OBSTETRIC OUTCOME IN 100 WOMEN WITH SEVERE ANXIETY OVER CHILDBIRTH

Background. Extreme fear of delivery with request of cesarean section is a problem. The obstetric outcome in women given psychological and o bstetric support is described. Methods. Women, consecutively referred to the Psychosomatic outpatient clinic because of fear of delivery (n= 100), were compared to a matched reference group (n=100). Results. The women in the study group had higher frequency of psychic problems tha n the references. The majority, 68 of the women (68%) initially reques ted cesarean section (CS). After individualized psychological and obst etrical support, 38 of these women agreed to vaginal delivery (38%) an d 30 had an elective CS (30%). Ln the end another 13 (13%) women had a CS for obstetric or mixed reasons. Complication rate was low and simi lar in the groups. The 57 women who eventually had a vaginal delivery (57%) showed an obstetric outcome similar to the reference group. They had a higher frequency of induction of labor (p=0.02), and of epidura l and pudendal blocks for pain relief (p=0.002 and 0.05 respectively). They had shorter labor time (p=0.05). The cost of the psychological t herapy was well compensated for by the savings due to the reduction in the number of CS. Conclusions. Psychosomatic support for women with s evere fear of delivery resulted in a 50% reduction of CS for psychosoc ial indications and vaginal deliveries similar to a reference group. T he cost of psychosomatic support was less than savings due to fewer ce sarean sections.