Muhamed Tamool A S, Angelini Viola, Viluma Laura, Keedle Hazel, Peters L Lilian
University of Groningen, Faculty of Economics and Business, Department of Economics, Econometrics, and Finance, Nettelbosje, 9700, AV, Groningen, the Netherlands.
University of Groningen, University Medical Centre Groningen, Primary and Long-term Care, Section Midwifery Science, Hanzeplein 1, 9713, GZ, Groningen, the Netherlands.
Heliyon. 2024 Dec 15;11(1):e41254. doi: 10.1016/j.heliyon.2024.e41254. eCollection 2025 Jan 15.
Negative childbirth experience detrimentally impacts women's mental well-being, potentially leading to delaying future pregnancies, and an increased likelihood of requesting caesarean births.
To examine differences between women who reported positive and negative childbirth experience and detangle the complexity of negative childbirth experience by building a socio-ecological model that includes individual, interpersonal, and organisational factors.
We conducted the Birth Experience Study Netherlands (BESt-NL) survey in 2022 with two languages versions (Dutch-English), and incorporated validated measures, such as Mothers' autonomy in decision-making, the Mothers On Respect index, and the Nijmegen Continuity of Care questionnaire. We employed socio-ecological modelling of individual (e.g., sociodemographic, ethnicity, parity, adverse mental health, interpersonal (e.g., autonomy in decision-making, respect, partner support), and organisational factors (e.g., place of birth, continuity of care). We defined negative childbirth experience using the valid Childbirth Experience Questionnaire 2.0. We applied multivariable logistic regression to examine associations between those factors and negative childbirth experience.
In total, (N = 1141) women were included in the BEST-NL study population, and 25 % of women (N = 285) experienced negative childbirth. Higher percentages were observed for non-Dutch ethnicity, preterm births, pregnancy complications, non-spontaneous births, adverse mental health, obstetrician-led care, and low autonomy, respect, social support, and continuity of care. Upon modelling, significant associations emerged i.e., education; or diminished i.e., place of birth; leaving robust associations in preterm, non-spontaneous birth, and adverse mental health, and inverse associations in high autonomy, respect, social support, and continuity of care.
Socio-ecological modelling untangled the complexity of negative childbirth experience. This study recommends fostering efforts toward women with prenatal mental health conditions and migrants, emphasises the importance of high autonomy, respect, and continuity in high-quality intrapartum care, and highlights the positive impact of midwife-led care in reducing negative childbirth experience likelihood.
负面的分娩经历会对女性的心理健康产生不利影响，可能导致推迟未来的怀孕，并增加剖宫产的可能性。
研究报告了积极和消极分娩经历的女性之间的差异，并通过构建一个包括个人、人际和组织因素的社会生态模型来梳理消极分娩经历的复杂性。
我们在2022年进行了荷兰分娩经历研究（BESt-NL）调查，有两种语言版本（荷兰语-英语），并纳入了经过验证的测量方法，如母亲决策自主权、母亲尊重指数和奈梅亨护理连续性问卷。我们采用了个体（如社会人口统计学、种族、产次、不良心理健康）、人际（如决策自主权、尊重、伴侣支持）和组织因素（如出生地、护理连续性）的社会生态模型。我们使用有效的分娩经历问卷2.0来定义消极分娩经历。我们应用多变量逻辑回归来检验这些因素与消极分娩经历之间的关联。
共有1141名女性纳入了BESt-NL研究人群，25%的女性（285名）经历了消极分娩。在非荷兰裔、早产、妊娠并发症、非自然分娩、不良心理健康、由产科医生主导的护理以及低自主权、低尊重、低社会支持和低护理连续性方面，观察到的比例更高。经过建模，出现了显著的关联，即教育程度；或减弱的关联，即出生地；在早产、非自然分娩和不良心理健康方面留下了强烈的关联，而在高自主权、尊重、社会支持和护理连续性方面则呈现反向关联。
社会生态模型梳理了消极分娩经历的复杂性。本研究建议对有产前心理健康问题的女性和移民加大支持力度，强调在高质量的产时护理中高自主权、尊重和连续性的重要性，并突出助产士主导的护理在降低消极分娩经历可能性方面的积极影响。
