Retrospective and anticipated childbirth-related fears: Findings from an Austrian postpartum survey

Abstract Background Childbirth-related fears can be assessed in pregnancy using validated tools. However, little is known about mothers’ retrospective appraisal of such fears and their current concerns regarding future births. Capturing postpartum reflections can offer valuable information for improving birth preparation and communication. This study investigated childbirth-related fears retrospectively and assessed current fears regarding a potential future birth. Methods Data from an Austrian online survey of 544 mothers (mean age: 31.00 ± 4.32 years) up to two years postpartum, were analysed. Fears were assessed using two single-item rating scales (0-10, with 10 indicating very high concern), measuring emotional burden related to the last and a potential future birth. Mothers were asked: “To what extent did you experience fears and worries related to your last childbirth?” and “To what extent would you feel fears and worries if thinking about a future childbirth?”. Seventeen literature-based specific concerns (e.g. pain, loss of control) were assessed dichotomously, with an additional free-text item. Results Most mothers reported future concerns about not achieving their preferred mode of birth (41%), the baby's long-term health (37%) and labour pain (36%). Only 10% reported no fears. Qualitative responses included medical emergencies (13%), lack of compassionate care (13%) and birth injuries (11%). The mean concern levels decreased significantly from the last to a potential future birth (5.04 ± 3.16 vs. 4.41 ± 3.29, p < 0.001). The highest concern levels were observed in mothers aged ≥35 years and those with a prior caesarean birth, but both groups showed significant declines over time (p < 0.001). Conclusions The results show both retrospective and anticipatory childbirth-related worries and fears. Strengthening woman-centred care and maternal health literacy may reduce fears and promote sustainable well-being. Key messages • Childbirth-related fears can persist beyond birth and could be assessed retrospectively to better understand how they may affect future birth experiences. • Implications for interprofessional care models and communication strategies addressing fear of birth should be further explored in Austria to strengthen maternal health literacy at multiple levels.