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HEALTH

Fear of childbirth leads to longer labour: study

Pregnant women with a fear of childbirth need about an hour and a half more to bring their babies into the world than mums who take a more relaxed approach, a new Norwegian study has found.

Fear of childbirth leads to longer labour: study
Photo: Simona Balint (File)

Researchers at Akershus University Hospital made their findings after monitoring 2,206 pregnant women who planned to have natural births, medical news site Dagens Medisin reports.

The researchers tracked the women from the 32nd week of their pregnancies right up until they gave birth.

Some 7.5 percent of the respondents, who each filled out a detailed questionnaire, were found to fear giving birth. The study found that these women took an average of one hour and 32 minutes longer to give birth than the other budding mothers.     

Mums gripped by the fear factor spent an average of eight hours in labour, compared to six hours and 28 minutes for women who scored below 85 on the Wijma Delivery Expectancy Questionnaire.

“We reasoned that birth anxiety can affect the length of the birth in two different ways,” study co-author Samantha Salvesen Adams told Dagens Medisin.

“Birth anxiety can increase stress hormone levels. During the birth, an elevated stress hormone level can reduce contraction frequency, thereby delaying the birth.

“In addition, or alternatively, we believe that anxiety during a birth can affect communication between the woman giving birth and healthcare personnel, with possible consequences for the childbirth process,” said Adams.

Just over half of the women were first-time mothers, while the average age of participants was 30.9 years.

The study was first published last week in BJOG: An International Journal of Obstetrics & Gynaecology.

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HEALTH

When can doctors in Denmark refuse to continue treating patients?

General Practitioners in Denmark have the right to break off a patient-doctor relationship in specific circumstances.

When can doctors in Denmark refuse to continue treating patients?

Although doctors in Denmark have the right to decide not to continue treating a patient – requiring them to find a new GP – the circumstances in which this can happen are limited, and must be approved by health authorities.

The frequency in which the circumstances arise is also low. A doctor decided to no longer receive a patient on 375 occasions in 2016, according to the medical professionals’ journal Ugeskrift for Læger. The following year, newspaper Jyllands-Posten reported the figure at 458.

There are two main categories of circumstances in which a doctor can choose to take this step. The first is in instances of violent or threatening behaviour from the patient towards the doctor. 

The second (and most common) is when the doctor considers the relationship to have deteriorated to the extent that confidence has broken down, according to Ugeskrift for Læger.

It should be noted that patients are not bound by any restrictions in this regard, and can decide to change their GP without having to give any justification.

A patient also has the right to appeal against a doctor’s decision to ask them to find a new GP. This is done by appealing to the local health authority, called a Region in the Danish health system.

In such cases, a board at the regional health authority will assess the claim and if it finds in favour of the patient may order the doctor to attempt to repair the relationship.

Doctors cannot end a relationship with a patient purely because a patient has made a complaint about them to health authorities. This is because patients should have the option of making complaints without fear of consequences for their future treatment. 

However, if this is accompanied by the conclusion on the doctor’s part that there is no longer confidence in them on the part of the patient, they can remove the patient from their list.

The right to no longer see patients in the circumstances detailed above is provided by doctors’ collective bargaining agreements, the working conditions agreed on between trade unions and employer confederations under the Danish labour market system.

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