A survey of women who had recently given birth in the United Arab Emirates found that higher anxiety was associated with a lower sense of control during labor. The relationship was observed across all 169 participants, but the study cannot show whether anxiety affected control, whether a difficult labor affected anxiety, or whether another factor influenced both.
The findings were especially pronounced among first-time mothers. The researchers said the results support attention to anxiety and preparation for childbirth, while noting that their survey did not test whether screening or preparation programs improve outcomes.
Large difference between first-time and experienced mothers
The 2026 survey included women aged 20 to 45 who were admitted to Kanad Hospital in Al Ain for a full-term vaginal delivery. About 73% had given birth before.
Severe anxiety was reported by 39.1% of the full group, while 40.8% reported mild-to-moderate anxiety and 20.1% reported minimal anxiety. Anxiety was assessed with the 31-item Perinatal Anxiety Screening Scale, with scores of 42 or higher classified as severe.
Among 46 first-time mothers, 40—87.0%—had scores in the severe range. By comparison, 26 of 123 women who had given birth before—21.1%—were classified as having severe anxiety.
Perceived control showed a similar gap. Low control was reported by 80.4% of first-time mothers and 5.7% of experienced mothers. Only three first-time mothers reported high control.
Across the full sample, 26.0% reported low control, 45.6% moderate control and 28.4% high control. The Labor Agentry Scale used in the study assessed how much women felt in charge of themselves and their care during labor.
An association measured after birth
Across all participants, anxiety scores and perceived control had a moderate inverse correlation: higher anxiety scores were linked with lower control scores (r = −0.579, p < 0.001).
Both questionnaires were completed within 24 hours after birth. That timing is important when interpreting the results. A woman’s immediate experience of labor or her post-birth mood may have shaped both responses, and the study could not establish which factor came first.
The researchers also noted that the post-birth anxiety scores may reflect the labor experience rather than anxiety that was present during pregnancy. The survey was cross-sectional, meaning the participants were assessed at one point rather than followed over time.
Who was included—and who was not
The participants were predominantly Arab women, UAE nationals and Muslim women. The study included only uncomplicated vaginal births. Women with chronic illness, gestational diabetes, eclampsia, previous delivery complications or a planned cesarean were excluded.
Those design choices make the findings relevant to the population studied, but they limit how confidently the results can be applied to people having cesarean births, high-risk pregnancies or care in other settings.
The researchers also reported links between labor control and age or income, and between anxiety and age at marriage. High control was reported by 31.3% of Arab participants and 8.7% of Asian participants, although only 23 Asian women took part. These factors were not analyzed together with parity and the other characteristics in one model, so it is unclear how much the reported associations overlap.
What the findings add
Earlier research cited in the study points in a similar direction. A Portuguese study following 57 women from pregnancy to six to eight weeks after birth found that higher anxiety and depression during pregnancy were associated with more post-traumatic stress symptoms after childbirth through lower perceived control during labor.
A 2024 Chinese study of 347 women in early labor found that women who had given birth before reported less fear of childbirth than first-time mothers. It also linked lower childbirth self-efficacy and greater fear with stronger perceived labor pain.
Together, these studies suggest that anxiety, fear and perceived control may be connected around childbirth. They do not, however, establish that one of these experiences directly causes another.
Why the results matter
For people preparing for childbirth, the study highlights that first-time mothers may report particularly high anxiety and may feel less control during labor. It also underscores the importance of asking about emotional experiences as part of broader maternity care.
The UAE researchers recommended routine anxiety screening and childbirth preparation focused on coping skills, especially for first-time mothers. Their survey did not test either approach, so it cannot determine how effective those strategies would be or which elements would matter most.
Key takeaways
- In a UAE survey of 169 women, higher anxiety scores were associated with lower perceived control during labor.
- Severe anxiety was reported by 87.0% of first-time mothers compared with 21.1% of women who had given birth before.
- Low control during labor was reported by 80.4% of first-time mothers and 5.7% of experienced mothers.
- Because both measures were collected within 24 hours after birth, the study shows an association rather than a cause-and-effect relationship.
What this means
The findings are relevant to understanding emotional wellbeing during childbirth, particularly the experiences reported by first-time mothers. They describe patterns in one hospital population and do not predict how any individual will experience labor or establish that anxiety causes reduced control.
What the evidence cannot tell us
- The study was a single-hospital, cross-sectional survey using a convenience sample.
- It included only uncomplicated, full-term vaginal births and excluded several medical and pregnancy-risk groups.
- The first-time-mother comparison included only 46 women.
- Anxiety and perceived control were measured at the same time after birth, so the direction of the relationship is unknown and immediate post-birth mood may have influenced both responses.,
AI tools were used to assist with the preparation of this article under our editorial standards.
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