Abstract
Women’s subjective childbirth experience is a risk factor for postpartum depression and childbirth-related posttraumatic stress symptoms. Subjective childbirth experience is influenced not only by characteristics of the childbirth itself but also by maternal characteristics. A maternal characteristic that may be associated with a more positive childbirth experience is trait mindfulness. The current study aimed to assess this association and to assess whether trait mindfulness during pregnancy had a moderating role in the possible association between non-spontaneous delivery and perception of childbirth. A subsample of 486 women, participating in a longitudinal prospective cohort study (Holistic Approach to Pregnancy and the first Postpartum Year study), completed the Three Facet Mindfulness Questionnaire-Short Form at 22 weeks of pregnancy. Women completed the Childbirth Perception Scale and the Edinburgh Postnatal Depression Scale between 7 and 21 days postpartum. The mindfulness facets acting with awareness and non-reacting were significantly associated with a more positive perception of childbirth, after adjusting for covariates. Moderation analyses showed a significant interaction between acting with awareness and non-spontaneous delivery and non-judging and non-spontaneous delivery. Non-spontaneous delivery was associated with a more negative perception of childbirth for low/medium scores of acting with awareness and non-judging, but not for high scores on these mindfulness facets. Trait mindfulness during pregnancy may enhance a positive perception of childbirth. Because this is among the first studies examining the association between maternal dispositional mindfulness and perception of childbirth, future research is needed to confirm the results of the current study.
Highlights
Even though childbirth is usually experienced as painful and overwhelming, most women look back at it positively
The mindfulness facets acting with awareness and nonreacting were significantly inversely associated with the perception of childbirth
The current study showed that several aspects of maternal dispositional mindfulness were associated with a more positive postnatal perception of the mother’s most recent childbirth
Summary
Even though childbirth is usually experienced as painful and overwhelming, most women look back at it positively. Non-spontaneous delivery, including induced labor, instrumental vaginal delivery, and unplanned Caesarean section, has been associated with a more negative childbirth experience (Lobel and DeLuca 2007; Waldenstrom 1999; Waldenstrom et al 2004). Lower labor satisfaction was shown to be associated with the duration of the induction, mode of administration of the inducing agent, and more vaginal examinations (Shetty et al 2005). It should be noted, that rates of induction vary across western countries with lower rates in northern countries of Europe (Scandinavian, The Netherlands) and higher rates in southern countries. Primiparity, inaccurate expectations, lack of midwife and partner support, and anxiety and fear for labor during pregnancy as well as pain and lack of control during labor have been related to a more negative perception of childbirth (Hodnett 2002; Waldenstrom 1999; Waldenstrom et al 2004)
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