The mindset of birth predicts birth outcomes: Evidence from a prospective longitudinal study

In this paper we explore whether mental representations about birth (birth-related mindsets) assessed during pregnancy can predict labour and birth in the sense that the perception of birth as a natural (rather than a medical) event increases the probability of a low-intervention birth. Birth, in turn, might affect short-term and long-term psychological well-being. These assumptions were tested in a longitudinal study (N = 311), spanning the first half of pregnancy and up to 6 months after birth. The results of a single indicator model displayed a sequential process: women who held a more natural mindset prenatally were more likely to have low-intervention births, which resulted in a more positive evaluation of the birth experience, which in turn predicted well-being in the first weeks after birth (measured with ecological momentary assessment), and subsequently postpartum depression and post-traumatic stress symptoms 8 weeks after birth as well as mother-infant bonding 6 months after birth. The study demonstrates the relevance of psychological factors for childbirth. The construct of a birth-related mindset could contribute to a better understanding of childbirth and help to make women's birth experiences safer and more satisfying and to improve the transition to motherhood.