A cross-sectional study of low birth satisfaction among Iranian postpartum women during COVID-19 epidemics’ fifth wave

Abstract

Background : Birth dissatisfaction may increase the risk for postpartum depression and requests for an elective cesarean for the next birth. The outbreak of COVID-19 pandemic has had a considerable impact on the healthcare systems and their users in many aspects. We investigated predictors of birth satisfaction in a sample of Iranian postpartum women during the COVID-19 epidemics’ fifth wave. Methods : This cross-sectional study was conducted on 601 postpartum women admitted to postpartum wards of Mobini maternity hospital using a convenience sampling method between 2 Aug and 18 September 2021. We collected data on socio-demographic, obstetric, labor and birth, and psychological variables. We used the general linear model and multiple linear regression analyses to determine predictors of birth satisfaction. Results : The mean birth satisfaction score was 28.6±7.3. The percentages of mothers who gave birth by elective and emergency cesarean were 19.5% and 10.8%, respectively. Overall predictors of birth satisfaction were emergency cesarean [-7.463(-9.310, -5.616), instrumental birth [-3.571(-6.907, -0.235)], episiotomy [-2.227 ( -3.591, -0.862)], Entonox analgesia [-1.548(-2.726, -0.371)], Well-being score < 50 [-1.812(-3.146, -0.478)], fear of COVID -19 [-1.216(-2.288,, -0.144)], low satisfaction with pregnancy -2.539(-3.952, -1.127) and low satisfaction with spouse’s support [-2.419(-4.598, -0.240)]. Conclusions : During the pandemic, fear of COVID -19, low level of well-being, low satisfaction with pregnancy and low satisfaction with spouse’s support as well as women's experience of emergency cesarean, instrumental birth, episiotomy, and Entonox analgesia, are exerting negative influences on birth satisfaction. To improve birth satisfaction and thus maternal mental health interventions to lower fear of contracting COVID -19 and reduce rates of episiotomy, emergency cesarean, and instrumental birth are recommended.