address: I.K.Veringa@uva.nl.
² University of Amsterdam, Research Institute of Child Development and Education (RICDE), Research Priority Area Yield, Nieuwe Achtergracht 127, Amsterdam, WS 1018, the Netherlands; UvA-minds, Academic Center of the University of Amsterdam, Banstraat 29, Amsterdam, JW 1071, the Netherlands.
³ University of Amsterdam, Research Institute of Child Development and Education (RICDE), Research Priority Area Yield, Nieuwe Achtergracht 127, Amsterdam, WS 1018, the Netherlands; Arkin Institute for Mental Health, Wisselwerking 46, 1112XR Diemen, the Netherlands.
⁴ University of Amsterdam, Research Institute of Child Development and Education (RICDE), Research Priority Area Yield, Nieuwe Achtergracht 127, Amsterdam, WS 1018, the Netherlands.

PMID: 33691226
DOI: 10.1016/j.midw.2021.102969

Abstract

Objective: To examine whether the Wijma Delivery Expectation Questionnaire (W-DEQ-A) and the one-item Fear of Childbirth-Postpartum-Visual Analogue Scale (FOCP-VAS) - measuring high FOC - are useful tools in predicting requested and received non-urgent obstetric interventions in pregnant women.

Design: A prospective cohort study.

Population and setting: Self-selected pregnant women from midwifery care settings (n=401).

Methods: W-DEQ-A and FOCP-VAS were assessed at two timepoints in pregnancy. Measures of non-urgent obstetric interventions which were derived from medical files were: induction of labour, epidural analgesia, augmentation with oxytocin due to failure to progress and self-requested caesarean section. Hierarchical logistics regression models were used.

Main outcome measures: The change in the Nagelkerke R² was examined for three models predicting two outcome measures: (1) explicitly requested non-urgent obstetric interventions during pregnancy and (2) received non-urgent obstetric interventions during labour. The first model only included participants' characteristics, the second model also included FOCP-VAS ≥5, and in the third model the W-DEQ-A ≥66 was added.

Results: High FOC measured with FOCP-VAS≥5 predicted requested (pseudo-R²=0.33, X²=59.82, P<0.001) and received non-urgent obstetric interventions (pseudo-R²=0.19, X²=32.81, P<0.001) better than high FOC measured with W-DEQ-A≥66.

Conclusion: This study is the first evaluating self-reported FOC and postpartum based on VAS (subjective outcome) in relation to actual pregnancy and childbirth outcomes derived from medical files (objective outcome). Non-urgent obstetric interventions could already be predicted in the first half of pregnancy by means of a simple FOC assessment with the one-item FOCP-VAS. Implementing this easy to use one-item screening tool in midwifery care is suggested.

Keywords: Fear of childbirth; Obstetric interventions; Screening; Visual analogue scale; Wijma delivery expectation questionnaire.

MeSH terms

Cesarean Section*
Delivery, Obstetric
Fear
Female
Humans
Parturition
Pregnancy
Pregnant Women*
Prospective Studies
Surveys and Questionnaires