The effects of COVID-19 restrictions and other perinatal factors on women’s sense of control during childbirth: a prospective cohort study

Abstract

Background

Restrictions around childbirth, introduced during the COVID-19 pandemic in 2020, could decrease maternal feelings of control during birth. The aim of this study was to compare the sense of control of women who gave birth during the COVID-19 pandemic with women who gave birth before COVID-19. The secondary objective was to identify other factors independently associated with women’s sense of control during birth.

Methods

A prospective cohort study, in a sub-cohort of 504 women from a larger cohort (Continuous Care Trial (CCT), n = 992), was conducted. Sense of control was measured by the Labor Agentry Scale (LAS). Perinatal factors independently associated with women’s sense of control during birth were identified using multiple linear regression.

Results

Giving birth during the COVID-19 pandemic did not influence women’s sense of control during birth. Factors statistically significantly related to women’s sense of control were Dutch ethnic background (β 4.787, 95%-CI 1.319 to 8.254), antenatal worry (β − 4.049, 95%-CI −7.516 to −.581), antenatal anxiety (β − 4.677, 95%-CI −7.751 to 1.603) and analgesics during birth (β − 3.672, 95%-CI −6.269 to −1.075).

Conclusions

Despite the introduction of restrictions, birth during the COVID-19 pandemic was not associated with a decrease of women’s sense of control.

Keywords:

• Control
• COVID-19
• restrictions
• childbirth
• labor
• continuous care

Ethics approval

The current study was part of the Continuous Care Trial, which received ethical approval from the medical ethical committee of Maastricht University Medical Center (METC172041). All participants gave informed consent.

Author contributions

KC wrote the majority of the manuscript. HS and MN designed the Continuous Care Trial and provided major feedback on writing. LS advised and edited the text concerning statistical analysis. KC, AS, AL, BP, SJ and MLV are responsible for the practical organization of the Continuous Care Trial. AL, JL and RVL are responsible for organization of the trial in participating centers. AS, AL, JL, RVL, BP, SJ and MLV provided feedback on writing. All authors read and approved the final manuscript.

Disclosure statement

The authors report no conflict of interest.

Data availability statement

There is no online database. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

The current study was part of the Continuous Care Trial, which was supported by ZonMw (The Netherlands Organization for Health Research and Development; federal funding), under Grand 209070001, reference number 50–5200–98-170 NL51853.068.17. Dutch Health Insurance companies: CZ group, Menzis and VGZ provided funds for the care provided by a maternity care assistant during a medically indicated labor.