Higher negative couple conflict during pregnancy linked with worse birth outcomes (USA)

couple conflict

Rates of preterm birth, induced labour, caesarean section, low birth weight, low 5-minute Apgar score and labour complications are higher when the couple shows more negative conflict in the antenatal period. This holds true irrespective of measures of the mother’s health during pregnancy.

This is a correlation and does not prove causation. There could, for example, be other things driving both conflict and health problems, such as personality traits. Nevertheless, the correlation lifts a lid on something that has hardly been studied at all: the link between couple conflict and measures of birth health outcomes.

The researchers recommend that support around couple conflict during pregnancy be part of maternity health care.

The research involved 47 couples – low-risk, heterosexual, and cohabiting.

During the antenatal period, the couples participated together in three video-recorded discussions about conflict. One discussion followed the completion of a questionnaire by each partner separately. The questionnaire identified what areas of their relationship they would most like to change, such as sex and intimacy, household chores, and time spent on electronics. The researcher selected three things for the couple discussion – either topics both partners rated highly, or where partners’ ratings diverged.

These discussions were not just coded for what the couple said, but also their tone of voice, facial expression, gestures and body movement.

After the birth, each parent was asked to complete a questionnaire about their birth experience. Meanwhile, medical records were consulted in order to determine physical birth outcomes.

The researchers found significant correlations between negative conflict and physical birth outcomes, but not between negative conflict and subjective assessments of birth stress. It is possible that birth stress is influenced more by the mother’s health experiences during pregnancy, driving both more conflict and a more stressful birth experience.

Earlier research shows a link between psychological stress and poor birth outcomes and also physical health.

There is also some research linking couple relationship quality and later birth outcomes. Women who report low support from their partner are more likely to experience high stress after childbirth. Couple conflict is also linked to low birth weight, though this research focuses on the more extreme situation of intimate partner aggression. Negative conflict is also linked more generally to lower physical health, affecting the immune system and blood pressure.

The research specifically on the links between couple conflict and birth outcomes has been surprisingly scarce to date.


Khaled M, Horton K, Khoddam H, Stoycos S & Saxbe DE (2020), Prenatal relationship conflict behavior predicts childbirth experiences and birth outcomes, Journal of Family Psychology

Header photo: Daniel Cruz. Creative Commons.