Factors associated with birth satisfaction in Chinese women: a prospective cohort study

This study aimed to evaluate birth satisfaction and identify its key influencing factors among Chinese women, acknowledging the increasing significance of a positive birth experience in perinatal care.

Between February and August 2023, 635 women were assessed during the third trimester and again at 6 weeks postpartum. Prenatal psychological and psychosocial factors were measured using validated scales, and birth satisfaction was assessed using the Chinese Birth Satisfaction Scale-Revised Indicator. Stepwise multiple linear regression was retained as an exploratory analysis, and a theory-driven hierarchical regression model was performed as a sensitivity analysis, entering mode of delivery and physical discomfort in Block 1 and prenatal psychological and psychosocial variables in Block 2.

Mean birth satisfaction was 8.54 (SD = 2.16). Feeding pattern and gestational weight gain were not significantly associated with birth satisfaction in the univariate analyses. The final hierarchical model explained 21.3% of the variance in birth satisfaction (R ² = 0.213, adjusted R ² = 0.204; F = 24.215, p < 0.001). Pregnancy pressure (β = -0.242, p < 0.001), mode of delivery (β = 0.220, p < 0.001), resilience (β = 0.147, p = 0.002), and physical discomfort (β = -0.090, p = 0.013) remained independently associated with birth satisfaction. In this cohort, caesarean delivery was associated with a higher birth satisfaction score than vaginal delivery; however, elective and emergency caesarean deliveries and several relevant intrapartum characteristics were not distinguished.

Birth satisfaction among Chinese women was associated with mode of delivery, pregnancy pressure, resilience, and physical discomfort. These findings support continuous, individualized care across pregnancy, childbirth, and early postpartum recovery.