The Effect of Childbirth Self-Efficacy on Perinatal Outcomes

Abstract

Objective To synthesize and critique the quantitative literature on measuring childbirth self-efficacy and the effect of childbirth self-efficacy on perinatal outcomes. Data Sources Eligible studies were identified through searching MEDLINE, CINAHL, Scopus, and Google Scholar databases. Study Selection Published research using a tool explicitly intended to measure childbirth self-efficacy and also examining outcomes within the perinatal period were included. All manuscripts were in English and published in peer-reviewed journals. Data Extraction First author, country, year of publication, reference and definition of childbirth self-efficacy, measurement of childbirth self-efficacy, sample recruitment and retention, sample characteristics, study design, interventions (with experimental and quasi-experimental studies), and perinatal outcomes were extracted and summarized. Data Synthesis Of 619 publications, 23 studies published between 1983 and 2015 met inclusion criteria and were critiqued and synthesized in this review. Conclusions There is overall consistency in how childbirth self-efficacy is defined and measured among studies, facilitating comparison and synthesis. Our findings suggest that increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes. Moreover, there is evidence that childbirth self-efficacy is a psychosocial factor that can be modified through various efficacy-enhancing interventions. Future researchers will be able to build knowledge in this area through: (a) utilization of experimental and quasi-experimental design; (b) recruitment and retention of more diverse samples; (c) explicit reporting of definitions of terms (e.g. ‘high risk’); (d) investigation of interventions that increase childbirth self-efficacy during pregnancy; and, (e) investigation regarding how childbirth self-efficacy enhancing interventions might lead to decreased active labor pain and suffering. Exploratory research should continue to examine the potential association between higher prenatal childbirth self-efficacy and improved early parenting outcomes.

Socioeconomic risk factors for labour induction in the United Kingdom

“…Studies have shown that educational attainment can influence a women's perceived control over her health care and her ability to navigate the health care system available to her, and higher education has been linked to lower risk of labour induction and higher confidence in medical decision making in previous research [20,14]. Previous research posits that an increase in educational attainment can lead to an increase in self-efficacy, which is "the belief that one can successfully accomplish a task and one's estimation that if the task is accomplished, it will lead to specific outcomes" [21], meaning that women who are more educated may be able to more confidently advocate for themselves both before and during their labours. Women with greater feelings of self-efficacy have been found to be more positive about pregnancy and birth, and to feel less pain and use fewer interventions (such as epidural pain management) during labour [21,22].…”

“…Previous research posits that an increase in educational attainment can lead to an increase in self-efficacy, which is "the belief that one can successfully accomplish a task and one's estimation that if the task is accomplished, it will lead to specific outcomes" [21], meaning that women who are more educated may be able to more confidently advocate for themselves both before and during their labours. Women with greater feelings of self-efficacy have been found to be more positive about pregnancy and birth, and to feel less pain and use fewer interventions (such as epidural pain management) during labour [21,22]. As the number of women in higher education has risen since 2000, future research into how education and parity influence maternal choice in childbirth in more recent cohorts would help illuminate the relationship between maternal self-efficacy and labour induction.…”

Women's Perceptions of Prenatal Influences on Maternal Confidence for Physiologic Birth

“…Maternal confidence has been shown to generally increase over the course of pregnancy without intervention and to be inversely related to fear, which decreases during pregnancy . A recent integrative review also concluded that maternal self‐efficacy is related to childbirth outcomes and is likely modifiable through specific interventions . Finally, women who responded affirmatively about being confident in labor were more likely to have responded to open‐ended questions with comments about previous pregnancy experiences, positive communication with their maternity care providers, and opportunity for shared decision making .…”

“…18 A recent integrative review also concluded that maternal self-efficacy is related to childbirth outcomes and is likely modifiable through specific interventions. 29 Finally, women who responded affirmatively about being confident in labor were more likely to have responded to open-ended questions with comments about previous pregnancy experiences, positive communication with their maternity care providers, and opportunity for shared decision making. 30 Our findings complement and extend these studies through more detailed discussions with women focusing on the client-provider relationship and external supports.…”

On the relation of self-efficacy and coping with the experience of childbirth

“…A review of the quantitative literature on the effect of childbirth self-efficacy on perinatal outcomes reported that "increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes". [13] The choice of Bandura's construct for the analysis is rooted in its extensive use in childbirth studies. Manning and Wright began to analyze the role of self-efficacy in the women's ability to cope with childbirth.…”