Swedish midwives' perceptions of fear of childbirth.

OBJECTIVES: to describe midwives' experiences with, and perceptions of, women with fear of childbirth.

DESIGN: a qualitative study with a phenomenographic approach. Data were collected by means of interviews in focus groups.

SETTING: four focus groups at four types of hospital in Southern Sweden over a period of 18 months, 2004-2006.

PARTICIPANTS: 21 experienced midwives.

FINDINGS: four description categories emerged, i.e. appearance of fear of childbirth, origins of fear of childbirth, consequences of fear of childbirth, and fear of childbirth and midwifery care.

KEY CONCLUSION: fear of childbirth is seen as a continuum from normal to irrational, severe fear. It has various origins which are more or less difficult to operationalise. Fear of childbirth influences the experience of pregnancy, the labour process and the transition to parenthood. Midwifery care of women with fear of childbirth is emotionally demanding and time consuming. Aspects of care required early identification of women with fear of childbirth, individual care, preparation for giving birth, support of a companion during labour, and postpartum follow-up.