Childbirth can leave lasting impressions, and for some women the memory is dominated by fear, pain or distress. How a birth is remembered may shape later mental health and the choice to have another child. A new study from China suggests that some of those memories can be traced back to feelings during pregnancy and to events around delivery.

Researchers at Shenzhen Hospital of Southern Medical University and partner institutions followed 1,123 pregnant women through to the early weeks after birth. The findings appear in BMC Psychology. Of the 1,110 women in the valid cohort, 984 were assessed within 72 hours of delivery, and 747 completed a birth memory questionnaire six to 12 weeks later.

The questionnaire covers six dimensions of birth memory, including emotional content, sensory detail and ease of recall. The team tested 36 factors measured before the follow-up, including fears during pregnancy, mood, obstetric details and the health of the baby. A statistical method selected the most relevant factors for each dimension, and the results were adjusted for the risk of false positives from multiple testing. Missing answers were filled in using multiple imputation, a method that estimates gaps from the information available, so that results did not rest only on women who completed every stage.

Emotional memory describes how strongly feelings are attached to the recollection of the birth. Sensory memory refers to vivid recall of sights, sounds and physical sensations. Recall is how easily a woman can bring the events back to mind.

Women who reported greater fear of childbirth during pregnancy had higher emotional memory scores. Those who felt more satisfied with their birth had lower scores. Both links remained after the statistical corrections. Emotional memory scores therefore moved in opposite directions with fear and with satisfaction, which fits the idea that a better birth experience leaves a less distressing memory.

Infant complications were linked to higher sensory memory and recall scores. Higher depressive symptoms during pregnancy were also linked to higher recall scores. No factor stood out for coherence, which describes how well ordered the memory feels.

The women’s own rating of how traumatic the birth was, taken at follow-up, was linked to several dimensions. Because it was measured at the same time, the study could not say which came first. Women who completed every stage differed from those who dropped out mainly in education and number of previous births.

The study has clear limits. It was observational, so it cannot show that any factor shapes a memory, and only 747 of the original women completed the final stage. Memories were reported once in the first weeks after birth, the women came from one region of China, and the authors say the findings do not justify changes in practice.

Earlier work has focused on overall birth appraisals and trauma-related outcomes. By separating memory into dimensions, this study suggests that fear and satisfaction matter most for emotional memories, and it points antenatal support towards fears before the birth.