Factors Associated with Perceptions of Maternal Control and Support During Childbirth and Relationship with...

Background and Objectives: The World Health Organisation (WHO) promotes respectful, woman-centred care during childbirth, aimed at preserving women's autonomy, their sense of control and the fulfilment of their expectations. Loss of control during childbirth has been linked to a poorer birth experience and adverse emotional consequences in the postpartum period. To analyse the maternal and perinatal factors associated with perceived control and support during childbirth, and their relationship with childbirth satisfaction in women in Spain. Materials and Methods: A cross-sectional study was conducted with postpartum women who had given birth within the previous six months in Spain. Validated instruments were used, including the "Support and Control in Birth" (SCIB) scale and the "Birth Satisfaction Scale-Revised" (BSS-R). Sociodemographic, obstetric and neonatal variables were also collected. Associations were assessed using multiple linear regression models. Results: A total of 302 postpartum women participated, with a mean age of 35.2 years (SD = 4.18), of whom 70.2% (n = 212) were primiparous. Satisfaction with childbirth (BSS-R) was the strongest positive association with all dimensions of the SCIB: internal control (adjusted mean difference [aMD] = 0.56; 95% CI: 0.48, 0.64), external control (aMD = 0.75; 95% CI: 0.61, 0.89), support (aMD = 0.89; 95% CI: 0.77, 1.01) and overall score (aMD = 2.34; 95% CI: 2.13, 2.56). Greater pain intensity was associated with a lower perception of internal control (aMD = -1.00; 95% CI: -1.31, -0.70). In comparison with adherence to the birth plan, non-adherence showed a negative association with the support dimension (aMD = -7.71; 95% CI: -10.72, -4.71) and with the overall SCIB score (aMD = -10.21; 95% CI: -16.01, -4.42). Women's active participation in decision-making was positively associated with perceived control and support (aMD = 7.15; 95% CI: 2.21, 12.09). Conclusion: A greater perception of support and control during labour is associated with a more positive birth experience. Deviation from the birth plan and greater pain intensity are associated with a poorer perception of control, whilst women's active participation was associated with higher perceived control. These findings underscore the importance of personalised and respectful care to improve women's childbirth experience, particularly perceived support, control and satisfaction.