The effect of psychological flexibility level and pregnancy stress on traumatic birth perception and breastfeeding success in primiparous pregnant women in the latent phase.

BACKGROUND: Pregnancy and childbirth are significant life events that can affect women's mental health and maternal functioning. Psychological flexibility, defined as the ability to adapt to changing situations and maintain balance under stress, plays a crucial role in this process. This study aimed to examine the effects of psychological flexibility and pregnancy stress on the perception of traumatic birth and breastfeeding success among primiparous pregnant women in the latent phase. METHODS: This cross-sectional study was carried out between January 2021 and June 2022 at a training and research hospital in eastern Türkiye. The study sample consisted of 310 primiparous pregnant women, selected through simple random sampling among eligible participants admitted in the latent phase of labor. Data were collected using the Personal Information Form, Psychological Flexibility Scale, Pregnancy Stress Rating Scale, Traumatic Birth Perception Scale, and LATCH Breastfeeding Assessment Tool. Data were analyzed using descriptive statistics, Pearson correlation analysis, and path analysis based on structural equation modeling (SEM). RESULTS: The study found a significant negative correlation between psychological flexibility and traumatic birth perception (r = -.183, p < .001) and was positively correlated with breastfeeding success (r = .208, p < .001). Pregnancy stress was positively correlated with the perception of traumatic birth (r = .472, p < .001) and negatively correlated with breastfeeding success (r = -.263, p < .001). Path analysis demonstrated that psychological flexibility had a significant negative effect on traumatic birth perception (β = -.159, p = .001) and a significant positive effect on breastfeeding success (β = .214, p < .001). Pregnancy stress had a significant positive effect on traumatic birth perception (β = .468, p < .001) and a significant negative effect on breastfeeding success (β = -.257, p < .001). CONCLUSION: Increased psychological flexibility was associated with a lower perception of traumatic birth and higher breastfeeding success. Conversely, higher pregnancy stress was linked to higher traumatic birth perception and lower breastfeeding success. These findings highlight the importance of integrating psychological flexibility-based interventions into prenatal education and midwifery care to promote maternal mental health and breastfeeding outcomes. In addition, future studies could explore intervention programs designed to enhance psychological flexibility among pregnant women to prevent traumatic birth experiences and improve postpartum adaptation.