Perceived Labor Control Among Latinas: Examining the Role of Pregnancy Loss, Prenatal Depression, and Childbirth Pain...

Prenatal mental health, perception of pain, and pregnancy histories can affect a birthing person's sense of control during labor. Although recent research has focused on cesarean births, less attention has been given to the role those factors play in perceived control during vaginal births. These gaps are particularly critical for Latinas, who experience health care intrapartum disparities in the United States. This study addresses these gaps by examining how prenatal depression symptoms, history of pregnancy loss, and pain severity are related to perceived control during labor among Latinas birthing vaginally. The findings may inform intrapartum care for a patient population at increased risk of health care inequities.

This secondary data analysis included 119 self-identified Latina women who had a vaginal childbirth in North Carolina. Hierarchical linear regressions tested associations between prenatal depressive and anxiety symptoms, history of pregnancy loss, labor pain severity, and perceived control of labor.

A history of pregnancy loss was associated with lower perceived control during labor across all models, even after controlling for covariates, mental health, and perinatal variables (B = -0.450; P =  .024). Prenatal depressive symptoms were also a robust predictor, showing an inverse association with perceived control of labor in the final model with all predictors (B = -0.076; P =  .014). Lastly, there was a significant and negative association between pain severity and perceived control of labor, even after controlling for covariates, histories of pregnancy loss, prenatal depressive symptoms, and analgesia use in labor (B = -0.355; P <  .001).

Latinas in the United States encounter health care inequalities during and after childbirth. The findings underscore the need for clinicians to screen for depressive symptoms, discuss patients' pregnancy histories, support pain management during labor, and implement shared decision-making protocols.