Midwifery
November 1, 2024
Orli Dahan, Alexander Zibenberg, Alon Goldberg
14 citations
Women who gave birth without medical interventions—such as epidural anesthesia or instruments—reported a significantly higher flow state during labor than those who had interventions. Flow, a positive altered state of consciousness, was measured using the Flow State Scale in 766 Israeli women recruited via social media. All nine dimensions of flow—including challenge-skill balance, sense of control, and transformation of time—applied to childbirth. This finding empirically supports the concept of "birthing consciousness," a peak experience resembling flow. Understanding women's subjective experience during physiological birth can improve clinical care and promote positive birth experiences with health benefits.
Frontiers in Psychiatry
February 9, 2023
Orli Dahan
14 citations
The subjective experience of childbirth strongly influences a mother's long-term mental health, yet many modern births are negative. This paper applies the psychedelic theory of 'set and setting'—where mindset and environment shape an altered state of consciousness—to childbirth. Recent evidence indicates that women enter a natural altered state ('birthing consciousness') during physiological labor. The author argues that deliberately framing birth preparation and the delivery environment using set and setting principles can improve both the psychological and physiological aspects of birth, promoting positive experiences and physiological births, a key but unmet goal in modern obstetrics and public health.
Frontiers in global women's health
January 1, 2025
Orli Dahan, Alon Goldberg
4 citations
During physiological childbirth, women who give birth at home report a significantly higher flow state—a sense of empowerment and fulfillment when challenge matches ability—compared to women who give birth in hospitals. This finding, based on 421 Israeli women who experienced physiological labor, shows that the home birth environment is correlated with heightened flow across several dimensions: challenge-skill balance, action-awareness merging, clear goals, unambiguous feedback, concentration, and joy. The birthing environment appears to crucially affect the mental state of women during labor, contributing a novel perspective to discussions on optimizing the childbirth experience.
Midwifery
July 16, 2025
Orli Dahan, Sapir Bar
2 citations
Postnatal debriefing, intended as a therapeutic conversation to help women process birth and prevent distress, can have variable effects, especially for those who experienced trauma. This commentary argues that when debriefing focuses only on women's expectations while ignoring the institutional and relational context of the birth, it can become a form of subtle coercion. This risks shifting responsibility for trauma from systemic failures onto the individual woman, reinforcing gaslighting and epistemic injustice. The authors propose that debriefing should be viewed as an ethically charged relational act, not a neutral task. A set and setting-informed approach may foster deeper validation, accountability, and healing.
Birth
December 1, 2025
Orli Dahan, Alon Goldberg
One-on-one continuous professional support during labor is linked to higher rates of physiological birth and a heightened state of flow—an altered consciousness characterized by complete absorption and energized focus. In a survey of 788 women who had given birth, those supported one-on-one by a midwife (80.9%) or doula (65.7%) had natural childbirth more often and fewer medical interventions than those receiving conventional assistance (44.4% natural birth). Women with one-on-one support also reported the highest flow state levels. The findings validate a correlation between continuous professional support and physiological birth, and establish for the first time a connection between such support and an empowering flow experience during childbirth.
Journal of reproductive and infant psychology
October 18, 2025
Orli Dahan, Yael Sciaky-Tamir, Shenhav Albo et al.
A flow-like mental state during childbirth, termed 'birthing consciousness' and characterized by hyperfocus, self-efficacy, and calm, is associated with shorter labor and better postpartum mental health. In a prospective cohort of 138 women planning vaginal births at an Israeli medical center, higher flow scores correlated with shorter second and third stages of labor and with lower postpartum stress. Women who rated their birth experience positively reported significantly higher flow than those with a negative experience. Logistic regression indicated that each additional flow point increased the odds of a positive birth experience. The findings suggest that attending to a woman's mental state during labor may improve outcomes.