[Are womens attitudes towards pregnancy, childbirth and motherhood associated with length of labour?]

To examine the association between length of labour and womens attitudes towards pregnancy, childbirth and motherhood, while controlling for biomedical and maternal psychosocial characteristics.

Original study.

Department of Psychology, Faculty of Arts and Philosophy, Charles University, Prague.

The sample consisted of 362 women who gave birth in one of the five maternity hospitals in Vysočina region (Havlíčkův Brod, Jihlava, Pelhřimov, Třebíč, Nové Město na Moravě) between October 2013 and September 2014. The data were collected at two points in time. In the third trimester of pregnancy, womens attitudes towards pregnancy, childbirth and motherhood and other psychosocial characteristics were surveyed using the range of validated tools. Within one week of delivery, women were asked about social support they received during labour. Data concerning the course of labour were extracted from medical records. The dependent variable was the active phase of the first stage of labour (time from 3 cm to full dilatation). The differences among women with prolonged/rapid labour (duration above 90th percentile/less than 10th percentile) with respect to their attitudes towards pregnancy, childbirth and motherhood and other characteristics were assessed using the Students t test and the χ2 test. Factors associated with length of labour were analysed using logistic regression. The results were adjusted for maternal age, marital status and newborn weight.

In labours without oxytocin administration, the median of the duration of active phase of the first stage was 180 minutes for primiparas and 144 minutes for multiparas. Women with prolonged labour reported more frequently low maternal self-esteem compared to women with normal labour duration (34.0% vs. 19.1%; p = 0,021), but maternal self-esteem was not a significant predictor of prolonged labour in regression analysis. No other differences were found with respect to psychosocial and personality characteristics in women with prolonged and normal labour. Women with rapid labour did not differ from women with normal labour as for their attitudes towards pregnancy, labour and motherhood. Nevertheless, they reported clinically relevant scores for trait anxiety more frequently, a difference that approached statistical significance (52.6% vs. 38.3%; p = 0,090). Multiple regression analysis showed a trend towards trait anxiety being associated with rapid labour (p = 0,098). No significant predictor of labour duration was identified except newborn weight which predicted both prolonged and rapid labour.

Our data indicate that the association between length of labour and womens attitudes towards pregnancy, childbirth and motherhood is rather weak and clinically less relevant. Our results portray the newborn weight as a key factor affecting labour duration.