Expectations vs experiences of birth: a systematic review and bibliometric analysis

Background/Aims Childbirth expectations and experiences are critical determinants of maternal satisfaction, psychological wellbeing and long-term health outcomes. However, studies often focus on either expectations or experiences, lacking an integrated understanding of trends, instruments and multidimensional influences. Methods This systematic review searched PubMed, Scopus and Web of Science to identify studies on childbirth expectations and experiences. The included studies were assessed with a bibliometric approach to map publication trends and thematic clusters. Results Overall, 71 studies were analysed, with seven thematic clusters found. Birth experience, medical interventions, satisfaction and birth planning were dominant themes. Three overarching categories of influence were identified: individual psychological and experiential factors; external socio-community and healthcare service factors; and umbrella variables, such as health policies. Conclusions Childbirth expectations and experiences are interconnected and shaped by multidimensional factors. This review highlights key research gaps and strategies to promote positive childbirth experiences, such as birth planning, midwifery-led continuity of care and respectful maternity care. Implications for practice There is a need to improve antenatal education on labour pain management, implement birth plans and provide psychological support to ensure that women have positive experiences. Future research should aim to strengthen the evidence on non-pharmacological pain management and explore factors that influence birth expectations and experiences.