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Related Experiment Video

Updated: Jan 3, 2026

Assessment of Stress Effects on Cognitive Flexibility using an Operant Strategy Shifting Paradigm

Assessment of Stress Effects on Cognitive Flexibility using an Operant Strategy Shifting Paradigm

Published on: May 4, 2020

Does cognitive flexibility affect the course of labor? A prospective study.

Aula Asali¹, Netanella Miller¹, Offra Engel¹

¹Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics

|November 23, 2019

Summary

High cognitive flexibility positively impacts labor and delivery outcomes. Women with greater cognitive flexibility were more likely to have a vaginal delivery, highlighting the mind-body connection during childbirth.

Keywords:

Cesarean delivery Cognitive flexibility Labor and delivery outcomes Parturient Psychological Flexibility Questionnaire Vaginal delivery

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Area of Science:

Obstetrics and Gynecology
Psychology
Perinatal Health

Background:

Cognitive flexibility, the ability to adapt thinking and behavior, is increasingly recognized for its role in health outcomes.
The interplay between maternal psychological states and labor/delivery experiences is an area of growing research interest.
Understanding factors influencing delivery mode is crucial for optimizing maternal and infant care.

Purpose of the Study:

To investigate the association between cognitive flexibility and labor and delivery outcomes in nulliparous women.
To explore the relationship between psychological flexibility, hope for vaginal delivery, and delivery expectations.
To compare outcomes such as vaginal delivery, vacuum extraction, and cesarean delivery between groups with varying levels of cognitive flexibility.

Main Methods:

A prospective study involving nulliparous women with singleton term pregnancies undergoing labor.
Administration of the Psychological Flexibility Questionnaire to assess cognitive flexibility.
Collection of data on delivery mode, hope for vaginal delivery, and delivery expectations post-birth.

Main Results:

Women with higher cognitive flexibility were significantly more likely to achieve a vaginal delivery compared to those with lower flexibility (74.2% vs 20.8%).
Cesarean delivery rates were lower in the more flexible group (5% vs 12.5%).
Higher expectation scores were correlated with delivery without severe perineal tears (P=0.032).

Conclusions:

Enhanced cognitive flexibility is linked to a greater likelihood of successful vaginal delivery.
Maternal cognitive perceptions and psychological state appear to influence labor and delivery processes.
These findings suggest that assessing and supporting maternal cognitive flexibility could be beneficial during labor counseling.