Perceived Control and Maternal Satisfaction with the Childbirth Experience

Abstract

The quality of the childbirth experience, particularly whether the mother perceives a sense of control over the birth environment, can significantly impact postpartum adjustment. Although maternal "satisfaction" is a common outcome variable in childbirth research, studies have not adequately distinguished satisfaction from affective reactions to birth. Furthermore, adequate measures of perceived control and maternal satisfaction are lacking. Drawing from a person-environment fit theory of satisfaction, the current study examined the validity of two new instruments to assess perceived control over the childbirth environment (PCCh) and satisfaction with the childbirth experience (SWCh). Items constructed from existing measures and qualitative data were administered to 187 women who had given birth to a healthy infant in the last four months. Exploratory factor analysis supported single-factor structures for the PCCh and the SWCh, with high internal consistency reliability for both instruments (alpha .90). The PCCh was significantly correlated with childbirth self-efficacy, satisfaction, and external control. The SWCh was only moderately correlated with positive and negative affect, childbirth self-efficacy, and external control. Low scores on both instruments were significantly associated with postpartum stress symptoms. Preliminary analyses revealed that perceived control accounted for more variance in childbirth satisfaction than obstetric variables such as labor pain, duration of labor, obstetric complications, and having an unplanned cesarean section. Results of these analyses are presented with recommendations for future development and clinical use of the PCCh and SWCh.