Factors associated with birth satisfaction in Chinese women: a prospective cohort study.

BACKGROUND: This study aimed to evaluate birth satisfaction and identify its key influencing factors among Chinese women, acknowledging the increasing significance of a positive birth experience in perinatal care. METHODS: Between February and August 2023, 635 women were assessed during the third trimester and again at 6 weeks postpartum. Prenatal psychological and psychosocial factors were measured using validated scales, and birth satisfaction was assessed using the Chinese Birth Satisfaction Scale-Revised Indicator. Stepwise multiple linear regression was retained as an exploratory analysis, and a theory-driven hierarchical regression model was performed as a sensitivity analysis, entering mode of delivery and physical discomfort in Block 1 and prenatal psychological and psychosocial variables in Block 2. RESULTS: Mean birth satisfaction was 8.54 (SD = 2.16). Feeding pattern and gestational weight gain were not significantly associated with birth satisfaction in the univariate analyses. The final hierarchical model explained 21.3% of the variance in birth satisfaction (R 2 = 0.213, adjusted R 2 = 0.204; F = 24.215, p < 0.001). Pregnancy pressure (β = -0.242, p < 0.001), mode of delivery (β = 0.220, p < 0.001), resilience (β = 0.147, p = 0.002), and physical discomfort (β = -0.090, p = 0.013) remained independently associated with birth satisfaction. In this cohort, caesarean delivery was associated with a higher birth satisfaction score than vaginal delivery; however, elective and emergency caesarean deliveries and several relevant intrapartum characteristics were not distinguished. CONCLUSION: Birth satisfaction among Chinese women was associated with mode of delivery, pregnancy pressure, resilience, and physical discomfort. These findings support continuous, individualized care across pregnancy, childbirth, and early postpartum recovery.