Antenatal fear of childbirth and emergency cesarean section delivery: A systematic narrative review

Backgorund: Fear of childbirth is a common feeling among expectant mothers. Although this feeling represents a physiological expression of women’s concerns, it can become a clinical condition that is characterized by several symptoms compromising the woman’s daily activities as well as her coping strategies during labor and delivery. Research has focused on adverse intrapartum and postpartum outcomes of fear of childbirth. As regards intrapartum outcomes, some studies have investigated the association between fear of childbirth and type of delivery, with contrasting results. Objective: The aim of this study was to review the literature on the association between fear of childbirth and emergency cesarean section delivery, specifically considering the issues of women’s parity and fear’s assessment instruments. Method: This systematic narrative review was based on an electronic database search of English-language published studies through December, 2018. Following the search process, 14 studies were included. Results: These studies revealed that both sample characteristics, specifically for parity, and assessment instruments (type and time) are not criteria for explaining the different result with respect to the association between fear and emergency cesarean section delivery. Conclusions: The importance of distinguishing between fear and severe fear was highlighted because the effect of fear on the type of delivery was present only for clinical fear. However, the different cut-off values included in the studies did not make it possible to reach a clear result, making further investigation necessary.