{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:29:56Z","timestamp":1768433396994,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T00:00:00Z","timestamp":1611360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008376","name":"Helsingin ja Uudenmaan Sairaanhoitopiiri","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008376","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To evaluate the effect of method of induced abortion and other abortion\u2010associated variables on the incidence of fear of childbirth in subsequent pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This population\u2010based register study cohort includes all nulliparous women with their first pregnancy ending in an induced abortion in 2000\u20102015 and subsequent pregnancy with live singleton delivery between 2000 and 2017 (n\u00a0=\u00a021\u00a0479). Data were derived from three national registers maintained by the Finnish Institute for Health and Welfare. We divided the study population in three cohorts: (a) medical and (b) surgical abortion during first trimester (\u226484\u00a0days of gestation), and (c) medical abortion during second trimester (85\u2010168\u00a0days of gestation). Primary outcome measures were the incidence of registry\u2010identified fear of childbirth and cesarean delivery related to it.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall incidence of fear of childbirth was 5.6% (n\u00a0=\u00a01209). Altogether, 19.2% (n\u00a0=\u00a04121) of women underwent cesarean delivery. The odds were elevated especially for elective cesarean delivery (odds ratio [OR] 9.30, 95% CI 7.95\u201010.88, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) in women with fear of childbirth. In multivariable analysis, the odds for fear of childbirth (adjusted OR [aOR] 0.80, 95% CI 0.68\u20100.94) and cesarean delivery (aOR 0.66, 95% CI 0.84\u20100.90) were decreased in women with a history of first\u2010trimester medical abortion compared with those with first\u2010trimester surgical abortion. Second\u2010trimester medical abortion had no effect on the odds for fear of childbirth (aOR 1.04, 95% CI 0.71\u20101.50). Maternal age of 30\u201039\u00a0years and interpregnancy interval over 2\u00a0years were additional risk factors for both fear of childbirth and cesarean delivery, but surgical evacuation of uterus after the abortion was not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>One first\u2010 or second\u2010trimester medical abortion does not increase the odds for fear of childbirth, and cesarean delivery related to it in subsequent pregnancy when compared with first\u2010trimester surgical abortion. Older maternal age and longer interpregnancy interval emerged as risk factors for fear of childbirth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14078","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T09:39:43Z","timestamp":1609753183000},"page":"743-750","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Fear of childbirth after medical vs surgical abortion. Population\u2010based register study from Finland"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2834-6487","authenticated-orcid":false,"given":"Venla","family":"Kemppainen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0927-0472","authenticated-orcid":false,"given":"Maarit","family":"Niinim\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology PEDEGO Research Unit and Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aini","family":"Bloigu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology PEDEGO Research Unit and Medical Research Center Oulu University of Oulu and Oulu University Hospital Oulu Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terhi","family":"Saisto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Rouhe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Finnish Institute of Health and Welfare (THL) Helsinki Finland"},{"name":"Karolinska Institute Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-130X","authenticated-orcid":false,"given":"Oskari","family":"Heikinheimo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarit","family":"Mentula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12599"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.02002.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-275"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000222902.37120.2f"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340902998436"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02967.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(99)00413-5"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.srhc.2014.06.007"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2011.06.001"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02250.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12147"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00950.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0655-4"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12594"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12011"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-004047"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-004883"},{"key":"e_1_2_10_19_1","unstructured":"Statistical report 4\/2019. 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