Perceived Safety in Childbirth: Pregnancy Predictors of Women's Experiences During Childbirth

Women's perceived safety during childbirth contributes to their childbirth experience, which can impact mental health and the experience of future pregnancies. Unexpected birth events may predict negative experiences of childbirth, but there is limited evidence about the role of demographic, health, and psychological factors known during pregnancy. The aim of this paper was to model pregnancy predictors of women's perceived safety during childbirth.

Women (n = 313) < 20 weeks' gestation were recruited from a large maternity hospital in Melbourne, as part of the Mercy Pregnancy and Childbirth Study (MPEWS). The dependent variable was the Perceived Safety Scale score from the Childbirth Experience Questionnaire, administered at 6 months postpartum. Hierarchical linear regression was conducted to determine factors significantly associated with scores, in two steps: (1) Step 1: demographic and health factors, depression, anxiety symptoms, recalled childhood trauma, and sense of coherence in pregnancy and (2) Step 2: birth events and complications.

Step 1 (p < 0.001) explained 20% and Step 2 (p < 0.001) an additional 3% of the variance in Perceived Safety scores. Higher trait anxiety (β = -0.255, p = 0.004), smoking during pregnancy (β = -0.124, p = 0.027), and emergency Caesarean births (β = -0.133, p = 0.048) predicted lower Perceived Safety. Multiparity was associated with significantly greater Perceived Safety (β = 0.116, p = 0.035).

Although emergency Caesarean births contribute to poorer perceived safety during childbirth, other factors, which are known during pregnancy, can also impact negatively on women's perceived safety during childbirth. Targeted support during pregnancy may therefore facilitate higher perceived safety during childbirth.