• Anne-Marie Sluijs, CleirenMarc P H DMPHDFaculty of Social Sciences, Honours College, Leiden University, Leiden, The Netherlands., van LithJan M MJMMDepartment of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands., Barbro Wijma, and Klaas Wijma.
• Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
• Birth. 2020 Mar 1; 47 (1): 144-152.

BackgroundIn The Netherlands, women with low-risk pregnancy are routinely given the option of home birth, providing a unique opportunity to study the relationship between fear of childbirth (FOC) and preference for childbirth location, and whether women experience higher FOC when the actual location differs from their preference.MethodsIn this prospective cohort study, 331 nulliparous and parous women completed a questionnaire at gestational week 30 (T1) and two months postpartum (T2). FOC was assessed using versions A (T1) and B (T2) of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ).ResultsAt T1, women who preferred home birth had significantly lower FOC compared with women who preferred a hospital birth (mean ± SD W-DEQ scores: 55 ± 19.8 and 64 ± 18.3, respectively, P < .01). About 28% of women who responded at T2 gave birth at home. Congruence between the preferred and actual childbirth location was not predictive of FOC assessed at T2 when adjusted for obstetric and psychological variables. In an extended analysis, we found that except for prepartum FOC, the following variables also correlated with postpartum FOC: being referred because of complications and poor neonatal condition.ConclusionsCompared to women who prefer hospital birth, women who prefer home birth have lower prepartum and postpartum FOC. Giving birth at a location other than the preferred location does not appear to affect postpartum FOC. Whether giving birth at home or in the hospital, caregivers should pay extra attention to women with high FOC because they are vulnerable to postpartum FOC, especially after a complicated birth and referral.© 2019 The Authors. Birth published by Wiley Periodicals, Inc.

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