Moving Toward a Positive Birth: The Protective Role of Psychological Capital in Shaping Childbirth Experiences.

PURPOSE: Positive childbirth experiences (CBEs) impact maternal and child well-being, but many women, particularly those of low socioeconomic status, report negative or traumatic births. This mixed-methods longitudinal study investigated whether and how psychological capital-a psychological construct composed of hope, self-efficacy, resilience, and optimism-moderates the associations between birth complications, birth trauma, and perceived own capacity, a critical indicator of positive CBEs.

METHODS

Mixed-methods data were extracted from a prospective longitudinal perinatal cohort study of birthing individuals experiencing at least one indicator of socioeconomic disadvantage. The quantitative data are from 141 individuals during pregnancy (third trimester) and the postpartum period (6 weeks postpartum); 16 of these individuals participated in an interview at 6 weeks postpartum to share their perceptions of their birth experiences. Quantitative data were analyzed using hierarchical linear regression modeling; postpartum interviews were analyzed using thematic and sentiment analysis.

RESULTS

Hierarchical linear regression revealed that psychological capital during pregnancy was positively and significantly associated with perceived own capacity related to subjective CBEs, after adjusting for birth complications, birth trauma, and sociodemographic characteristics (p < .01). Interview participants who reported positive CBEs displayed self-efficacy, hope, and optimism. Mixed-methods integration further indicated that self-efficacy and optimism were associated with positive CBEs, even among those who experienced birth complications.

CONCLUSIONS

Public health efforts should consider targeting strengths-based strategies to bolster psychological resources during pregnancy, such as evidence-based psychological capital interventions, to promote more positive CBEs. Future work is necessary to understand how to adapt and tailor interventions to better support perinatal individuals experiencing socioeconomic disadvantage through the childbirth process.