{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T10:11:59Z","timestamp":1781863919470,"version":"3.54.5"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"region \u00f6sterg\u00f6tland and link\u00f6ping university","award":["815081"],"award-info":[{"award-number":["815081"]}]},{"name":"region \u00f6sterg\u00f6tland and link\u00f6ping university","award":["938249"],"award-info":[{"award-number":["938249"]}]},{"DOI":"10.13039\/501100003945","name":"Link\u00f6ping University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Womens Ment Health"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The primary aim of the study was to analyze differences in post-traumatic stress symptoms (PTSS) and quality of life (QoL) between women with and without severe fear of childbirth postpartum (PP FOC). The secondary aims were to analyze the correlation between PP FOC and PTSS, and PP FOC and QoL, in women undergoing complicated childbirth. This cross-sectional study was conducted in South-East Sweden. Women aged\u2009\u2265\u200918\u00a0years who had undergone complicated childbirth (i.e., acute or emergency cesarean section, vacuum extraction, child in need of neonatal care, manual placenta removal, sphincter rupture, shoulder dystocia, or hemorrhage\u2009\u2265\u20091000\u00a0ml) were invited. Seventy-six women answered demographic questions and three validated instruments measuring PP FOC, PTSS, and QoL. The study population was divided into two sub groups: severe PP FOC or no severe PP FOC. Statistical analyses were conducted using Mann\u2013Whitney <jats:italic>U<\/jats:italic>-test, chi-square test or Fisher\u2019s exact test, and Spearman\u2019s rank-order correlation. Severe PP FOC was reported by 29% of the women, and 18% reported PTSS indicating post-traumatic stress disorder. Women with severe PP FOC reported significantly higher levels of PTSS, and significantly lower QoL in five dimensions: physical role functioning, emotional role functioning, energy\/fatigue, emotional well-being, and social functioning. There was a positive significant correlation between level of PP FOC and PTSS. There were also significant negative correlations between level of PP FOC and most of the QoL dimensions. In conclusion, almost one-third of the women with complicated childbirth reported severe PP FOC, and almost one-fifth reported PTSS indicating post-traumatic stress disorder. PP FOC correlated with PTSS and deteriorated QoL.<\/jats:p>","DOI":"10.1007\/s00737-022-01219-7","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T16:41:50Z","timestamp":1646152910000},"page":"485-491","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Fear of childbirth postpartum and its correlation with post-traumatic stress symptoms and quality of life among women with birth complications \u2014 a cross-sectional study"],"prefix":"10.1007","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0260-8194","authenticated-orcid":false,"given":"Hanna","family":"Grundstr\u00f6m","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Malmquist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Ivarsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elin","family":"Torbj\u00f6rnsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Walz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katri","family":"Nieminen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,1]]},"reference":[{"key":"1219_CR1","volume-title":"Quick reference to the diagnostic criteria from DSM-IV-TR","author":"American Psychiatric Association","year":"2002","unstructured":"American Psychiatric Association (2002) Quick reference to the diagnostic criteria from DSM-IV-TR. Pilgrim Press, Malm\u00f6"},{"issue":"3","key":"1219_CR2","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1097\/01.grf.0000129919.00756.9c","volume":"47","author":"S Ayers","year":"2004","unstructured":"Ayers S (2004) Delivery as a traumatic event: prevalence, risk factors, and treatment for postnatal posttraumatic stress disorder. Clin Obstet Gynecol 47(3):552\u2013567. https:\/\/doi.org\/10.1097\/01.grf.0000129919.00756.9c","journal-title":"Clin Obstet Gynecol"},{"issue":"2","key":"1219_CR3","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.midw.2013.12.001","volume":"30","author":"S Ayers","year":"2014","unstructured":"Ayers S (2014) Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care. Midwifery 30(2):145\u2013148. https:\/\/doi.org\/10.1016\/j.midw.2013.12.001","journal-title":"Midwifery"},{"issue":"3","key":"1219_CR4","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1111\/scs.12144","volume":"29","author":"M Barimani","year":"2015","unstructured":"Barimani M, Oxelmark L, Johansson S-E, Hylander I (2015) Support and continuity during the first 2 weeks postpartum. Scand J Caring Sci 29(3):409\u2013417. https:\/\/doi.org\/10.1111\/scs.12144","journal-title":"Scand J Caring Sci"},{"key":"1219_CR5","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1016\/j.brat.2003.07.010","volume":"41","author":"M Creamer","year":"2003","unstructured":"Creamer M, Bell R, Falilla S (2003) Psychometric properties of the Impact of Event Scale Revised. Behav Res Ther 41:1489\u20131496. https:\/\/doi.org\/10.1016\/j.brat.2003.07.010","journal-title":"Behav Res Ther"},{"issue":"4","key":"1219_CR6","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.midw.2012.09.006","volume":"29","author":"U Dahlberg","year":"2013","unstructured":"Dahlberg U, Aune I (2013) The woman\u2019s birth experience-the effect of interpersonal relationships and continuity of care. Midwifery 29(4):407\u2013415. https:\/\/doi.org\/10.1016\/j.midw.2012.09.006","journal-title":"Midwifery"},{"issue":"1","key":"1219_CR7","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1891\/1058-1243.23.1.17","volume":"23","author":"E Declercq","year":"2014","unstructured":"Declercq E, Sakala C, Corry M, Applebaum S, Herrlich A (2014) Major survey findings of listening to mothers(SM) III: new mothers speak out: report of national surveys of women\u2019s childbearing eexperiences. J Perinat Educ 23(1):17\u201324. https:\/\/doi.org\/10.1891\/1058-1243.23.1.17","journal-title":"J Perinat Educ"},{"issue":"9","key":"1219_CR8","doi-asserted-by":"publisher","first-page":"2104","DOI":"10.1111\/j.1365-2648.2010.05371.x","volume":"66","author":"E Emmanuel","year":"2010","unstructured":"Emmanuel E, St John W (2010) Maternal distress: a concept analysis. J Adv Nurs 66(9):2104\u20132115. https:\/\/doi.org\/10.1111\/j.1365-2648.2010.05371.x","journal-title":"J Adv Nurs"},{"key":"1219_CR9","first-page":"152","volume":"11","author":"D Gulseren","year":"2018","unstructured":"Gulseren D, Dilek B, \u00d6zkan SA (2018) Depression, anxiety and quality of life of mothers in the early postpartum period. Int J Behav Sci 11:152\u2013159","journal-title":"Int J Behav Sci"},{"issue":"2","key":"1219_CR10","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/s02666138(96)90002-9","volume":"12","author":"S Halldorsdottir","year":"1996","unstructured":"Halldorsdottir S, Karlsdottir SI (1996) Journeying through labour and delivery: perceptions of women who have given birth. Midwifery 12(2):48\u201361. https:\/\/doi.org\/10.1016\/s02666138(96)90002-9","journal-title":"Midwifery"},{"issue":"11","key":"1219_CR11","doi-asserted-by":"publisher","first-page":"1668","DOI":"10.1007\/s10995-018-2565-3","volume":"22","author":"E Henshaw","year":"2018","unstructured":"Henshaw E, Cooper M, Jaramillo M, Lamp J, Jones A, Wood T (2018) \u201cTrying to figure out if you\u2019re doing things right, and where to get the info\u201d: parents recall information and support needed during the first 6 weeks postpartum. Matern Child Health J 22(11):1668\u20131675. https:\/\/doi.org\/10.1007\/s10995-018-2565-3","journal-title":"Matern Child Health J"},{"issue":"4","key":"1219_CR12","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1007\/s00737-017-0729-6","volume":"20","author":"MH Hollander","year":"2017","unstructured":"Hollander MH, van Hastenberg E, van Dillen J, van Pampus MG, de Miranda E (2017) Stramrood C (2017) Preventing traumatic childbirth experiences: 2192 women\u2019s perceptions and views. Arch Womens Ment Health 20(4):515\u2013523. https:\/\/doi.org\/10.1007\/s00737-017-0729-6","journal-title":"Arch Womens Ment Health"},{"issue":"1","key":"1219_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3109\/01674820309042796","volume":"24","author":"RC Johnson","year":"2003","unstructured":"Johnson RC, Slade P (2003) Obstetric complications and anxiety during pregnancy: is there a relationship? J Psychosom Obstet Gynecol 24(1):1\u201314. https:\/\/doi.org\/10.3109\/01674820309042796","journal-title":"J Psychosom Obstet Gynecol"},{"key":"1219_CR14","doi-asserted-by":"publisher","unstructured":"Kazemi F, Nahidi F, Kariman N (2017) Exploring factors behind pregnant women\u2019s quality of life in Iran: a qualitative study. Electron Physician 9(12):5991\u20136001. https:\/\/doi.org\/10.19082\/5991","DOI":"10.19082\/5991"},{"key":"1219_CR15","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102700","volume":"85","author":"M Khwepeya","year":"2020","unstructured":"Khwepeya M, Monsen K, Kuo S-Y (2020) Quality of life and the related factors in early postnatal women in Malawi. Midwifery 85:102700. https:\/\/doi.org\/10.1016\/j.midw.2020.102700","journal-title":"Midwifery"},{"issue":"6","key":"1219_CR16","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1111\/aogs.12634","volume":"94","author":"B Larsson","year":"2015","unstructured":"Larsson B, Karlstr\u00f6m A, Rubertsson C, Hildingsson I (2015) The effects of counseling on fear of childbirth. Acta Obstet Gynecol Scand 94(6):629\u2013636. https:\/\/doi.org\/10.1111\/aogs.12634","journal-title":"Acta Obstet Gynecol Scand"},{"key":"1219_CR17","doi-asserted-by":"publisher","first-page":"253","DOI":"10.3390\/ijerph16020253","volume":"16","author":"J Martinez-Galiano","year":"2019","unstructured":"Martinez-Galiano J, Hern\u00e1ndez-Mart\u00ednez A, Rodr\u00edguez-Almagro J, Delgado-Rodr\u00edguez M, Rubio-Alvarez A, G\u00f3mez-Salgado J (2019) Women\u2019s quality of life at 6 weeks postpartum: influence of the discomfort present in the puerperium. Int J Environ Res Public Health 16:253. https:\/\/doi.org\/10.3390\/ijerph16020253","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"1219_CR18","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.enfcli.2018.04.005","volume":"29","author":"C Martins","year":"2019","unstructured":"Martins C (2019) Transition to parenthood: consequences on health and well-being. A qualitative study. Enferm Clin 29(4):225\u2013233. https:\/\/doi.org\/10.1016\/j.enfcli.2018.04.005","journal-title":"Enferm Clin"},{"key":"1219_CR19","unstructured":"National Board of Health and Welfare (2017) Care after childbirth\u2014a national survey of postpartum care (In Swedish). https:\/\/www.socialstyrelsen.se\/globalassets\/sharepointdokument\/artikelkatalog\/ovrigt\/2017-413.pdf Accessed July 1 2021"},{"issue":"1","key":"1219_CR20","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s12884-018-1659-7","volume":"18","author":"C Nilsson","year":"2018","unstructured":"Nilsson C, Hessman E, Sj\u00f6blom H, Dencker A, Jangsten E, Mollberg M, Patel H, Sparud Lundin C, Wigert H, Begley C (2018) Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Preg Childb 18(1):28. https:\/\/doi.org\/10.1186\/s12884-018-1659-7","journal-title":"BMC Preg Childb"},{"issue":"3","key":"1219_CR21","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1016\/j.wombi.2015.10.009","volume":"29","author":"M Simpson","year":"2016","unstructured":"Simpson M, Catling C (2016) Understanding psychological traumatic birth experiences: a literature review. Women Birth 29(3):203\u2013207. https:\/\/doi.org\/10.1016\/j.wombi.2015.10.009","journal-title":"Women Birth"},{"issue":"3","key":"1219_CR22","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1111\/aogs.12072","volume":"92","author":"H St\u00f8rksen","year":"2013","unstructured":"St\u00f8rksen H, Garthus-Niegel S, Vangen S, Eberhard-Gran M (2013) The impact of previous birth experiences on maternal fear of childbirth. Acta Obstet Gynecol Scand 92(3):318\u2013324. https:\/\/doi.org\/10.1111\/aogs.12072","journal-title":"Acta Obstet Gynecol Scand"},{"key":"1219_CR23","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1016\/0277-9536(95)00125-q","volume":"41","author":"M Sullivan","year":"1995","unstructured":"Sullivan M, Karlsson J, Ware J (1995) The Swedish SF-36 Health Survey I. Evaluation of data quality, scaling assumptions populations, reliability and construct validity across general populations in Sweden. Soc Sci Med 41:1349\u20131358. https:\/\/doi.org\/10.1016\/0277-9536(95)00125-q","journal-title":"Soc Sci Med"},{"key":"1219_CR24","unstructured":"Sullivan M, Karlsson J, Taft C (2002) SF-36 H\u00e4lsoenk\u00e4t: Svensk Manual och Tolkningsguide. (In Swedish) Sahlgrenska universitetssjukhuset:G\u00f6teborg, Sweden"},{"key":"1219_CR25","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1192\/bjp.180.3.205","volume":"180","author":"E Sundin","year":"2002","unstructured":"Sundin E, Horowitz M (2002) Impact of Event Scale: psychometric properties. Br J Psychiatry 180:205\u2013209. https:\/\/doi.org\/10.1192\/bjp.180.3.205","journal-title":"Br J Psychiatry"},{"issue":"2","key":"1219_CR26","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1080\/01674820600712172","volume":"27","author":"J S\u00f6derquist","year":"2006","unstructured":"S\u00f6derquist J, Wijma B, Wijma K (2006) The longitudinal course of post-traumatic stress after childbirth. J Psychosom Obstet Gynaecol 27(2):113\u2013119. https:\/\/doi.org\/10.1080\/01674820600712172","journal-title":"J Psychosom Obstet Gynaecol"},{"issue":"5","key":"1219_CR27","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1111\/j.1471-0528.2008.02083.x","volume":"116","author":"J S\u00f6derquist","year":"2009","unstructured":"S\u00f6derquist J, Wijma B, Thorbert G, Wijma K (2009) Risk factors in pregnancy for post traumatic stress and depression after childbirth. BJOG 116(5):672\u2013680. https:\/\/doi.org\/10.1111\/j.1471-0528.2008.02083.x","journal-title":"BJOG"},{"key":"1219_CR28","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.ejogrb.2014.11.041","volume":"185","author":"D Van der Woude","year":"2015","unstructured":"Van der Woude D, Pijnenborg J, de Vries J (2015) Health status and quality of life in postpartum women: a systematic review of associated factors. Eur J Obstet Gynecol Reprod Biol 185:45\u201352. https:\/\/doi.org\/10.1016\/j.ejogrb.2014.11.041","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"1219_CR29","first-page":"399","volume-title":"Assessing psychological trauma and PTSD","author":"DS Weiss","year":"1997","unstructured":"Weiss DS, Marmar CR (1997) The Impact of Event Scale-Revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and PTSD. Guilford, New York, pp 399\u2013411"},{"key":"1219_CR30","doi-asserted-by":"crossref","unstructured":"Wijma K, Wijma B (2017) A woman afraid to deliver: how to manage childbirth anxiety. In: Bio-psycho social obstetrics and gynecology. Springer International Publishing, Switzerland","DOI":"10.1007\/978-3-319-40404-2_1"},{"issue":"2","key":"1219_CR31","doi-asserted-by":"publisher","first-page":"84","DOI":"10.3109\/01674829809048501","volume":"19","author":"K Wijma","year":"1998","unstructured":"Wijma K, Wijma B, Zar M (1998) Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol 19(2):84\u201397. https:\/\/doi.org\/10.3109\/01674829809048501","journal-title":"J Psychosom Obstet Gynaecol"},{"key":"1219_CR32","unstructured":"World Health Organization (2018) Definition of skilled health personnel providing care during childbirth. WHO\/RHR\/18.14. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/272817\/9789241514200-eng.pdf. Accessed 2020\u201302\u201306"},{"issue":"208","key":"1219_CR33","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1016\/j.jad.2016.10.009","volume":"15","author":"PD Yildiz","year":"2017","unstructured":"Yildiz PD, Ayers S, Phillips L (2017) The prevalence of posttraumatic stress disorder in pregnancy and after birth: a systematic review and meta-analysis. J Affect Disord 15(208):634\u2013645. https:\/\/doi.org\/10.1016\/j.jad.2016.10.009","journal-title":"J Affect Disord"}],"container-title":["Archives of Women's Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00737-022-01219-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00737-022-01219-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00737-022-01219-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T08:20:48Z","timestamp":1647246048000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00737-022-01219-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":33,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["1219"],"URL":"https:\/\/doi.org\/10.1007\/s00737-022-01219-7","relation":{},"ISSN":["1434-1816","1435-1102"],"issn-type":[{"value":"1434-1816","type":"print"},{"value":"1435-1102","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,1]]},"assertion":[{"value":"2 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. It was approved by the Swedish Ethical Review Authority 2019\u201311-28 (Reg. no. 2019\u201304820).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Consent for data publication was obtained from all participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}