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Open Access 01-12-2021 | Post Traumatic Stress Disorder | Research

When birth is not as expected: a systematic review of the impact of a mismatch between expectations and experiences

Authors: Rebecca Webb, Susan Ayers, Annick Bogaerts, Ljiljana Jeličić, Paulina Pawlicka, Sarah Van Haeken, Nazihah Uddin, Rita Borg Xuereb, Natalija Kolesnikova, COST action CA18211:DEVoTION team

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Abstract

Background

Pregnancy and childbirth are significant events in women’s lives and most women have expectations or plans for how they hope their labour and birth will go. It is possible that strong expectations about labour and birth lead to dissatisfaction or other negative outcomes if these expectations are not met, but it is not clear if this is the case. The aim was therefore to synthesise prospective studies in order to understand whether unmet birth expectations are associated with adverse outcomes for women, their partners and their infants.

Method

Searches were carried out in Academic Search Complete; CINAHL; Medline; PsycINFO, PsychArticles, PubMed, SCOPUS and Web of Science. Forward and backward searches were also completed. Studies were included if they reported prospective empirical research that examined the association between a mismatch in birth expectations/experience and postnatal outcomes in women, their children and/or their partners. Data were synthesised qualitatively using a narrative approach where study characteristics, context and methodological quality were extracted and summarised and then the differences and similarities among studies were used to draw conclusions.

Results

Eleven quantitative studies were identified for inclusion from nine countries. A mismatch between birth expectations and experiences was associated with reduced birth satisfaction. Three studies found a link between a mismatch and the development of postnatal post-traumatic stress disorder (PTSD). The evidence was inconsistent for postnatal depression, and fear of childbirth. Only one study looked at physical outcomes in the form of health-related quality of life.

Conclusions

A mismatch between birth expectations and experiences is associated with birth satisfaction and it may increase the risk of developing postnatal PTSD. However, it is not clear whether a mismatch is associated with other postnatal mental health conditions. Further prospective research is needed to examine gaps in knowledge and provide standardised methods of measuring childbirth expectations-experiences mismatch. To ensure women’s expectations are met, and therefore experience a satisfying birth experience, maternity providers should provide sensitive care, which acknowledges women’s needs and preferences, is based on open and clear communication, is delivered as early in pregnancy as possible, and enables women to make their own decisions about care.

Trial registration

Protocol registration: PROSPERO CRD42020191081.

Available only for authorised users

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Title: When birth is not as expected: a systematic review of the impact of a mismatch between expectations and experiences
Authors: Rebecca Webb
Susan Ayers
Annick Bogaerts
Ljiljana Jeličić
Paulina Pawlicka
Sarah Van Haeken
Nazihah Uddin
Rita Borg Xuereb
Natalija Kolesnikova
COST action CA18211:DEVoTION team
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Post Traumatic Stress Disorder
Sectio Ceasarea
Sectio Caesarea
Published in: BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-021-03898-z

2024 ASCO Annual Meeting

Springer Medicine

When birth is not as expected: a systematic review of the impact of a mismatch between expectations and experiences

Abstract

Background

Method

Results

Conclusions

Trial registration

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Method

Results

Conclusions

Trial registration

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