ABSTRACT

Fear of childbirth (FOC), or tokophobia, can influence several medical and obstetric variables, and is a significant predictor of maternal and mental health outcomes and birth experiences. Current practice in the UK does not include initial screening for tokophobia, rather, assessment and support occur under extreme circumstances e.g. maternal requests for caesarean sections or pregnancy termination requests in order to avoid childbirth. Moreover, while there are several candidate outcome measures for FOC, none have been evaluated in terms of their perceived suitability by specialist practitioners within perinatal healthcare pathways. The present study explores the perceived barriers and facilitators reported by health professionals working within the maternity and mental health services for the use of FOC candidate outcome measures. Evaluated measures included the Fear of Birth Scale, the Oxford Worries about Labour Scale, The Wijma Delivery Expectancy Scale, the Slade-Pais Expectations of Childbirth Scale the Tokophobia Severity Scale. The Tokophobia Severity Scale, followed by the Slade-Pais Expectations of Childbirth Scales were the most favourable scales selected for use according to clinicians. The identification of preferred scales and how they can be used in the local maternity system is a step towards the application of these consistently in clinical practice, to aid in the identification and assessment of FOC. The use of the correct tool at each stage of contact with the local maternity system will improve clinician confidence in the identification of FOC and facilitate the efficient implementation of treatment and support through the development of pathways of care.

摘要

分娩恐惧症 (FOC) 或生育恐惧症会影响多种医疗和产科变量，并且是孕产妇和心理健康结果以及分娩经历的重要预测因素。英国目前的做法不包括对生育恐惧症的初步筛查，而是在极端情况下进行评估和支持，例如母亲要求剖腹产或终止妊娠以避免分娩的要求。此外，虽然 FOC 有多种候选结果指标，但围产期保健途径中的专家从业者尚未对它们的适用性进行评估。本研究探讨了在孕产和心理健康服务领域工作的卫生专业人员报告的使用 FOC 候选结果测量的障碍和促进因素。评估的指标包括出生恐惧量表、牛津担心分娩量表、维吉玛分娩预期量表、斯莱德-派斯分娩预期量表和生育恐惧症严重程度量表。临床医生选择使用的最有利的量表是生育恐惧症严重程度量表，其次是斯莱德-派斯分娩期望量表。确定首选量表以及如何在当地妇产系统中使用它们是朝着在临床实践中一致应用这些量表迈出的一步，以帮助识别和评估 FOC。在与当地妇产系统接触的每个阶段使用正确的工具将提高临床医生对 FOC 识别的信心，并通过制定护理途径促进有效实施治疗和支持。