Factors associated with positive childbirth experiences among women: A quantitative cross-sectional analysis using the Babies Born Better survey

PROBLEM: The Babies Born Better (B3) survey is an international instrument for evaluating childbirth experiences. However, its application in China remains limited. BACKGROUND: Identifying factors associated with positive childbirth experiences helps recognise specific aspects that may inform future improvements in maternity care. AIM: To assess childbirth experiences of women and identify influencing factors using quantitative data from the B3 study. METHODS: A cross-sectional survey was conducted in central China using the cross-culturally adapted version 3 of the B3 survey. Women with childbirth experience were recruited through convenience sampling between July 2025 and February 2026. The dependent variable was childbirth experience, categorised as positive or non-positive. The independent variables included socio-demographic, obstetric, and care-related perceptual factors. Univariate analyses were performed, followed by binary logistic regression analyses. FINDINGS: The study included 838 women, of whom 65.9% reported a positive childbirth experience. Among obstetric factors, term birth (OR=1.986, 95% CI: 1.075-3.671), giving birth in tertiary hospitals (OR=2.641, 95% CI: 1.396-4.998), and giving birth influenced by the COVID-19 pandemic (OR=5.929, 95% CI: 3.672-9.574) were associated with positive childbirth experience. Among care-related perceptual factors, women with better ability to cope with labour pain and high spousal involvement in maternity care were more likely to report a positive childbirth experience. CONCLUSIONS: This is the first systematic application of a culturally adapted version of B3 in China. A positive childbirth experience was associated with specific clinical and care-related factors. Healthcare providers should strengthen supportive maternity care, enhance women's ability to cope with labour pain, and promote spousal involvement in maternity care.