Experiences of labor in women undergoing induced and spontaneous onset of labor: Associations with depressive symptoms and sleep disturbances

Purpose: A negative experience of labor (EOL) may have long-term adverse effects on maternal well-being. Induction of labor (IOL), depressive symptoms, and sleep disturbances may compromise the EOL. We evaluated whether EOL, depressive symptoms, and sleep disturbances are interrelated in women with IOL. Methods: The FinnBrain Birth Cohort with 2405 women comprising of 443 women in the IOL group and 1962 women in the spontaneous onset of labor (SOL) group. The Edinburgh Postnatal Depression (early pregnancy [pp ¹ ], mid-pregnancy [pp ² ] and late pregnancy points [pp ³ ]), the Basic Nordic Sleep Questionnaire (pp ¹ , pp ² , pp ³ and delivery point [pp ⁴ ]) and EOL were assessed, and the associations were investigated using logistic regression analyses. Results: Women reporting depressive symptoms at any point during pregnancy reported a more negative EOL (pp ¹ p =0.004; pp ² p =0.026; pp ³ p= 0.003). A more negative EOL was also reported by women with poor general sleep quality (pp ⁴ p =0.005), with higher Insomnia scores (pp ² p =0.042; pp ⁴ p =0.007), and with higher Sleepiness scores (pp ² p =0.001; pp ³ p =0.028; pp ⁴ p =0.034). At different pregnancy time points, several sleep disturbances, such as difficulty to fall asleep (pp ⁴ p =0.003) and nocturnal awakenings (pp ³ p =0.025) were associated with a more negative EOL. However, all of these findings were similar in both groups. Conclusions: Depressive symptoms and sleep disturbances were associated with a negative EOL independently of IOL. Our findings highlight psychological distress and sleep difficulties as distinct, clinically relevant determinants of EOL. Early identification and targeted management of these modifiable factors may improve EOL and maternal well-being. Trial registration number : ETMK 57/180/2011, meeting 14.6.2011 § 168.