Psychological aspects of childbirth: Evidence for a birth-related mindset

Psychological research on childbirth is rare, even though research from other scientific fields such as obstetrics or midwifery highlights the importance of psychological factors in childbirth. In this article, the theoretical construct of a birth-related mindset and direct and indirect measures for assessing the mindset are proposed. It is assumed that childbirth can be mentally presented as a rather natural (natural mindset) or a rather medicalized (medicalized mindset) event. In three online studies (Study 1: N = 117, Study 2: N = 206, Study 3: N = 192), we aimed to explore whether the proposed birth-related mindset is related to the retrospectively reported process of labor and birth (operationalized, e.g., by performed interventions, duration of birth, place of birth). For this, the relation between the mothers' birth-related decisions and outcomes of childbirth and the mothers' birth-related mindsets were analyzed. Results indicated that (1) birth-related criteria such as place of birth, epidural anesthesia, and C-sections were associated with the birth-related mindset, (2) these aspects of the delivery were related to the evaluation of the birth (birth experience), (3) the birth-related mindset moderated the relationship between C-section and birth experience, and (4) the indirect measures had little to no added explanatory value to the developed Mindset and Birth Questionnaire. Thus, the results indicate that the birth process experienced by the women and the mental representations of birth (birth-related mindset) are closely related. Future studies need to investigate to what extend the experienced birth process influences the mindset of birth, or the mindset the experienced birth process, or both.