# Fear of Childbirth After Major Orthopedic Traumas: A Nationwide Multi‐Register Analysis

## TL;DR

This study found that women with major orthopedic traumas are more likely to have an increased rate of elective cesarean birth due to fear of childbirth, but not because of the fear itself.

## Contribution

The study provides new insights into how major orthopedic traumas may influence intended mode of delivery through fear of childbirth.

## Key findings

- Women with spine fractures had the highest adjusted odds for elective cesarean birth as intended delivery mode.
- There was no significant difference in fear of childbirth between trauma groups and the control group.
- Major trauma itself is likely responsible for increased elective cesarean birth rates.

## Abstract

The aim of this study was to evaluate the association between previous major traumas and the prevalence of fear of childbirth (FOC) and the subsequent effects of FOC on the intended mode of delivery.

In this nationwide retrospective register‐based cohort study, data from the Care Register for Health Care were linked with the National Medical Birth Register (MBR) to evaluate the prevalence of FOC after major traumas. A total of 18,573 pregnancies met the inclusion criteria. A multivariable logistic regression model was used to assess the effects of FOC on the intended mode of delivery. Women with major traumas before pregnancy were compared to individuals with wrist fractures. Adjusted odds ratios (aORs) with 95% CIs between the groups were compared.

Of those pregnancies that occurred after major traumas, 785 (6.2%) women were diagnosed with FOC after traumatic brain injury (TBI), 111 (6.1%) women after spine fracture, 38 (5.0%) women after pelvic fracture, 22 (3.2%) women after hip or thigh fracture, and 399 (5.2%) women in the control group. Among those women diagnosed with FOC, the adjusted odds for elective CB as an intended mode of delivery were highest among women with previous spine fractures (aOR 2.28, CI 1.45–3.60) when compared to the control group.

We found no evidence of differences in maternal FOC in patients with preceding major traumas when compared to the control group. Therefore, it seems highly likely that the major trauma itself is the explanatory factor for the increased rate of elective CB.

The incidence of fear of childbrith after major orthopedic traumas.