Background: To improve negative birth experiences among women who experience\nintense labor pain during labor, it is important to examine the relationship\nbetween fear of childbirth immediately after vaginal delivery and the\nactual intensity of labor pain. However, previous studies have generally evaluated\nlabor pain in a retrospective setting. Purpose: This study examined the\nrelationship between fear of childbirth immediately after vaginal delivery and\nthe actual labor pain intensity and accumulated labor pain intensity without\npharmacological pain relief during labor in Japan. Methods: A prospective\nobservational study was conducted between July 2015 and April 2016. Forty-\nseven pregnant Japanese women were available for analysis. Fear of childbirth\nwas measured by the Japanese version of the Wijma Delivery Expectancy/\nExperience Questionnaire (JW-DEQ) version B on the third day after vaginal\ndelivery. Participants with scores of 85 or higher were categorized in the\nhigh JW-DEQ group, having severe fear of childbirth. Labor pain intensity\nwas examined chronologically in real time with stepwise usage of two types of\nNumeric Rating Scale (NRS). Accumulated labor pain intensity was calculated\nusing the area under the curve (AUC). Results: Nine participants were\nin the high JW-DEQ group and eight of the nine were primiparae. Primiparae\nin the high JW-DEQ group experienced significantly longer duration and larger\naccumulated labor pain intensity between the onset of labor and 4 to 6 cm of\ncervical dilatation than those in the low JW-DEQ group (P = 0.024 and P =\n0.021, respectively). Conclusions/Implications for Practice: The latent\nphase of labor was a key stage to improve fear of childbirth immediately after\nvaginal delivery without pharmacological pain relief among Japanese primiparae.\nMidwives should give assistance in the latent phase of labor by focusing\non progressing labor smoothly and relieving labor pain to improve negative\nbirth experiences.
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