Women's experiences of labor, surgery and first postnatal week by an emergency cesarean section

Abstract

PurposeThis study investigated the experiences of Japanese women who underwent emergency cesarean sections (c-sections), including their experiences during labor before to the decision for surgery, during surgery, and during the first postnatal week.MethodsEleven Japanese women who delivered live babies by emergency c-section at a private maternity hospital were interviewed in a semi-structured manner on the second and seventh postpartum days. Interviews were tape-recorded, and transcripts and participant observation in the postnatal ward assisted the interpretation. Data were analyzed qualitatively and inductively.ResultsEleven women (seven primiparas, four multiparas) participated in the study. The main reasons for surgery were fetal distress (n=9) and arrest of labor (n=2). The time between making the decision to perform surgery and birth ranged from 15 to 69 minutes. Six themes were evident from the women's experiences: shock of disappointed expectations, unavoidable fear and responsibility, release from pressure, re-experience of fear and pain, being saved by the baby, and getting out of a vicious cycle. Trying labor pain, shock, fear of their babies' or their own deaths, and feeling powerless and guilty contributed to the women's negative feelings about their birth experiences by emergency c-section. After surgery, however, women felt loving toward their babies, who had been born safely as a result of the surgery, and eagerly breast-fed or took care of the infants with midwifery/nursing support.ConclusionsThe findings suggest that prenatal childbirth classes need to include information on and discussion of possible emergency c-section and that emotional support from midwives and nursing staff in the operating room/postpartum unit helps to decrease a woman's negative feelings about birth experiences by emergency c-section and enhance her experiences as a mother. In addition, medical staff should be more aware of the birth trauma felt by the expectant mother surrounding emergency c-section.