“Being in the zone” makes a difference: flow, birth experience, birth duration, and postpartum Stress

Aims and Background: The subjective childbirth experience is crucial for a woman’s well-being. This study examines the relationship between ‘birthing consciousness’–a flow-like state of hyperfocus, self-efficacy, and calm–and birth outcomes, including subjective experience, labour duration, and postpartum mental health. Methods: Data were collected prospectively from a cohort of birthing women (January-September 2023) at Ziv Medical Center, Israel. Women planning a vaginal birth (N = 138) completed surveys at three time points: Antenatal: During antenatal care at 34–41 weeks’ gestation; Postpartum: 72 hours postpartum, assessing flow state using the Flow State Scale (FSS); Postpartum: 8 weeks postpartum, assessing mental health using the Depression Anxiety Stress Scales (DASS-21). Pregnancy and birth details, including demographic variables and birth stage durations, were obtained from electronic medical records. Results: Higher flow was associated with shorter labour;(Stage 2: r = −0.316, p =.002, n = 98; Stage 3: r = −0.302, p =.002, n = 98) and lower postpartum stress;(r = −0.451, p <.001, n = 93). Women reporting a positive birth experience had higher flow than those reporting a negative experience (Welch’s t = 4.00, p <.001; Cohen’s d = 1.25; n = 83). In logistic regression, higher flow increased the odds of a positive birth experience (OR = 1.02 per point, 95% CI [1.00–1.05], p =.043). Conclusions: Experiencing flow can enhance the childbirth experience and shorten birth’s critical stages. These findings highlight the significance of attending to a woman’s mental state during labour to optimise her health outcomes.