Assessment of childbirth experience in a tertiary care hospital: a cross-sectional questionnaire-based study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20261479Keywords:
Childbirth experience, CEQ, Labour support, Mode of delivery, Respectful maternity care, Labour analgesiaAbstract
Background: Childbirth is a multidimensional experience influenced by physical, emotional, interpersonal, and environmental factors. Understanding women’s experiences during childbirth is essential to improving the quality of maternity care and promoting positive maternal outcomes.
Methods: A descriptive cross-sectional study was conducted among 150 postpartum women within 72 hours of delivery at a tertiary care teaching hospital. The childbirth experience questionnaire (CEQ), consisting of four domains - Own Capacity, Professional Support, Perceived Safety, and Participation was administered in English or Kannada. Sociodemographic, obstetric, and neonatal data were collected using structured proforma through interview of mother and review of hospital records. CEQ domain and total scores were converted to a 0-100 scale. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and multivariate linear regression. A p value <0.05 was considered statistically significant.
Results: The mean total CEQ score was 67.7±9.8, indicating a moderately positive childbirth experience. Highest scores were observed in Professional Support (78.6±10.1) and Perceived Safety (74.3±11.8), while Own Capacity (61.2±13.5) and Participation (56.8±14.9) were lower. Vaginal delivery was associated with significantly higher CEQ scores compared to caesarean section (p=0.01). Labour analgesia use was also associated with higher CEQ scores (p=0.03). Pain scores showed a negative correlation with childbirth satisfaction (r= –0.33), while perceived control correlated positively (r=+0.42). Independent predictors of positive childbirth experience included vaginal delivery, higher professional support, lower pain, and greater participation.
Conclusions: Although women reported strong support and perceived safety, their sense of control and involvement in decision-making required improvement. Enhancing respectful maternity care and promoting shared decision-making may improve childbirth experiences.
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References
Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy Childbirth. 2010;10:81. DOI: https://doi.org/10.1186/1471-2393-10-81
Bell AF, Andersson E. The birth experience and women’s postnatal depression: a systematic review. Midwifery. 2016;39:112-23. DOI: https://doi.org/10.1016/j.midw.2016.04.014
Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychol Med. 2016;46(6):1121-34. DOI: https://doi.org/10.1017/S0033291715002706
Downe S, Finlayson K, Oladapo OT, Bonet M, Gülmezoglu AM. What matters to women during childbirth: a systematic qualitative review. PLoS One. 2018;13(4):e0194906. DOI: https://doi.org/10.1371/journal.pone.0194906
Lowe NK. The nature of labor pain. Am J Obstet Gynecol. 2002;186(5):S16-24. DOI: https://doi.org/10.1067/mob.2002.121427
Hodnett ED. Pain and women’s satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002;186(5):S160-72. DOI: https://doi.org/10.1016/S0002-9378(02)70189-0
Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2017;7:CD003766. DOI: https://doi.org/10.1002/14651858.CD003766.pub6
Bowser D, Hill K. Exploring evidence for disrespect and abuse in facility-based childbirth: report of a landscape analysis. Boston: USAID-TRAction Project, Harvard School of Public Health. 2010.
White Ribbon Alliance. Respectful maternity care: the universal rights of childbearing women. Washington, DC: White Ribbon Alliance. 2011.
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med. 2015;12(6):e1001847. DOI: https://doi.org/10.1371/journal.pmed.1001847
WHO. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization. 2018. Available at: https://www.who.int/publications/i/item/9789241550215. Accessed on 09 December 2025.
Benton M, Salter A, Tape N, Wilkinson C, Turnbull D. Women’s psychosocial outcomes following an emergency caesarean section: a systematic literature review. BMC Pregnancy Childbirth. 2019;19(1):535. DOI: https://doi.org/10.1186/s12884-019-2687-7
Larkin P, Begley CM, Devane D. Women’s preferences for childbirth experiences in the Republic of Ireland; a mixed methods study. BMC Pregnancy Childbirth. 2017;17(1):19. DOI: https://doi.org/10.1186/s12884-016-1196-1
Behruzi R, Hatem M, Goulet L, Fraser W, Misago C. Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework. BMC Pregnancy Childbirth. 2013;13:205. DOI: https://doi.org/10.1186/1471-2393-13-205
Larkin P, Begley CM, Devane D. Women’s experiences of labour and birth: an evolutionary concept analysis. Midwifery. 2009;25(2):e49-59. DOI: https://doi.org/10.1016/j.midw.2007.07.010
Afulani PA, Diamond-Smith N, Phillips B, Singhal S, Sudhinaraset M. Predictors of person-centered maternity care: the role of socioeconomic status, empowerment, and facility type. BMC Health Serv Res. 2018;18(1):360. DOI: https://doi.org/10.1186/s12913-018-3183-x
Shorey S, Yang YY, Ang E. The impact of negative childbirth experience on future reproductive decisions: a quantitative systematic review. J Adv Nurs. 2018;74(6):1236-44. DOI: https://doi.org/10.1111/jan.13534
Balaguru S, Pal A, Begum J, Mohan A. Experiences and felt needs of women during childbirth in a tertiary care center: a hospital-based cross-sectional descriptive study. J Obstet Gynaecol India. 2021;71(1):21-6. DOI: https://doi.org/10.1007/s13224-020-01359-9
Whitburn LY, Jones LE, Davey MA, Small R. The meaning of labour pain: how the social environment and other contextual factors shape women’s experiences. BMC Pregnancy Childbirth. 2017;17(1):157. DOI: https://doi.org/10.1186/s12884-017-1343-3
Vogels-Broeke M, Cellissen E, Daemers D, Budé L, De Vries R, Nieuwenhuijze M. Women’s decision-making autonomy in Dutch maternity care. Birth. 2023;50(2):384-95. DOI: https://doi.org/10.1111/birt.12674
Ghanbari-Homayi S, Dencker A, Fardiazar Z, Jafarabadi MA, Mohammad-Alizadeh-Charandabi S, Meedya S, et al. Validation of the Iranian version of the childbirth experience questionnaire 2.0. BMC Pregnancy Childbirth. 2019;19(1):465. DOI: https://doi.org/10.1186/s12884-019-2606-y
Mamuk R, Şahin N, Dişsiz M. The Turkish version of the Childbirth Experience Questionnaire (CEQ): reliability and validity assessment. Bakirkoy Tip Dergisi. 2019;15(3):265-71. DOI: https://doi.org/10.4274/BTDMJB.galenos.2019.20190123082356
Shiva L, Desai G, Satyanarayana VA, Venkataram P, Chandra PS. Negative childbirth experience and post-traumatic stress disorder – a study among postpartum women in South India. Front Psychiatry. 2021;12:640014. DOI: https://doi.org/10.3389/fpsyt.2021.640014
Khalife-Ghaderi F, Amiri-Farahani L, Haghani S, Hasanpoor-Azghady SB. Examining the experience of childbirth and its predictors among women who have recently given birth. Nurs Open. 2021;8(1):63-71. DOI: https://doi.org/10.1002/nop2.603