The Role of Trait Mindfulness and Fear of Childbirth in Physiological Birth

Objectives
Physiological birth is defined as a spontaneous vaginal childbirth between 37-42 weeks without medical intervention. Non-physiological births – such as augmented labor, instrumental birth, or unplanned caesarean section – are associated with increased risks of postpartum mental health problems and poor infant development, and may be influenced by known risk factors including primiparity, obesity, and advanced age. Fear of childbirth may reduce the likelihood of physiological birth, whereas trait mindfulness may facilitate more effective coping. This study examined the association between trait mindfulness and physiological birth, and the potential mediating role of fear of childbirth.

Methods
Participants in the Brabant Study (n=349) completed the Three Facet Mindfulness Questionnaire-Short Form at 20 weeks and the Fear of Birth Scale at 28 weeks. A cut-off ≥60 identified women with fear of childbirth. Physiological birth data were extracted from obstetric records.

Results
No association was found between trait mindfulness facets (acting with awareness, non-judging, non-reacting) and physiological birth, and no mediating effect of fear of childbirth (p>0.05). Non-judging (B=-2.61, p=0.001) and non-reacting (B=-1.37, p=0.042) were inversely associated with fear of childbirth. Having fear of childbirth was negatively associated with physiological birth (OR=0.63, 95%CI [0.40, 0.99], p=0.046).

Conclusions
Trait mindfulness may facilitate effective coping with fear of childbirth, but did not predict physiological birth, whereas fear of childbirth may be a risk factor for non-physiological birth. This was the first study examining trait mindfulness and fear of childbirth in relation to physiological birth. Further research is needed to confirm these findings in more diverse samples.

Preregistration
This study is not preregistered.