Maternity nurses: how parents see us

Abstract

A major study of obstetrical units was conducted as far back as 1956 by Lesser and Keane in the United States. They found inadequacies in the emotional care and support given to labouring mothers. Danzinger (1979) observed women’s interactions with staff members in a traditional obstetrical setting and found both nurses and doctors offered arbitrary, uniform and, in her opinion, often inappropriate responses to labouring women. The rules for birthing conduct were laid down by professional rather than negotiated with individual women. Parents, however, tended to accept the rules and constraints and rarely violated them. Another study (Shields, 1978) examined subjective needs of labouring women. Supportive care was found to be most critical in the way mothers viewed their labour. Congruency between the mother’s expectation and perception of the time the nurse spent with her in labour also appeared to be important to mother’s satisfaction. Nunnally and Aguiar (1974) reported that attenders at prenatal classes had a significantly more favourable attitude to labour than did non-attenders. Birch (1982) examined the congruence between the anticipated and actual extent to which 30 mothers participated in decision making in labour. The majority of the mothers felt it important for them to have a say in decisions related to pain medication, privacy and ambulation during labour. Just over half of the mothers in her sample wanted a say in relating to fetal monitoring, internal examinations, whether or not they would receive food and fluids and choice of position for delivery. Approximately 40% of the women wanted a say as to when hospital personnel would be present, whether or not labour would be induced and whether or not they would have an enema. Ball (1981) undertook an extensive study in England to identify the patterns of care associated with different levels of emotional satisfaction or distress in the mother. Differences in levels of emotional satisfaction experienced by mothers were found to be statistically significant in relation to the type of parent craft classes attended, the social class of the mother and the mother’s feelings at the birth of her baby and the mother’s perception of postnatal care, as recalled 6-8 weeks after birth. One major cause of emotional distress reported by the mothers was feeling alone while they were in labour, particularly if they felt that labour had been difficult.