{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T16:13:27Z","timestamp":1765728807810,"version":"3.46.0"},"reference-count":44,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Helsinki University Hospital Research Grant","award":["TYH2019302"],"award-info":[{"award-number":["TYH2019302"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,5,28]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore how the time of delivery influences childbirth experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Childbirth in the four Helsinki and Uusimaa Hospital District hospitals, Finland, from 2012 to 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>105 847 childbirths with a singleton live fetus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Childbirth experience measured by Visual Analogue Scale (VAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The major difference in average childbirth experience measured by VAS was between primiparas (8.03; 95% CI 8.01 to 8.04) and multiparas (8.47; 95% CI 8.45 to 8.48). Risk ratio (RR) of the low VAS (\u22645) was 2.3 when primiparas were compared with multiparas. Differences in VAS between distinct periods were found in two stages: annual and time of day. The decrease in VAS from 2012\u20132016 to 2017\u20132018 in primiparas was from 7.97 (95% CI 7.95 to 7.99) to 7.80 (95% CI 7.77 to 7.83) and from 2014\u20132016 to 2017\u20132018 in multiparas from 8.60 (95% CI 8.58 to 8.61) to 8.49 (95% CI 8.47 to 8.52). Corresponding RRs of low VAS were 1.3 for primiparas and 1.2 for multiparas. Hourly differences in VAS were detected in primiparas between office hours 08:00\u201315:59 (7.97; 95% CI 7.94 to 7.99) and other times (night 00:00\u201307:59; 7.91; 95% CI 7.88 to 7.94; and evening 16:00\u201323:59; 7.90; 95% CI 7.87 to 7.92). In multiparas differences in VAS were detected between evening (8.52; 95% CI 8.50 to 8.54) and other periods (night; 8.56; 95% CI 8.54 to 9.58; and office hours; 8.57; 95% CI 8.55 to 8.59).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The maternal childbirth experience depended on the time of delivery. Giving birth during the evening led to impaired childbirth experience in both primiparas and multiparas, compared with delivery at other times. The impact of labour induction on childbirth experience should be further examined. The reorganisation of delivery services and the reduction of birth preparations might affect annual VAS. VAS is a simple method of measuring the complex entity of childbirth experience, and our results indicate its ability to capture temporal variation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-046433","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T13:03:51Z","timestamp":1623848631000},"page":"e046433","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Maternal childbirth experience and time of delivery: a retrospective 7-year cohort study of 105 847 parturients in Finland"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6349-7419","authenticated-orcid":false,"given":"Johanna","family":"Joensuu","sequence":"first","affiliation":[{"name":"Faculty of Management and Business, Tampere University, Tampere, Finland"},{"name":"Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannu","family":"Saarij\u00e4rvi","sequence":"additional","affiliation":[{"name":"Faculty of Management and Business, Tampere University, Tampere, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Rouhe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland"},{"name":"Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Information, Finnish Institute of Health and Welfare, Helsinki, Finland"},{"name":"Division of Family Medicine, Karolinska Institute Department of Neurobiology, Care Sciences and Society, Huddinge, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veli-Matti","family":"Ulander","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seppo","family":"Heinonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland"},{"name":"Faculty of Medicine, University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomi","family":"Mikkola","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland"},{"name":"Folkh\u00e4ls\u00e4n Research Center, Biomedicum, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"key":"2025120521182421000_11.6.e046433.1","doi-asserted-by":"crossref","unstructured":"Nilv\u00e9r H , Begley C , Berg M . Measuring women\u2019s childbirth experiences: a systematic review for identification and analysis of validated instruments. BMC Pregnancy and Childbirth 2017;203.","DOI":"10.1186\/s12884-017-1356-y"},{"key":"2025120521182421000_11.6.e046433.2","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1089\/jwh.2006.0030","article-title":"Risk factors for poor self-rated health in women at 2 months and 1 year after childbirth","volume":"16","author":"Schytt","year":"2007","journal-title":"Journal of Women's Health"},{"key":"2025120521182421000_11.6.e046433.3","doi-asserted-by":"publisher","DOI":"10.1080\/13548500600708409"},{"key":"2025120521182421000_11.6.e046433.4","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.0730-7659.2005.00336.x","article-title":"Continuous support for women during childbirth","volume":"32","author":"Hodnett","year":"2005","journal-title":"Birth"},{"key":"2025120521182421000_11.6.e046433.5","first-page":"P160","article-title":"Pain and women\u2019s satisfaction with the experience of childbirth: A systematic review","volume":"186","author":"Hodnett","year":"2002","journal-title":"Obstet Gynecol"},{"key":"2025120521182421000_11.6.e046433.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2004.0270.x"},{"key":"2025120521182421000_11.6.e046433.7","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.srhc.2010.11.003","article-title":"Factors independently related to a negative birth experience in first-time mothers","volume":"2","author":"Larsson","year":"2011","journal-title":"Sexual & Reproductive Healthcare"},{"key":"2025120521182421000_11.6.e046433.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-020-03106-4","article-title":"Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two-year cohort study","volume":"20","author":"Adler","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025120521182421000_11.6.e046433.9","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-1"},{"key":"2025120521182421000_11.6.e046433.10","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/S0301-2115(01)00558-9","article-title":"Severe acute maternal morbidity and mortality in the Pretoria academic complex: changing patterns over 4 years","volume":"102","author":"Vandecruys","year":"2002","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025120521182421000_11.6.e046433.11","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2012.710280"},{"key":"2025120521182421000_11.6.e046433.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.07.007"},{"key":"2025120521182421000_11.6.e046433.13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-1"},{"key":"2025120521182421000_11.6.e046433.14","doi-asserted-by":"publisher","DOI":"10.3109\/00016349.2010.514324"},{"key":"2025120521182421000_11.6.e046433.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7132.657"},{"key":"2025120521182421000_11.6.e046433.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-006291","article-title":"A prospective cohort study of the morbidity associated with operative vaginal deliveries performed by day and at night","volume":"4","author":"Butler","year":"2014","journal-title":"BMJ Open"},{"key":"2025120521182421000_11.6.e046433.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.c3498","article-title":"Time of birth and risk of neonatal death at term: retrospective cohort study","volume":"341","author":"Pasupathy","year":"2010","journal-title":"BMJ"},{"key":"2025120521182421000_11.6.e046433.18","first-page":"504","article-title":"Risks of stillbirth and early neonatal death by day of week","volume":"170","author":"Luo","year":"2004","journal-title":"CMAJ"},{"key":"2025120521182421000_11.6.e046433.19","doi-asserted-by":"publisher","DOI":"10.1136\/jech.37.1.57"},{"key":"2025120521182421000_11.6.e046433.20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.22.2958"},{"key":"2025120521182421000_11.6.e046433.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.06.009"},{"key":"2025120521182421000_11.6.e046433.22","doi-asserted-by":"crossref","first-page":"705.e1","DOI":"10.1016\/j.ajog.2015.07.018","article-title":"Effect of time of birth on maternal morbidity during childbirth hospitalization in California","volume":"213","author":"Lyndon","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"2025120521182421000_11.6.e046433.23","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2010.545913"},{"key":"2025120521182421000_11.6.e046433.24","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000168627.33566.3c"},{"key":"2025120521182421000_11.6.e046433.25","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7256.274"},{"key":"2025120521182421000_11.6.e046433.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.046"},{"key":"2025120521182421000_11.6.e046433.27","doi-asserted-by":"crossref","first-page":"634.e1","DOI":"10.1016\/j.ajog.2016.06.026","article-title":"The influence of hours worked prior to delivery on maternal and neonatal outcomes: a retrospective cohort study","volume":"215","author":"Aiken","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"2025120521182421000_11.6.e046433.28","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1055\/s-0035-1567891","article-title":"Does time of delivery influence the risk of neonatal morbidity?","volume":"33","author":"Brookfield","year":"2016","journal-title":"Am J Perinatol"},{"key":"2025120521182421000_11.6.e046433.29","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200303000-00017"},{"key":"2025120521182421000_11.6.e046433.30","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7325.1327"},{"key":"2025120521182421000_11.6.e046433.31","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-12-1"},{"key":"2025120521182421000_11.6.e046433.32","doi-asserted-by":"publisher","DOI":"10.1023\/A:1007379029182"},{"key":"2025120521182421000_11.6.e046433.33","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1111\/aogs.12302","article-title":"The Nordic medical birth registers--a potential goldmine for clinical research","volume":"93","author":"Langhoff-Roos","year":"2014","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025120521182421000_11.6.e046433.34","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.bpobgyn.2014.10.008","article-title":"Obesity in pregnancy","volume":"29","author":"Lim","year":"2015","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2025120521182421000_11.6.e046433.35","doi-asserted-by":"publisher","DOI":"10.1080\/0887044042000272912"},{"key":"2025120521182421000_11.6.e046433.36","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/j.1471-0528.2008.02002.x","article-title":"Fear of childbirth according to parity, gestational age, and obstetric history","volume":"116","author":"Rouhe","year":"2009","journal-title":"BJOG"},{"key":"2025120521182421000_11.6.e046433.37","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2003.02981.x"},{"key":"2025120521182421000_11.6.e046433.38","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(02)00239-2"},{"key":"2025120521182421000_11.6.e046433.39","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1038\/jp.2015.135","article-title":"Timing of induction of labor and association with nighttime delivery: a retrospective cohort","volume":"35","author":"Namaky","year":"2015","journal-title":"J Perinatol"},{"key":"2025120521182421000_11.6.e046433.40","doi-asserted-by":"crossref","first-page":"2166","DOI":"10.1111\/jog.13775","article-title":"Post-Partum duration of satisfaction with childbirth","volume":"44","author":"Turkmen","year":"2018","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"2025120521182421000_11.6.e046433.41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-019-2633-8","article-title":"The impact of obstetric interventions and complications on women\u2019s satisfaction with childbirth a population based cohort study including 16,000 women","volume":"19","author":"Falk","year":"2019","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025120521182421000_11.6.e046433.42","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3956(97)00029-0"},{"key":"2025120521182421000_11.6.e046433.43","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-536X.2003.00254.x"},{"key":"2025120521182421000_11.6.e046433.44","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2004.00287.x"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-046433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:18:35Z","timestamp":1764998315000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-046433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6]]},"references-count":44,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6,16]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/bmjopen-2020-046433"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-046433","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2021,6]]}}}