This thesis describes the relation of fear of childbirth (FOC), measured pre- and postpartum, with the preferred and actual place and mode of giving birth and with the use of pharmacological pain... Show moreThis thesis describes the relation of fear of childbirth (FOC), measured pre- and postpartum, with the preferred and actual place and mode of giving birth and with the use of pharmacological pain relief during labour. The studies were embedded in the Dutch obstetric system, where midwives have an independent profession and where home birth is an accepted option for women with a low-risk pregnancy. The general finding, consistent across all studies in this thesis, is that the level of FOC in pregnancy was strongly related to, and predictive of the level of postpartum FOC. Furthermore, women with severe FOC during pregnancy were prone to preferring a hospital birth, having pharmacological pain relief during labour and requesting an elective Caesarean Section. Congruence between one’s own preference (of place or mode of giving birth) and the actual delivery situation was not related to the degree of postpartum FOC. Instead, predictors for high postpartum FOC were: being referred from midwifery-led care to obstetrician-led care, emergency Caesarean Section, and a poor condition of the new-born. For guiding women with severe FOC through pregnancy and childbirth, a close collaboration between the obstetric caregiver and a psychotherapist is advised. Show less
Outcomes on effect, costs and experiences are identical for women with low-risk pregnancies who plan birth in a birth centre compared with women who plan to give birth in a hospital. Women who... Show moreOutcomes on effect, costs and experiences are identical for women with low-risk pregnancies who plan birth in a birth centre compared with women who plan to give birth in a hospital. Women who planned home birth had better outcomes on al aspects mentioned. Oppurtunities to easily optimize the outcomes for women who do not want to give birth at home, have been identified. Birth centres have the beste potential to easily implement these opportunities. After this implementantiona, and with the fact that more and more obstetric units in the Netherlands are dealing with capacitty problems, birth centres are an added value as birth location for women who don't plan to give birth at home. Show less
Hitzert, M.; Hermus, M.A.A.; Scheerhagen, M.; Boesveld, I.C.; Wiegers, T.A.; Akker-van Marie, M.E. van den; ... ; Graaf, J.P. de 2016
