Psychological aspects of childbirth: Evidence for a birth‐related mindset

Abstract

Psychological research on childbirth is rare, even though research from other scientific fields such as obstetrics or midwifery highlights the importance of psychological factors in childbirth. In this article, the theoretical construct of a birth‐related mindset and direct and indirect measures for assessing the mindset are proposed. It is assumed that childbirth can be mentally presented as a rather natural (natural mindset) or a rather medicalized (medicalized mindset) event. In three online studies (Study 1: N = 117, Study 2: N = 206, Study 3: N = 192), we aimed to explore whether the proposed birth‐related mindset is related to the retrospectively reported process of labor and birth (operationalized, e.g., by performed interventions, duration of birth, place of birth). For this, the relation between the mothers’ birth‐related decisions and outcomes of childbirth and the mothers' birth‐related mindsets were analyzed. Results indicated that (1) birth‐related criteria such as place of birth, epidural anesthesia, and C‐sections were associated with the birth‐related mindset, (2) these aspects of the delivery were related to the evaluation of the birth (birth experience), (3) the birth‐related mindset moderated the relationship between C‐section and birth experience, and (4) the indirect measures had little to no added explanatory value to the developed Mindset and Birth Questionnaire. Thus, the results indicate that the birth process experienced by the women and the mental representations of birth (birth‐related mindset) are closely related. Future studies need to investigate to what extend the experienced birth process influences the mindset of birth, or the mindset the experienced birth process, or both.

Childbirth fear, birth-related mindset and knowledge in non-pregnant women without birth experience

“…The participants first answered demographic and birth-related questions in the online questionnaire. Then they filled in the childbirth fear questionnaire (Childbirth Fear Prior to Pregnancy Questionnaire CFPP [ 30 ]), knowledge questionnaire, and the medical versus natural mindset questions (Mindset and Birth Questionnaire MBQ [ 33 ]):…”

“…The Mindset and Birth Questionnaire (MBQ) [ 33 ] was used to assess birth-related mindset. The MBQ is a self-report instrument with originally 18 items which include trust in midwives, negative view of drug support, low shame and disgust sensitivity, and positive view of vaginal birth.…”

The mindset of birth predicts birth outcomes: Evidence from a prospective longitudinal study

“…Natural birth views focus instead on methods to minimize interventions during labor and birth (Cosans, 2004). Based on these two views -which are common among professionals and laypersons (Hoffmann & Banse, 2021;Preis & Benyamini, 2017;Preis et al, 2018;Wilson & Sirois, 2010) -and the general notion that mindsets impact behavior (e.g., Dweck, 2012;Job et al, 2010), Hoffmann and Banse (2021) proposed the construct of a birth-related mindset and developed and validated a questionnaire -the Mindset and Birth questionnaire (MBQ).…”

“…A factor closely associated with labor and birth is the birth experience, the women's subjective evaluation of the birth. Existing studies suggest that unexpected medical problems (Waldenströmet al, 2004) and corresponding births resulting in a C-section (DiMatteo et al, 1996) as well as other performed interventions (Hoffmann & Banse, 2021) are associated with a poorer birth experience. A negatively perceived birth experience can have a negative impact on the mother-child interaction even months after birth (DiMatteo et al, 1996;Durik et al, 2000) and on the occurrence of postpartum depression (Bell & Andersson, 2016) and posttraumatic stress symptoms (Garthus-Niegel et al, 2013;Slade, 2006).…”

“…Birth experience. The birth experience was assessed with the Birth experience scale (Hoffmann & Banse, 2021). The 10-item scale includes questions about happiness and other birth-related feelings (e.g., confidence).…”