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Aim: To determine the relationship between perceived satisfaction with childbirth and perceived autonomy in decision making during the childbirth process. Design: Cross-sectional study. Methods: The study took place within the international INTERSECT project. Data were collected in four hospitals in Slovakia. The research group consisted of 437 female respondents (average age 30.5 ± 4.8). Birth Satisfaction was measured by the Birth Satisfaction Scale - Revised (BSS-R). Level of autonomy in decision making during childbirth was measured by the Mothers' Autonomy in Decision Making Scale (MADM). Results: Respondents who perceived a higher level of autonomy in decision making during childbirth perceived higher overall satisfaction with childbirth (p = 0.001, r = 0.416). Higher age of mothers was also associated with higher birth satisfaction (p = 0.004, r = 0.139). Almost 17% of respondents perceived their childbirth to be a traumatic event. Respondents described lower levels of satisfaction with childbirth (p = 0.001) and lower levels of autonomy in decision making during childbirth (p = 0.002) if they subjectively perceived their childbirth as traumatic. Significant associations for the BSS-R score were also demonstrated regarding parity (p = 0.001), mode of delivery (p = 0.001), and type of delivery (p = 0.001). Conclusion: The involvement of the mother in the decision-making process of her own birth is a fundamental aspect of healthcare during childbirth and overall satisfaction with the birth.

Background: Pregnancy, childbirth and the postpartum period represent a unique experience in a woman's life that significantly changes their life. Methods: The aim of the study is to analyse risk factors of postpartum depression and posttraumatic stress disorder symptoms after birth in a sample of women in Slovakia. Data from the INTERSECT project were collected, including 437 postpartum women (mean age 30.5 ± 4.8). Posttraumatic stress disorder was (PTSD) measured through the City BiTS questionnaire, postpartum depression (PPD) symptoms were detected using the Edinburgh Postnatal Depression Scale (EPDS) and birth satisfaction was measured by the Birth Satisfaction Scale- Revised (BSS-R). Results: An increased risk for the development of PPD (the EPDS score >12.5) was found in 11.4 % of respondents, PTSD after birth was identified among 2.8 % of respondents. In the linear regression models, birth satisfaction (95%CI: 0,56; −0,19), subjective perception of birth (95%CI: 0,82; 1,63), previous trauma (95%CI: 0,27; 3,74), respect during birth (95%CI: 5,08; −0,45), and health complications of both mother (95%CI: 0,12; 2,81) and child (95%CI: 1,53; 1,84) were found significantly associated with the posttraumatic stress symptoms after birth (total explained variance 37 %). Subjective perception of birth as traumatic (95%CI: 0,82; 1,63), previous trauma in the anamnesis (95%CI: 0,27; 3,74) and respect during birth (95%CI: 5,08; −0,45) were significantly associated with the depression symptoms (total explained variance 15 %). Conclusion: Subjective perception of birth, birth satisfaction, previous trauma in anamnesis as well as lack of respect during birth were found as crucial risk factors for both PPD and postpartum PTSD.

Aim: To explore associations between expectations regarding birth (including mode of delivery) and experience of the previous birth among multiparous women. Design: A cross-sectional study. Methods: A specially designed questionnaire was used to explore subjective perceptions of previous births. We also used the standardized questionnaire of birth-related fear (W-DEQ). Descriptive statistics and the ANOVA test, chi-square test, and Student t-test were used. The research group consisted of 111 pregnant women with a mean age of 31 (± 3.58) years. Results: Most women preferred cesarean section as a mode of delivery (63.1%). Women who preferred cesarean section less frequently considered experiencing every stage of the birth to be an advantage of vaginal delivery. They more often perceived pelvic floor damage as a disadvantage of vaginal delivery (p = 0.000), and shorter delivery time as an advantage of cesarean section (p = 0.048). Significant fear of childbirth was confirmed in 25.2% of respondents. We found statistical significance between cesarean section preference and increased fear of childbirth (p = 0.05). Conclusion: Focusing on the impact of childbirth on the psychological state of a woman, should be one of the priorities of midwives to reduce fear of subsequent labor and prevent serious mental health issues.