Changes in the basic birth beliefs following the first birth experience: Self-fulfilling prophecies?

Heidi Preis,Yoav Peled,Yael Benyamini,Joseph Pardo,Christine E East

doi:10.1371/journal.pone.0208090

Abstract

Women's basic beliefs about birth as a natural and as a medical process are associated with childbirth choices and experience. These beliefs have only recently been quantified and not much is known about their development. In the current study, we assessed the differential effects of the objective and the subjective birth experience on changes in these beliefs. Using self-report questionnaires, we evaluated prenatal to postpartum changes among 342 Israeli first-time mothers. Participants were recruited during pregnancy, between February 2016 and January 2017, mostly in clinical settings, and followed-up two months postpartum. On average, women's beliefs about birth being natural weakened following childbirth and their belief about birth being medical strengthened. In regression models, it was either the objective or the subjective experience that was related to change in the basic birth beliefs: A more medicalized birth was associated with strengthening of the medical belief while greater birth satisfaction was related to strengthening of the natural belief. A mediation effect was observed, which indicated that the beliefs are strengthened when the lived experience fulfilled women's expectation about birth being satisfying, natural or medical. This study adds to the growing body of knowledge regarding the development and evolution of the birth beliefs. It highlights the need to view the beliefs separately and to distinctively assess the objective and subjective birth experience. It supports the need to empower mothers, especially those who had more medicalized births or unsatisfactory ones, which would help conserve their belief in their body and in the normal physiological course of birth.

Highlights

People’s decision-making regarding health-related issues is heavily based on their beliefs and perceptions [1]
Haines et al [14] found that having a previous negative birth experience and having a cesarean delivery (CD) are related to viewing birth as less natural, suggesting that perhaps the lived birth experience might affect women’s perception of birth
Women approaching their first birth mostly agreed that birth is a natural process yet were more varied regarding the belief that it is a medical process

Summary

Introduction

People’s decision-making regarding health-related issues is heavily based on their beliefs and perceptions [1]. The birth experience is made up of two distinct yet intertwined constructs: the objective or actual birth (i.e. mode of delivery, interventions during birth) as well as the subjective birth experience (i.e. the cognitive appraisal or emotional experience of birth) [16] In their recent study, Haines et al [14] found that having a previous negative birth experience and having a CD are related to viewing birth as less natural, suggesting that perhaps the lived birth experience might affect women’s perception of birth. Having an emergency CD was found to be associated with an increase in fear of birth [17,18] and lower birth satisfaction was found to be related to an increase in postpartum depression [19,20] Those studies suggest that perceptions regarding birth can change following the objective or the subjective birth experience. We assume that changes in the beliefs could take place following childbirth and expect that more medicalized birth and or a more negative subjective experience will be related to strengthening of the medical birth beliefs and weakening of the natural birth belief

Participants

Procedure

Results

Discussion