Open AccessBirth experience of women conceiving with assisted reproduction: a prospective multicenter study
Author(s) -
Poikkeus Piia,
Saisto Terhi,
Punamaki RaijaLeena,
UnkilaKallio Leila,
Flykt Marjo,
Vilska Sirpa,
Repokari Leena,
Tulppala Maija,
Tiitinen Aila
Publication year - 2014
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.12440
Subject(s) - medicine , childbirth , odds ratio , psychosocial , pregnancy , infertility , obstetrics , logistic regression , prospective cohort study , confidence interval , anxiety , patient satisfaction , nursing , psychiatry , surgery , genetics , biology
Objective To determine how infertility and subsequent assisted reproductive treatment ( ART ) affect a woman's childbirth experience. Design Prospective multicenter case‐control study. Setting We recruited women pregnant with a singleton fetus after either ART ( n = 324) or spontaneous conception ( n = 304) from five infertility clinics and one university maternity clinic in Finland. Methods We studied their childbirth experience with the Delivery Satisfaction Scale. We compared how psychosocial and obstetric factors affected satisfaction and dissatisfaction with childbirth between and within the ART and the control group. Logistic regression was then used to analyse the most important contributors to the experienced dissatisfaction. Results Dissatisfaction with childbirth was as common in the ART group (11%) as in the control (10%) group. In the ART group, the women's education level, cesarean section ( CS ) and their partner's absence from the delivery were associated with dissatisfaction. In the control group, significant factors for dissatisfaction were nulliparity, severe pregnancy‐related anxiety, emergency CS , recalled intense pain and the partner's absence from the delivery. According to adjusted logistic regression analysis of the whole sample, the independent risk factors were elective CS [odds ratio ( OR ) 5.7; 95% confidence interval ( CI ) 2.2–14.1] and emergency CS ( OR 2.9; 95% CI 1.3–6.5), recalled intense pain ( OR 6.8; 95% CI 3.3–16.2) and the partner's absence from the delivery ( OR 2.7; 95% CI 1.1–7.3). Conclusion ART is not a risk factor for dissatisfaction with childbirth by itself. However, the contributors to an unsatisfactory childbirth differ partly between women conceiving with ART and those conceiving spontaneously.