Mid Sweden University

Aim

National guidelines in Sweden suggest that certain ‘priority’ groups of pregnant women, including women with fear of childbirth (FOC), may benefit from increased continuity in midwifery care. Although comorbidity indeed exists between FOC and mental health problems, it might also be mediated by individual resources. The purpose of the study was to identify profiles of women based on FOC, depressive symptoms, major worries and sense of coherence (SOC) and to study those profiles in relation to women’s perceptions of changes occurring during pregnancy.

Methods

A longitudinal cohort study was conducted on 171 pregnant women with FOC or depressive symptoms in a rural area of Sweden, whose care was following a midwifery continuity of care (MCoC) model. After collecting data using two online questionnaires (in mid-pregnancy and 2 months after birth), addressing background and including validated instruments measuring FOC, depressive symptoms, major worries and SOC, a k-means cluster analysis was conducted to define profiles of women.

Results

The three identified clusters: Emotionally healthy, Fearful with resources and Emotionally fragile, showed no differences in socio-demographic background or type of MCoC model. However, major differences did emerge in women’s feelings and perceptions of changes during pregnancy, along with minor differences in health-related variables. Women in the Emotionally fragile cluster had less positive scores for most questionnaire items.

Conclusion

The results indicate levels of vulnerability within certain priority groups. In response, healthcare professionals should examine pregnant women’s backgrounds beyond screening in order to more fully understand their emotional states.