Fear of childbirth and use of labor analgesia: A nationwide register-based analysis in Finland

Objective: To calculate the rates of labor analgesia among women with fear of childbirth (FOC) in multiparous and nulliparous women, because FOC might be associated with higher rates of labor analgesia. Methods: In this retrospective register-based cohort study, data from the National Medical Birth Register was used to evaluate the usage of labor analgesia in pregnancies with FOC, when compared with those without. The analgesia methods were stratified into neuraxial analgesia, pudendal, paracervical, nitrous oxide, other medical, other non-medical, and no analgesia. Results: A total of 19 285 pregnancies with diagnosed maternal FOC were found during our study period. The control group consisted of 757 997 pregnancies without diagnosed maternal FOC. Nulliparous women with diagnosed FOC had a higher rate of epidural analgesia (70.2% vs 67.1%), spinal analgesia (12.3% vs 7.6%), and pudendal block (17.6% vs 9.6%). Multiparous women with FOC had a notably higher rate for epidural analgesia (47.0% vs 29.0%). Conclusion: The main finding in this study was that women with diagnosed FOC had a higher rate of labor analgesia. The results of this study can be used by midwives, obstetricians, and anesthesiologists to provide optimal pain relief for mothers with FOC.