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Labour fear 'boosts caesareans'

06/02/2008

Women's fear of childbirth increases the number of caesareans carried out each year, a new study claims.

Previous research into caesarean sections has looked into causes such as medical diagnoses, age and lifestyle factors.

The latest study, published in BJOG: An International Journal of Obstetrics and Gynaecology, examined expectations of childbirth among females due to give birth for the first time.

Nearly 500 first-time mothers with a healthy pregnancy at 37 to 39 weeks of gestation were involved in the study and a follow-up was carried out three months after delivery.

Women were divided into three groups: those who wanted an elective C-section, those who wanted a C-section because of breech delivery and women planning a vaginal delivery.

Prior to birth the women were asked questions about what they thought childbirth would be like, their levels of fear about labour and their anticipation about motherhood.

Over four in ten women requesting a caesarean were found to have a clinically significant fear of childbirth as a result of negative expectations of a vaginal delivery.

These women said they felt less happy before the delivery and were afraid their child would die.

Dr Ingela Wiklund from the division of obstetrics and gynaecology at the Karolinska Institute in Stockholm, Sweden, described the findings as "startling".

"Women suffering from significant childbirth fear indicate that they are less self-confident, unhappy, afraid that the child will be injured and don’t long for the child," she added.

"This clearly emphasises the need for pre and postnatal support."

BJOG editor-in-chief Professor Philip Steer said: "For each woman requesting to have a caesarean, as doctors, we provide them with a consultation on the advantages and disadvantages of the procedure.

"The overall c-section rate in the UK is high but comparable to other western countries. If we are to lower the numbers, we need to understand sympathetically why some women, with no medical reasons, are choosing to have caesareans."

He added: "Healthy women are sometimes criticised for choosing a c-section over a normal delivery. This study reveals that a psychological reason may be behind elective caesareans. Some women may be too scared, rather than too posh, to push."