Women's satisfaction with the quality of the birth experience: A prospective study of social and psychological predictors

Abstract
A prospective study of 59 first-time mothers-to-be was conducted. The women were interviewed twice, towards the end of their pregnancies and again after the birth of their babies, to determine their satisfaction with the quality of the birth experience. Measures of preparation for childbirth, satisfaction with information, social support, expected pain and health locus of control were taken at time 1, and measures of preparation for childbirth, social SUPPOK, reported pain, symptoms of stress, reports of the baby's behaviour, and satisfaction with the birth experience were taken at time 2. Working-class women felt they had been less well prepared than middle-class women and they were less satisfied with the information about childbirth. Middle-class women felt better supposed by their partners, family and neighbours than did working-class women. Working-class women were more likely to attribute both health and illness to chance than were middle-class women, and they were less satisfied with the birth experience. When the variables were entered into a hierarchical multiple regression analysis, 56% of the variance in satisfaction with the childbirth experience was explained. Path analysis showed that social class affected both social support and information. Working-class women felt less informed and less supported than middle-class women. Women who felt supported at time I, whether from working-class or middle-class backgrounds, reported less pain during the birth, and women who felt less pain reported greater satisfaction with the birth experience. Women who felt informed felt more prepared for the birth, and preparation also led to greater satisfaction. Women who were satisfied with the birth experience reported fewer symptoms of stress and were also more likely to give more positive reports of their child's behaviour. The implications for pregnancy care are discussed.