Birthing during the stress of war: mode of birth and flow state.

Background and objectives: This study investigated the impact of war stress on birth outcomes, specifically birth mode and the subjective childbirth experience ("flow"). We hypothesized that war stress would adversely affect birth mode and the reported "flow."

Design and methods: A comparative study was conducted utilizing birth data from two online surveys of 411 Israeli women who gave birth before (82%) and during (17.8%) the Israel - Hamas war. Data collected included demographics, birth mode, and self-reported childbirth experience.

Results: Contrary to our initial hypothesis, no significant differences between the two groups regarding birth mode or reported flow during childbirth were found.

Conclusions: These findings suggest women possess an innate ability to immerse themselves in the birthing process, disconnecting from external stressors, particularly within a safe and supportive birthing environment. We explain our findings from evolutionary, psychological, and biochemical perspectives. Humans have likely evolved to focus on childbirth and shut out external threats. A safe birthing space allows women to enter a focused state for successful birth. Moreover, women tend toward "tend-and-befriend" behavior under stress, seeking safety and social support. The study highlights the importance of the immediate birthing environment for successful childbirth outcomes, even during times of significant external stress.