Thematic Analysis of Women’s Feelings Relating to Bladder Care During Birth With Epidural Anesthesia

Abstract

To evaluate how the method of bladder management after epidural anesthesia may affect a woman’s feelings of empowerment during birth. Thematic evaluation of women’s feelings regarding the type of bladder management they received during birth. A single, large, Midwestern hospital with more than 3,000 births annually. Surveys completed on postpartum unit between July 2017 and June 2018. Women giving birth to single, term neonates, receiving epidural anesthesia during birth. One hundred and sixty-three surveys were returned, with 106 participants answering qualitative questions. Types of bladder care evaluated included bedpan use (n = 12), intermittent catheterization (IC; n = 21), continuous indwelling Foley catheter (CIF; n = 27), and mixed (n = 46). Open-ended questions as part of a mixed-methods survey tool were used to garner thoughts from the birthing woman’s perspective, specifically asking if any positive or negative effects or feelings about their birth process came from their voiding experience–bladder maintenance (both using a bedpan and having a catheter). Direct quotations were evaluated by authors for common themes. Women who were offered the bedpan during birth were 1.6 times as likely to report experiencing more power and control of their birth experience by having a voice in their bladder care (confidence interval = 95%). Seventy percent of women were likely to appreciate the option of bedpan prior to catheterization (p = .0098). Common themes expressed addressed Comfort, Birth Process, and Catheter Avoidance. Participants in the bedpan group also expressed themes of Control, Capability, Participation, Choice, and Appreciation. The women in the IC and CIF groups expressed Relief and Ease. The CIF group expressed Lack of Worry and Convenience. Negative themes included Frustration and Difficulty (bedpan), Stress (IC group) and Discomfort–Pain (IC and CIF groups). Some women will prefer CIF placement for convenience and to help decrease their own level of worry, whereas other women will want to have a more active role in their bladder management during birth. Being offered the bedpan allows a woman a sense of power and control in the birth process and may lead to a better birth experience. Practitioners should address women’s preferences before catheterization and be prepared to address any possible negative feelings as they arise. Efforts should be made to protectively empower women during birth.