How can couple conflict influence the childbirth experience? The role of psychological distress and prenatal attachment

Previous research highlights that couple conflict is associated with a more challenging childbirth experience, such as a more complicated labor. However, less is known about possible mediators of this relationship. This study aims to build upon previous evidence by examining the serial mediating role of maternal psychological distress and prenatal attachment on the relationships between couple conflict and labor experience. A longitudinal design was carried out on 162 nulliparous pregnant women (M_age = 31.64 ± 4.87). At weeks 31-32 of gestation, participants filled out a battery of well-known self-report measures to assess the level of couple conflict, prenatal anxiety and depression, and prenatal attachment. The day of childbirth, hospital healthcare staff registered the clinical data of labor (duration of labor, administration of oxytocin and epidural analgesia in hours). The assessed structural model showed an adequate fit to the data, accounting for 49.40% of the variance in the labor experience. Couple conflict affects the experience of labor only indirectly, both through the serial mediating role of psychological distress and maternal-fetal attachment (<i>β</i> = 0.04; 95%CI: 0.003-0.048) and through the simple mediation of psychological distress (β = 0.10; 95%CI: 0.013-0.102). The results showed that the presence of conflict favors the psychological distress of women which, in turn, adversely affects their ability to bond with the fetus, and this chain of effects contributes to a more complicated labor experience. Therefore, these findings highlight the importance of systematically assessing couple conflict and maternal psychological distress during pregnancy, as timely psychological support and relational interventions may help reduce psychological distress, promote maternal - fetal bonding, and ultimately contribute to smoother and less complicated labor experiences.