Abstract
BackgroundMaternal childbirth dissatisfaction has short- and long-term negative effects on the mothers’ health and life, as well as on relation with her child and family. Due to lack of studies in Iran and other counties, we aimed to determine pre- and during- labour predictors of low birth satisfaction.MethodsSeven hundred women with low risk singleton pregnancy participated in this prospective analytical study. The participants were hospitalized for vaginal delivery with fetus in cephalic presentation and gestational age of 370–416 at two teaching centers in Tabriz (Iran). Woman characteristics, anxiety state (using Spielberger inventory) and dehydration were assessed at cervical dilatation of 4–6 cm. Iranian (Persian) birth satisfaction scale-revised was applied 12–24 h after birth. Multiple linear regression was used to determine the predictors.ResultsExcluding 26 women who were outliers, 674 women were analyzed. The mean birth satisfaction score was 23.8 (SD 6.5) from an attainable score of 0–40. The during-labour predictors of low birth satisfaction score were severe and moderate anxiety, labour dystocia, insufficient support by staff, vaginal birth with episiotomy and tear, emergency cesarean section, labour induction and labour augmentation with oxytocin, and woman dehydration. The pre-labour predictors included being primiparous, sexual and emotional violence during pregnancy, gestational age of 400–416, preference for cesarean section, no attendance at pregnancy classes, and insufficient household income. The proportion of the variance explained by the during-labour variables was 75%, by pre-labour variables was 14% and by overall was 76%.ConclusionsThe controllable during-labour predictors explains most of the variance of the satisfaction score. It seems that responding to women’s physical and psychological needs during labour and applying less interventions could improve women’s childbirth satisfaction.
Highlights
Maternal childbirth dissatisfaction has short- and long-term negative effects on the mothers’ health and life, as well as on relation with her child and family
In a study conducted in Italy, the results showed that women with a higher level of educational attainment undergoing vaginal birth were more satisfied with childbirth compared to less educated ones [21]; or a study conducted in Iran indicated that there was no correlation between mode of childbirth and level of satisfaction [22]
Participant characteristics Data was collected between Oct 2018 and Jun 2019. 26 out of the 700 women were detected as multivariate outliers using Mahalanobis distances [40] and were excluded from analysis
Summary
Maternal childbirth dissatisfaction has short- and long-term negative effects on the mothers’ health and life, as well as on relation with her child and family. The multidimensional aspects of healthcare provision are receiving increasing attention within the framework of healthcare quality determined by the World Health Organization (WHO) [2]. Care during labour and childbirth should be woman-centred and be provided for women and newborns based on a comprehensive approach that is evidence-based and in line with human rights [5]. Through creating a negative experience of childbirth, dissatisfaction with childbirth can induce many problems such as woman psychological disorders, disrupted parent-child relations, severe fear of childbirth, sexual dysfunction [6], disrupted husband-wife relations, post-traumatic stress disorder [7], and reduced inclination to have another child or long intervals between pregnancies [8]
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