The lasting effects of fear of childbirth: parous women’s experiences of postponing or avoiding subsequent pregnancies

In research and clinical practice, fear of childbirth (FOC) is mainly identified and acknowledged during pregnancy. Hence, knowledge about how FOC affects women before and between pregnancies is limited. Here, we aimed to explore the experience of FOC among non-pregnant women who had previously given birth but were hesitant to become pregnant again despite a strong desire for more children. This study was part of a larger qualitative interview study exploring FOC among non-pregnant women and builds on eight semi-structured interviews. All participating women had given birth once or twice before. They longed for one or more children but were hesitant about another pregnancy and birth due to FOC. Six of them had experienced FOC during their last pregnancy. We analyzed the interviews using reflective thematic analysis. Through analysis, we identified five themes: “Fear disturbs my daily life and makes me avoid another pregnancy,” “Negative perinatal care experiences fueled my pre-existing fears,” “I want to control the mode of birth as I expect a worst-case scenario,” “I need professional support even if I’m not pregnant,” and “See me for who I am and listen to my specific needs.” These were summarized under the overarching theme: “In the grip of fear, striving to find a way out.” Despite the women’s desire for more children, fear led them to delay or avoid future pregnancies. This fear often originated before or during their first pregnancies and was sometimes intensified by traumatic childbirth experiences. A lack of professional support and individualized care left them feeling isolated and unsupported, which significantly impacted their lives and reproductive futures, illustrating their ongoing struggle to escape the grip of fear. The findings highlight an urgent need for support systems, addressing the psychological needs of women with FOC, not only during pregnancy but whenever support is needed throughout their reproductive lives. To help women manage their FOC and regain confidence in giving birth, it is essential to respect their individual concerns, choices, and preferences. Maternal care providers must be equipped to offer a broader range of options within maternal care to meet these needs. Fear of childbirth (FOC) is usually recognized during pregnancy, but we don’t know much about how it affects women before and between pregnancies. This study explored the experiences of non-pregnant women who had previously given birth but were hesitant to become pregnant again due to FOC, even though they wanted more children. The study involved eight interviews with women who had given birth once or twice. These women wanted more children but were uncertain about facing another pregnancy because of FOC. Six of them had experienced FOC during their last pregnancy. The analysis showed that the women’s fear often started before or during their first pregnancies and was sometimes worsened by traumatic birth experiences. The women also emphasized the need for professional support even when not pregnant and stressed the importance of being seen, heard, and treated as individuals. These experiences had a big impact on their lives and future pregnancies, showing their ongoing struggle to overcome their fear. The study highlights that women with FOC need psychological support throughout their reproductive period, not just during pregnancy. To help women manage their FOC and feel more confident about childbirth, it’s important to respect their unique concerns, choices, and preferences. Maternal care providers should be prepared to offer various options to meet these needs.