Am J Perinatol 2023; 40(02): 122-127
DOI: 10.1055/a-1882-9940
SMFM Fellowship Series Article

Dispositional Optimism, Mode of Delivery, and Perceived Labor Control among Recently Delivered Parturients

1   Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
2   Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
,
Anna R. Whelan
1   Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
2   Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
,
Olivia Recabo
3   Warren Alpert Medical School at Brown University, Providence, Rhode Island
,
Tess E. K. Cersonsky
3   Warren Alpert Medical School at Brown University, Providence, Rhode Island
,
Margaret H. Bublitz
4   Women's Medicine Collaborative at Lifespan Hospital System, Providence, Rhode Island
5   Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
,
Meghan C. Sharp
4   Women's Medicine Collaborative at Lifespan Hospital System, Providence, Rhode Island
5   Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
,
Adam K. Lewkowitz
1   Division of Maternal Fetal Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
2   Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, Rhode Island
› Author Affiliations
Funding None.

Abstract

Objective Dispositional optimism (DO) is an understudied transdiagnostic resilience factor among peripartum individuals. Low DO is associated with increased fear and pain in labor and increased rates of emergent cesarean delivery, but it is unknown whether DO is associated with perceived control over the labor process.

Study Design This a planned secondary analysis of a prospective observational cohort of term parturients (n = 164) who were recruited in July and August 2021 during their delivery hospitalization at a single, tertiary medical center. Participants completed a baseline demographic survey prior to delivery and then completed evaluations of DO (Revised Life-Orientation Test [LOT-R]) and control over the labor process (Labor Agentry Scale [LAS]) during their postpartum hospitalization. DO was dichotomized into low and high by score of ≤14 or >14 on LOT-R, respectively, and labor agentry scores were compared between groups. Maternal demographics, pregnancy, and delivery characteristics were compared by DO status. Multivariable regression was performed, adjusting for known confounders (induction, labor analgesia, and mode of delivery).

Results Demographic, pregnancy, and neonatal characteristics were similar between those with low compared with high DO. People with low DO had significantly higher rates of cesarean section (44 vs. 24%, p = 0.02) and overall had lower LAS scores (139.4 vs. 159.4, p < 0.001), indicating that they felt less control over their labor process than those with high DO. In the multivariable regression, those with low DO had higher odds of a low LAS score after controlling for induction, labor analgesia, and mode of delivery (adjusted odds ratio = 1.29, 95% confidence interval: 1.20–1.39).

Conclusion People with low DO had significantly lower perceived control over their labor, even after controlling for differences in mode of delivery. Interventions to alter DO may be an innovative way to improve birth experience and its associated perinatal mental health morbidities.

Key Points

  • It is unknown if there is an association between DO and perceived labor control.

  • People with low DO had higher rates of cesarean delivery and lower perceived labor control.

  • Altering DO may be a novel mechanism for improving birth experience.

Note

This study was previously presented at the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG) Biennial Conference, Ann Arbor, MI, on April 22-24, 2022.




Publication History

Received: 19 April 2022

Accepted: 17 June 2022

Accepted Manuscript online:
23 June 2022

Article published online:
16 September 2022

© 2022. Thieme. All rights reserved.

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