Poor childbirth experiences reduce birth rate

Negative childbirth experiences have a number of negative effects on the birth rate. However, a recently completed doctoral thesis indicates that most mothers consider their childbirth a positive experience.

In her doctoral thesis, Johanna Joensuu, MSc, investigated the childbirth experiences of those who gave birth in the Hospital District of Helsinki and Uusimaa (HUS) from 2012 to 2018. According to the study, childbirth experiences have, on average, weakened in Finland between 2012 and 2018.

“Even though the share of negative experiences has slightly increased, most mothers still consider their deliveries in Finland as a positive experience overall,” Joensuu says.

A total of 40% of first-time mothers and 60% of women who had previously given birth considered their childbirth experience very positive. Only 10% of the former group and 4% of the latter gave a negative assessment of their experience.

The registry dataset used in the study covered more than 120,000 deliveries, approximately one-third of the children born in Finland in the period 2012–2018.

A negative childbirth experience reduced the likelihood of having another child

Poor childbirth experiences have several negative effects on the birth rate: in the study, negative experiences decreased by one-fifth the likelihood of a subsequent birth during the seven-year follow-up period. Based on the follow-up dataset, negative childbirth experiences extended the time between births by 1.4 years compared to those whose experience was positive.

“Delaying attempts to have another child also poses challenges from the perspective of fertility, as more than half of the first-time mothers are over 30 years of age,” Joensuu says.

According to Joensuu’s assessment, a reduction in birthing classes and changes in the organisation of maternity services, among other things, underlie increasingly negative childbirth experiences.

The doctoral thesis posits that negative childbirth experiences are also associated with the induction of labour.

“However, it must be noted that inductions are usually reasoned, which can in itself expose you to a more weak childbirth experience,” Joensuu says.

Better experiences through good care

According to Joensuu, the experience of giving birth can be affected with good care.

“Childbirth includes a lot of unforeseen elements, which is why appropriate and trust-building childbirth preparation classes and care where consideration is given to the mother’s wishes have a key role in ensuring that mothers have positive childbirth experiences,” Joensuu says.

Discussing negative experiences after the fact with a professional is particularly important in preventing long-lasting adverse effects.

“With the birth rate at its lowest in our modern history, the childbirth experience is one of the relevant factors that can be influenced,” Joensuu sums up.


Further information:

Johanna Joensuu, Doctoral Researchers, University of Helsinki


How the study was conducted
  • The doctoral thesis is composed of four articles, all of which have been published in medical journals.
  • Three of the articles examine the link between the elements of childbirth experience (temporal factors, induction of labour, method of delivery as well as pain relief used) and the childbirth experience. The fourth article focuses on the link between maternal childbirth experience and the likelihood of a subsequent birth as well as the interval between births.
  • The childbirth experience assessment was collected from women giving birth using the VAS scale from 1 to 10, where 1 indicates a very negative and 10 a very positive experience. VAS values of 5 and lower were defined as negative.
  • In the doctoral thesis, the assessment of childbirth experiences have been combined with data from the Medical Birth Register, which includes data on the mother, pregnancy and childbirth as well as the newborn up to seven days after delivery.