Does fear of childbirth or family history affect whether pregnant Dutch women prefer a home- or hospital birth?

• Published in: Midwifery Vol. 31; no. 12; pp. 1143 - 1148
• Main Authors: Sluijs, Anne-Marie, Cleiren, Marc P.H.D., Scherjon, Sicco A., Wijma, Klaas
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.12.2015
• Subjects: Adult; Anxiety; Choice Behavior; Cohort Studies; Delivery, Obstetric - methods; Delivery, Obstetric - psychology; Fear; Fear of childbirth; Female; FOC; Home birth; Home Childbirth - psychology; Humans; Labor, Obstetric - psychology; Midwifery; Netherlands; Nursing; Parturition - psychology; Patient Preference - statistics & numerical data; Place of birth; Preference; Pregnancy; Pregnant Women - psychology; Referral; Surveys and Questionnaires; Young Adult; Netherlands; Fear of childbirth; Place of birth; FOC; Home birth; Preference; Referral
• ISSN: 0266-6138; 1532-3099; 1532-3099
• DOI: 10.1016/j.midw.2015.08.002

it is a generally accepted idea that women who give birth at home are less fearful of giving birth than women who give birth in a hospital. We explored fear of childbirth (FOC) in relation to preferred and actual place of birth. Since the Netherlands has a long history of home birthing, we also examined how the place where a pregnant woman׳s mother or sisters gave birth related to the preferred place of birth. a prospective cohort study. five midwifery practises in the region Leiden/Haarlem, the Netherlands. 104 low risk nulliparous and parous women. questionnaires were completed in gestation week 30 (T1) and six weeks post partum (T2). no significant differences were found in antepartum FOC between those who preferred a home or a hospital birth. Women with a strong preference for either home or hospital had lower FOC (mean W-DEQ=60.3) than those with a weak preference (mean W-DEQ=71.0), t (102)=−2.60, p=0.01. The place of birth of close family members predicted a higher chance (OR 3.8) of the same place being preferred by the pregnant woman. Pre- to postpartum FOC increased in women preferring home- but having hospital birth. the idea that FOC is related to the choice of place of birth was not true for this low risk cohort. Women in both preference groups (home and hospital) made their decisions based on negative and positive motivations. Mentally adjusting to a different environment than that preferred, apart from the medical complications, can cause more FOC post partum. the decreasing number of home births in the Netherlands will probably be a self-reinforcing effect, so in future, pregnant women will be less likely to feel supported by their family or society to give birth at home. Special attention should be given to the psychological condition of women who were referred to a place of birth and caregiver they did not prefer, by means of evaluation of the delivery and being alert to anxiety or other stress symptoms after childbirth. These women have higher chance of fear post partum which is related to a higher risk of psychiatric problems. •No difference in fear of childbirth between women preferring home- or hospital birth.•Place of birth of woman׳s near family predicts her own preferred place of birth.•Women giving birth at the place they preferred, show decrease of fear post partum.•Women planning home birth but actually give birth in hospital, show increase of fear.