The Influence of Personality and Anxiety Traits on Birth Experience and Epidural Use in Vaginal Deliveries - A Cohort Study

Analysis of influencing factors of psychological birth trauma among postpartum women in China: A multicenter cross-sectional study based on the ABC-X model

BACKGROUND

Little is known about the influencing factors of psychological birth trauma (PBT) among postpartum women in China.

METHODS

A multicenter cross-sectional survey was conducted from April to June 2023 among 2230 women within one year postpartum by convenience sampling. The measurement tools were selected based on the classical ABC-X model. PBT (factor X) was assessed using the Psychological Birth Trauma Assessment Scale. Data on predictors were collected from three aspects, including birth events (factor A), women's coping resources (factor B), and perception of birth events (factor C). Univariate analysis, correlation analysis, and multivariate linear regression analysis were performed to identify the influencing factors of PBT.

RESULTS

Multivariate linear regression analysis results showed that induced labor onset (β' = 0.086, P < .001), preterm birth (β' = 0.049, P = .001), instrumental vaginal delivery (β' = 0.031, P = .039), neuroticism (β' = 0.229, P < .001), and negative cognitions of birth events (β' = 0.375, P < .001) were risk factors for PBT among postpartum women in China. Perceived social support (β' = -0.175, P < .001) and nursing support (β' = -0.117, P < .001) were protective factors. These factors accounted for 52.5 % of explained variances in PBT.

CONCLUSIONS

Multifaceted influencing factors of PBT were identified based on the ABC-X model. Such efforts seem to provide information for identifying women at high risk of PBT and formulating interventions aimed at preventing or reducing PBT and its associated adverse consequences. Additional well-designed studies are required to validate our findings and deepen the understanding of this topic.

A longitudinal study of the subjective birth experience and the relationship to mental health

BACKGROUND

A satisfying birth experience has positive effects on the well-being of mother and child. The birth experience depends on subjective expectations and objective birth parameters, and the view of birth can also change over time. However, it is still unclear how birth anxiety and mode of birth affect the different dimensions of the birth experience in the first months after childbirth.

METHODS

In this prospective longitudinal study, 307 first-time mothers, planning to give birth vaginally, were assessed for fear of childbirth at approximately 34 weeks of gestation and for obstetric information. Postpartum birth experience and psychological stress was evaluated 2 days, 6 weeks and 6 months postpartum using the validated Childbirth Experience Questionnaire which comprises the four dimensions emotional experience, participation, professional support and coping possibilities, and a visual analogue scale for a global birth judgement, supplemented by the Edinburgh postpartum depression scale and the Impact of Event Scale.

RESULTS

The individual dimensions of the birth experience changed differently within the first six months. Mixed factorial ANOVAs identified a main effect of fear of childbirth for all four dimensions of the birth experience and the global birth judgment. Mode of birth influenced the dimension participation and the global judgement. For emotional experience, a complex interplay between fear of birth, birth mode and time was revealed. Correlation analyses showed significant associations between the birth experience and the psychological distress symptoms resulting from childbirth.

CONCLUSIONS

Prepartum fear of childbirth affects all dimensions of the subjective birth experience, even after six months. Birth mode, on the other hand, only affects the global birth judgement and participation. The stable correlations between the different dimensions of the birth experience and maternal mental health highlight the importance of the birth experience for clinical practise.

TRAIL REGISTRATION

Registered in the German Clinical Trials Register ("DRKS") (No. DRKS00022177) on 22 June 2020 ( https://drks.de/search/en/trial/DRKS00022177 ).

Neuroticism trait and postnatal depression among Chinese women: the mediating role of childbirth experience and the moderating role of perceived social support

BACKGROUND

Despite the link between neuroticism trait and postnatal depression has been confirmed, little is known about the factors that influence this association. This study aimed to examine whether childbirth experience mediated the association between neuroticism trait and postnatal depression, and whether this indirect effect was moderated by perceived social support.

METHODS

A cross-sectional study was conducted with 1686 women within one year postpartum from 38 hospitals in China. Participants completed anonymous questionnaires measuring neuroticism trait, postnatal depression, childbirth experience, perceived social support, and demographic and obstetric variables. Data were analyzed using SPSS 26.0 and PROCESS 4.0.

RESULTS

The prevalence of postnatal depression among Chinese women was 24.1%, higher than the global pooled prevalence. The results showed a positive correlation between neuroticism trait and postnatal depression, which was partially mediated by childbirth experience. The negative correlation between neuroticism trait and childbirth experience was moderated by perceived social support. Specifically, the negative impact of neuroticism trait on childbirth experience was stronger among women with high perceived social support.

CONCLUSIONS

Our findings highlight the critical importance of interventions dedicated to improving the childbirth experience, which may help reduce postnatal depression. Moreover, neuroticism and perceived social support are highly correlated and must be considered simultaneously to inform individualized interventions for postnatal depression.

Personality traits, childbirth expectations, and childbirth experiences: a prospective study

OBJECTIVES

The current study investigated the role of multiple psychological factors in predicting women's subjective birthing experiences.

METHODS

An online prospective survey methodology was conducted with women in the US who had never before given birth. Participants (N = 101) completed surveys regarding their personality traits, childbirth fear, and childbirth self-efficacy in their third trimester of pregnancy (range 28-40 weeks gestation). After giving birth (range 5-50 days post birth), participants (N = 58) completed a measure of subjective childbirth experience.

RESULTS

Significant correlations were found between personality traits, childbirth fear, childbirth self-efficacy, and subjective childbirth experience. Neuroticism, fear, and self-efficacy were all correlated with childbirth experiences. However, regression analysis indicated that only childbirth fear significantly predicted subjective childbirth experiences.

CONCLUSIONS

While previous research has looked at the relationships between personality and expectations or personality and experiences separately, the current findings underscore the importance of including all variables in order to get the most effective picture of the relationships among these variables. The results from the current study can inform methods of identifying women at-risk for negative birth expectations and inform interventions aimed at reducing negative childbirth experiences.

Personality impacts fear of childbirth and subjective birth experiences: A prospective-longitudinal study

Background

Previous research suggests that less emotionally stable, less conscientious, less extraverted, and less agreeable women tend to suffer from higher fear of childbirth and experience their delivery as worse. Moreover, there is evidence that birth characteristics and unexpected incidents during delivery may impact women’s birth experiences. However, it remains unknown whether the role of personality in subjective birth experiences varies between women with different birth characteristics.

Methods

We used data from the Maternal Anxiety in Relation to Infant Development (MARI) Study, a regional-epidemiological study among pregnant women, who were prospectively followed up in multiple waves across the peripartum period. During pregnancy, personality was assessed with the short version of the Big Five Inventory. The Wijma Delivery Expectancy/ Experience Questionnaire was used to measure fear of childbirth (version A) during pregnancy and subjective birth experiences (version B) within the first 10 days after delivery.

Results

Linear regressions revealed that lower levels of emotional stability, agreeableness, and extraversion predicted higher fear of childbirth during pregnancy. Moreover, personality affected subjective birth experiences especially in women with specific birth characteristics: Lower emotional stability predicted worse subjective birth experiences in women with (vs. without) a preterm delivery, and higher conscientiousness predicted worse subjective birth experiences in women with an emergency cesarean section (vs. spontaneous delivery). Subjective birth experiences were also worse in less emotionally stable and less open women with (general) anesthesia (vs. no anesthesia) during delivery. Finally, higher emotional stability predicted a subjective birth experience that was worse than expected, particularly in multiparous women and women without anesthesia during delivery.

Conclusions

These findings suggest that less emotionally stable, less conscientious, and less open women tend to experience their delivery as worse particularly in case of unexpected incidents (i.e., preterm delivery, emergency cesarean section, and necessity of anesthetics) and might thus profit from early targeted interventions.

Predictors of Negative Childbirth Experiences Among French Women

OBJECTIVES

To describe the prevalence of negative childbirth experiences and to identify potential predictors, including demographic, prenatal, obstetric, and psychological factors, of these experiences among French women.

DESIGN

Descriptive, correlational, cross-sectional study.

SETTING

A maternity ward in a hospital located near Paris, France.

PARTICIPANTS

A total of 256 women between the ages of 18 and 46 years were recruited while hospitalized in the maternity ward 1 to 6 days after childbirth.

METHODS

Participants completed a personal information form and five self-report scales: the Dyadic Adjustment Scale, the General Self-Efficacy Scale, the State-Trait Anxiety Inventory, the Relationship Scales Questionnaire, and the Questionnaire Assessing the Childbirth Experience. We performed linear regression analyses and used scores on the Questionnaire Assessing the Childbirth Experience as the dependent variable. We considered prenatal, psychological, and obstetric factors as independent variables and adjusted results for covariates.

RESULTS

The prevalence of a negative childbirth experience was 23.3% among our participants. We identified primiparity, high anxiety trait scores, and an anxious attachment style as the prenatal variables that contributed significantly to negative perceptions of childbirth based on the first step of the regression analysis (R² = .18; p < .001). We evaluated objective birth-related variables during the second step and found that mode of birth and use of epidural analgesia were significative predictors of the negative childbirth experience (R² = 0.36; p < .001). The last set of variables included subjective birth-related factors, such as absence of the partner during birth and low perceived sense of control; these variables increased the explained variance from 36% to 69% (p < .001) and showed that these aspects were powerful predictors of a negative childbirth experience.

CONCLUSIONS

Given that some prenatal factors influence women's perceptions of their birth experiences, preventive measures can be implemented by health professionals to support women with risk factors. In the early postpartum period, health care professionals should focus on subjective variables of childbirth because they strongly predict the overall childbirth experience for women.