Childbirth Experience Research Articles

Beyond the numbers: A phenomenological analysis of women's childbirth experiences in Spain’s evolving healthcare system

Beyond the numbers: A phenomenological analysis of women's childbirth experiences in Spain’s evolving healthcare system

Evaluation of childbirth readiness and its associated factors and consequences in pregnant women referring to health centers in Tabriz, Iran and providing strategies to promote childbirth readiness: a sequential explanatory mixed method study protocol.

Childbirth readiness encompasses interventions conducted during pregnancy that encourage pregnant women, their families and communities to plan for a healthy pregnancy, childbirth and postpartum period. It enhances women's childbirth experience and diminishes maternal mortality rates. This study seeks to assess the level of childbirth readiness, relevant factors and outcomes among pregnant women who have completed 37 or more weeks of gestational age and are attending health centres in Tabriz, Iran. The objective is to offer strategies for enhancing childbirth readiness. This sequential explanatory mixed-method study comprises three phases. The initial quantitative phase involves a descriptive-analytical longitudinal study focusing on pregnant women at 37 weeks of gestation or beyond. The quantitative data will be gathered by the sociodemographic and obstetric information questionnaire, the childbirth readiness scale, the pregnancy experience scale, the Wijma delivery expectancy/experience questionnaire (version A) (W-DEQ-Version A), the childbirth experience questionnaire-2, the childbirth outcome checklist, the Edinburgh's postnatal depression scale (EPDS), the postpartum specific anxiety scale research short-form, the next pregnancy desire questionnaire and the exclusive breastfeeding checklist. In the subsequent qualitative phase, purposive sampling will be employed, and data will be collected through individual, in-depth and semi-structured interviews featuring open-ended questions. Data analysis will be conducted using conventional content analysis techniques. In the final mixed-method phase, strategies to enhance childbirth readiness will be formulated by integrating findings from the quantitative and qualitative studies, a comprehensive literature review, and employing the Delphi method. This study has received approval from the Ethics Committee of Tabriz University of Medical Sciences in Tabriz, Iran (code number: IR.TBZMED.REC.1401.557). All participants will provide written informed consent before taking part in the study. The outcomes will be shared through articles published in journals, presentations at medical conferences, the validation of a reliable scale for assessing the level of childbirth readiness in pregnant women and the development of a policy brief outlining supportive strategies to improve childbirth readiness. These resources will be valuable for healthcare providers.

Childbirth Fear and Birth-Related Mindset of First-Time Mothers Who Registered for Antenatal Care in Public Hospitals in Nigeria

INTRODUCTION:Globally, studies have reported that many pregnant women often dread the childbirth experience. Its prevalence is higher in developing countries than in the developed countries. It is a problem more common among primigravid women, with consequences for their health and implications for their labor, birth, and postpartum period. Hence, there is a need to assess the level of childbirth fear and birth-related mindset among primigravida attending antenatal clinics in selected hospitals in Ibadan.METHODOLOGY:This study adopted a descriptive cross-sectional design. Two hundred and four primigravid women were selected using a simple random sampling technique. Data were collected with the aid of a questionnaire, and the result was analyzed using SPSS version 25.0.RESULTS:Findings of the study revealed that slightly above half (55.9%) of the respondents had a high level of childbirth fear. Also, majority (52%) of the respondents had a natural birth-related mindset. It further revealed that there is a significant association between age and childbirth fear with apvalue of <.001. Also, there is a significant association between childbirth fear and birth-related mindset with ap-value of <.001.CONCLUSION:The study concluded that there is a high level of childbirth fear among primigravida. It is recommended that there should be an increased focus on the fears of women of all ages toward childbirth. This should include providing tailored sensitive interpersonal care to them at all levels of care.

The Effect of Listening to the Surah Maryam in the First Stage of Childbirth on Traumatic Childbirth Perception, Post-traumatic Stress, and Postpartum Depression in Türkiye.

This randomized controlled trial was conducted to determine the effect of listening to Surah Maryam during the first stage of labor on postpartum depression, traumatic childbirth perception, and post-traumatic stress. Women in the Surah Maryam group (SMG) listened to Surah Maryam during the first stage of labor. Following the intervention, both groups were assessed using scales measuring the perception of traumatic childbirth, postpartum depression, and post-traumatic stress. Logistic regression analysis showed no statistically significant differences between the SMG and control group (CG) in terms of traumatic childbirth perception or postpartum depression following the intervention. However, listening to Surah Maryam was found to reduce post-traumatic stress in the SMG by 93% compared to the CG (OR = 0.070, 95% CI 0.017-0.286). Women should be allowed to perform spiritual practices according to their preferences during childbirth to ensure a positive childbirth experience and better mental health during the postpartum period.

Effectiveness of the Antenatal Training Program on Reducing Anxiety and Pain Levels in Mothers During Gestation at the Sobang Community Health Center in 2024

Women often experience anxiety and fear during pregnancy due to concerns about the pain of childbirth. This anxiety can lead to mental and physical tension, resulting in unnatural stiffness in muscles and joints. Such stress is associated with negative pregnancy outcomes, mood disturbances, and various somatic complaints. Physical exercise during pregnancy can be an effective intervention to reduce anxiety and pain, benefiting both maternal and fetal health. This study aimed to evaluate the effectiveness of the Antenatal Training Program in reducing anxiety and altering pain perception during pregnancy. The research involved 30 pregnant women at the Sobang Community Health Center, Pandeglang Regency, who completed pre-test and post-test questionnaires. The study results showed a significant improvement (p < 0.05) in reducing anxiety and pain perception among participants, confirming the effectiveness of antenatal exercise. The findings suggest that consistent participation in antenatal exercises positively impacts the childbirth experience. Additionally, pregnant women are advised to maintain proper nutrition and monitor their activities to ensure a healthy pregnancy and delivery activities carried out during the gestation period.

COVID-Related Visitor Restrictions and Childbirth Experiences in One US Hospital.

The objective of this study was to explore childbirth experiences during COVID-19 visitor restrictions. We used a descriptive phenomenological approach in our study, which took place in a postpartum unit at a level IV birthing hospital in the Mideastern United States, where 3617 births occurred in 2019. A total of 22 participants who were older than 18 years, who gave birth at 37 weeks gestation or more, and who had at least 1 birth experience in the United States prior to the COVID-19 pandemic participated in this study. We assessed participants' birth experiences before and during COVID-19 visitor restrictions through in-depth interviews. Participant perspectives revealed the following 6 themes after an iterative analysis: A Shared Personal Connection is a Valued Trait, A Female Support Person is Important, Nurses Went the Extra Mile, Support People Help with Decision-Making, Two is an Ideal Number of Support People, and Increased Psychological Burden. These findings are vital to inform hospital visitor policies moving forward in the endemic reality of COVID-19 pandemic.

Predictors of a positive birth experience in childbirth: A cross-sectional study

BackgroundRecognizing predictors of positive birth experience is viewed as essential for minimizing negative experiences during childbirth that are related to current obstetric care, especially when those could be attributed to intrapartum interventions. The CEQ-E is a suitable instrument for investigating maternal birth experience within the Spanish population, highlighting the necessity to identify predictors for all its domains. This study aimed to identify predictors of positive birth experience based on socio-demographic and clinical variables, and obstetric interventions. MethodsCross-sectional study conducted with consecutive sampling (N = 301). Quantitative data were collected by the Childbirth Experience Questionnaire (CEQ-E) and an Ad hoc questionnaire. Clinical data was obtained from participants' medical records. Descriptive, bivariant and multivariant analysis were performed. ResultsThe CEQ overall mean score was 3.18(SD:0.42), showing the highest score for the professional support (3.79; SD: 0.43) and the lowest for the own capacity (2.8; SD:0.57). All domains and overall score showed negative correlations with the number of intrapartum interventions (p ≤ .001). Inductions of labour, instrumental deliveries, and caesarean sections were inversely related to; overall birth experience score (p ≤ .001), perceived safety (p ≤ .001), and own capacity (p ≤ .001). Epidural analgesia was linked to worse values of birth experience (p ≤ .001). Predictors of positive birth experience were identified as having a midwife as birth attendant (p ≤ .001) and neonatal higher Apgar scores at birth (p ≤ .001), whereas higher maternal education grade (p = .04), inductions of labour (p ≤ .001) and caesarean births (p ≤ .001) had worse values on birth experience. ConclusionWomen reported a positive birth experience, and professional support was highly valued. Key predictors of lower scores in birth experience included higher maternal education, caesarean and instrumental deliveries, and neonatal intensive care unit (NICU) admission. Spontaneous labour onset predicted better capacity and safety. Epidural use decreased participation. Midwife-attended births reported better scores on birth experience, highlighting their importance in maternal care.

The Association Between Doula Care and Childbirth‐Related Post‐Traumatic Stress Disorder Symptoms: The Mediating Role of Childbirth Experience

ABSTRACTIntroductionAlthough the benefits of doula care during childbirth are well‐known, its impact on childbirth‐related post‐traumatic stress disorder (CB‐PTSD) symptoms are less thoroughly characterized. This study aimed to explore the association between doula care and CB‐PTSD symptoms and the potential mediating role of childbirth experience on this association.MethodsA prospective cohort study was conducted in a hospital in China, enrolling women with singleton live vaginal births. The exposure and primary outcome factors of interest were doula care and CB‐PTSD symptoms, with childbirth experience as a mediating factor. Questionnaires were administered to collect baseline data and childbirth experience at 3 days postpartum, and CB‐PTSD symptoms from participants at 42 days postpartum. Linear regression analysis was used to analyze the relationship between doula care, childbirth experience, and CB‐PTSD symptoms, while the mediating role of childbirth experience was analyzed using the SPSS (PROCESS) modeling tool.ResultsA total of 445 eligible women were included in the final analysis, including 120 who received doula care and 325 who did not. Linear regression analyses found that doula care was independently associated with CB‐PTSD symptoms (β = −0.11, p < 0.05) and childbirth experience (β = 0.50, p < 0.001). Childbirth experience was significantly associated with CB‐PTSD symptoms (β = −0.17, p < 0.001). Childbirth experience mediated the association between doula care and CB‐PTSD symptoms (indirect effect = −1.08, 95% CI −1.91 to −0.10), even after adjusting for potential confounders.ConclusionsChildbirth experience serves as a mediator of the association between doula care and CB‐PTSD symptoms. By providing supportive care for women during childbirth, their childbirth experience could be improved, thereby reducing the risk of CB‐PTSD symptoms.

Reclaiming lineage: Experiences of pregnancy and childbirth for Asian American adopted adults.

Reclaiming lineage: Experiences of pregnancy and childbirth for Asian American adopted adults.

Improving Maternity Care Where Home Births Are Still the Norm: Establishing Local Birthing Centers in Guatemala That Incorporate Traditional Midwives.

More than half of births among Indigenous women in Guatemala are still being attended at home by providers with no formal training. We describe the incorporation of comadronas (traditional midwives) into casas maternas (birthing centers) in the rural highlands of western Guatemala. Although there was initial resistance to the casa, comadronas and clients have become increasingly enthusiastic about them. The casas provide the opportunity for comadronas to continue the cultural traditions of prayers, massages, and other practices that honor the vital spiritual dimension of childbirth close to home in a home-like environment with extended family support while at the same time providing a safer childbirth experience in which complications can be detected by trained personnel at the casa, managed locally, or promptly referred to a higher-level facility. Given the growing acceptance of this innovation in an environment in which geographical, financial, and cultural barriers to deliveries at higher-level facilities lead most women to deliver at home, casas maternas represent a feasible option for reducing the high level of maternal mortality in Guatemala.This article provides an update on the growing utilization of casas and provides new insights into the role of comadronas as birthing team members and enthusiastic promotors of casas maternas as a preferable alternative to home births. Through the end of 2023, these casas maternas had cared for 4,322 women giving birth. No maternal deaths occurred at a casa, but 4 died after referral.The Ministry of Health of Guatemala has recently adopted this approach and has begun to implement it in other rural areas where home births still predominate. This approach deserves consideration as a viable and feasible option for reducing maternal mortality throughout the world where home births are still common, while at the same time providing women with respectful and culturally appropriate care.

GnRH-a-based fertility-sparing treatment of atypical endometrial hyperplasia (AEH) and early endometrial carcinoma (EC) patients: a multicenter, open-label, randomized designed clinical trial protocol

BackgroundAround 4% of women receive an endometrial cancer diagnosis before turning 40, mainly those without prior childbirth experience and a strong desire to preserve their ability to conceive. Consequently, for young patients diagnosed with atypical endometrial hyperplasia (AEH) or early endometrial carcinoma (EC), a fertility-preserving approach employing high-dose oral progesterone has been adopted. However, previous research has shown a notable relapse rate. Furthermore, the extended use of substantial oral progesterone doses may hinder ovarian function and raise the risk of weight gain, liver issues, blood clotting, and breast cancer. We previously assessed the clinical effectiveness and pregnancy outcomes of gonadotropin-releasing hormone agonist (GnRH-a) based re-treatment for women with EC and AEH who did not respond to oral progestin therapy but achieved favorable treatment results and reproductive outcomes.MethodsThis study will be an open-label, two-armed, randomized, investigator-initiated multicenter trial evaluating the combination of GnRH-a with the levonorgestrel-releasing intrauterine system or the combination of GnRH-a with an aromatase inhibitor (comprising a subcutaneous GnRH-a injection every 4 weeks and daily oral letrozole 2.5 mg). A total of 226 participants will be randomly allocated to one of the two treatment groups in a 1:1 ratio. The primary objective is to determine the effectiveness of GnRH-a-based re-treatment in achieving a complete response (CR) at 24 weeks for patients with AEH or EC. Secondary objectives include assessing the pregnancy rate 12 weeks after treatment, as well as post-treatment pregnancy outcomes and the rate of recurrence.Ethics and disseminationThe protocol received approval from the Institutional Review Board of Peking Union Medical College Hospital and from boards at five other institutions. The trial will adhere to the principles outlined in the World Medical Association’s Declaration of Helsinki and follow Good Clinical Practice standards. The trial results will be disseminated through publication in a peer-reviewed journal.ConclusionsProspective evidence supporting conservative treatment for EC and AEH is limited. There is a need for new approaches that can achieve higher CR rates with fewer side effects. This trial will assess the effectiveness of GnRH-a-based fertility-sparing treatment in obese women and recurrent patients, offering a promising alternative for patients with EC and AEH.Trial registration numberChinese Clinical Trial Registry ChiCTR2200067099. Registered on December 27, 2022.

Effect of Continued Midwifery Support in Labor on Childbirth Experience and Self-esteem of Primipara Women: A Randomized Controlled Trial

Introduction: During labor and delivery, mothers should be supported by people who give them comfort. The present study aims to determine the effect of continued midwifery support in labor on the childbirth experience and self-esteem of nulliparous women 6 weeks after childbirth. Methods: This randomized controlled trial was performed in 2021 on 70 pregnant women in the delivery ward. Participants were allocated to two groups through balanced block randomization. First, participants completed questionnaires. In the intervention group, the researcher stayed at the mother’s bedside and accompanied the mother continuously throughout the labor and up to 2 hours after childbirth. Both groups received routine care. Six weeks after childbirth, participants in both groups were contacted to complete the CEQ 2.0 and Rosenberg self-esteem questionnaires. The required data were collected and analyzed at a significance level of 0.05. Results: The mean (± SD) of childbirth experience 6 weeks after childbirth was 3.1 (± 0.2) in the intervention group and 2.6 (± 0.3) in the control group, and this difference was statistically significant (p < 0.001) (Cohen’s d = 1.7; 95% CI: 1.1, 2.3). The comparison of the mean of maternal self-esteem showed that this rate in the intervention group was 2.1 scores higher than that in the control group, and the difference was statistically significant (p = 0.02) (Cohen’s d = 0.6; 95% CI: 0.1, 1.1). Conclusions: Continued support of the midwife in labor and up to 2 hours after childbirth can lead to a better childbirth experience and enhance the mother’s self-esteem up to 6 weeks after childbirth.

Comparing the effect of haptonomy and CBT-based counseling on childbirth experience and postpartum depression of women with high fear of childbirth: A randomized clinical trial

Comparing the effect of haptonomy and CBT-based counseling on childbirth experience and postpartum depression of women with high fear of childbirth: A randomized clinical trial

Understanding the Impact of Childbirth: Postnatal Stress Symptoms in Psychologically Stable Mothers

This study examines the psychological impact of childbirth on first-time mothers, focusing on post-traumatic stress and depressive symptoms using the Impact of Event Scale (IES) and the Edinburgh Postnatal Depression Scale (EPDS). Many participants experienced intrusive thoughts, avoidance behaviors, and depressive symptoms within the first year postpartum. A strong correlation was found between mothers’ sense of safety and presence during childbirth and lower stress and EPDS scores. Additionally, the duration of Baby Blues was associated with higher IES and EPDS scores, suggesting that early emotional disturbances can have lasting effects on maternal mental health. The study also highlights how recounting birth experiences, either as reliving them or from a present perspective, influences stress levels. These findings underscore the importance of psychological support in postnatal care and advocate for routine screening for negative birth experiences and stress symptoms, emphasizing early intervention to improve maternal and family outcomes. Keywords: postnatal mental health, childbirth experience, maternal stress symptoms

Investigate mothers’ perceptions and experiences of natural childbirth and quality of care in childbirth management based on Safe Childbirth Checklist: A qualitative study

Investigate mothers’ perceptions and experiences of natural childbirth and quality of care in childbirth management based on Safe Childbirth Checklist: A qualitative study

The Interweaving of Pain and Perfection: A Qualitative Inquiry about the Experiences of Pregnant Women during Pregnancy and Childbirth in the COVID-19 Pandemic in Iran

Background: The prevalence of the COVID-19 pandemic has made the pleasant experiences of pregnancy and childbirth for women a source of fear and anxiety. Objective: To explore the experiences of pregnant women during pregnancy and childbirth in the COVID-19 pandemic. Methods: This qualitative conventional content analysis was conducted in Tehran, Iran, in May and June 2020. The 15 participants were selected via purposeful sampling including: 12 pregnant women, 2 relatives, and one nurse. Data were collected using in-depth and semi-structured interviews and the analysis adopted by Graneheim and Lundman (2004). MAXQDA version 12 was used for data organization. Results: According to the findings, 12 sub-categories, 6 categories, and one theme were extracted. The main theme that was derived from the analysis of the data was " the interweaving of pain and perfection". The categories include "emotional disorders", "obsessive disorders", "psychological disorders", "strengthening the dimension of spirituality" "the need for more support resources", and "inadequacy in presenting the role of motherhood. Conclusion: According to the experiences of pregnant women during pregnancy and childbirth during the outbreak of COVID-19, social, psychological, and emotional support through family and healthcare providers is recommended, as is the formation of virtual counseling groups to answer the questions of pregnant women. Health policymakers and decision-makers can use the results of this research to plan for providing services for pregnant women during future pandemics.

Predictors of Pregnant Women's Decision to Opt for Cesarean Section in Romania.

In Romania, the latest official report indicates that more than half of the births (80,890 cases, representing 52.88% of the total) are performed by cesarean, a rate significantly higher than the World Health Organization (WHO) recommendation of 15-20%. This study aims to identify the predictors associated with women's decisions to opt for cesarean in Romania. An analytical cross-sectional observational study was conducted in the general population of Romania. The study was carried out over the course of 2023, with a total duration of four months. During this period, researchers targeted pregnant women from various regions of the country, regardless of their place of residence, age, or education level. The primary data collection tool was a self-administered online questionnaire, distributed via Google Forms, an accessible and efficient platform that allows for automatic response collection. The questionnaire was distributed online, particularly on social media platforms frequented by pregnant women, such as Facebook, Instagram, and TikTok. A total of 1,301 participants were validated. Socio-demographic and clinical factors significantly influence women's decisions to give birth by cesarean.Among these participants, 435 expressed a preference for cesarean delivery. Key predictors include fear of pain and concern for the child's health. Fear of pain at birth is the first predictor in Romanian women to choose cesarean (OR=2.09; 95% CI: 1.62-2.68). Concerns about the child's health do not increase the likelihood of opting for a cesarean. By utilizing valuable resources such as midwives and implementing strategies like birth plans, significant contributions can be made toward reducing the cesarean rate and improving the childbirth experience for women worldwide.

Optimizing labor duration with pilates: evidence from a systematic review and meta-analysis of randomized controlled trials

BackgroundPilates has captured interest due to its possible advantages during pregnancy and childbirth. Although research indicates that Pilates may reduce labor duration, alleviate pain, and improve satisfaction with the childbirth experience, consensus on these outcomes remains elusive, underscoring the necessity for additional studies.AimThis systematic review and meta-analysis aimed to assess the impact of Pilates exercises on labor duration among pregnant women.MethodsThe online database was searched to yield the literature using the terms of ‘Pilates’, ‘childbirth’, and ‘labor duration’, and similar terms including PubMed, Clinical Key, Scopus, Web of Science, Embase, and Cochrane Database of Systematic Reviews up to June 25, 2023. Studies were considered eligible if they were randomized or clinical controlled trials (RCTs/CCTs) published in English, focusing on healthy pregnant women without exercise contraindications. The studies needed to include interventions involving Pilates or exercise movement techniques, a comparison group with no exercise, and outcomes related to labor duration, the period of the active phase, and the second stage of delivery.ResultsEleven studies, totalling 1239 participants, were included in the analysis. These studies provided high-quality evidence from exercise only RCTs/CCTs. The findings indicated a significant reduction in the active phase of labor (8 RCTs, n = 1195; Mean Difference [MD] = -56.35, 95% Confidence Interval [CI] [-89.46 to -23.25]) and overall labor duration (8 RCTs, n = 898; MD = -93.93, 95% CI [-138.34 to -49.51]) in pregnant women who engaged in Pilates exercises compared to those who did not but doesn’t affect on the duration of the second stage of labor (7 RCTs, n = 1135; MD = -0.11, 95% CI [-7.21 to 6.99]).ConclusionsWhile this review primarily addresses the effects of Pilates on healthy and low-risk pregnant women, the findings suggest a potential role for Pilates in shortening labor duration. Therefore, engaging in Pilates or similar physical activities is recommended for pregnant women to potentially facilitate a more efficient labor process.

“Letting themselves go during care” – exploring patient autonomy during co-designed intrapartum care in a Beninese maternity ward

BackgroundPatient autonomy is central to the provision of respectful maternity care. Enabling women to make decisions free of discrimination and coercion, and respecting their privacy and confidentiality can contribute to positive childbirth experiences. This study aimed to deepen the understanding of how patient autonomy is reflected through social practices during intrapartum care in Benin.MethodsSemi-structured interviews with women and midwives, a focus-group discussion with women’s birth companions, and non-participant observations in the delivery room were conducted within the frame of the ALERT research project. This study analysed data through a reflexive thematic analysis approach, in line with Braun and Clarke.ResultsWe identified two themes and five sub-themes. Patient autonomy was systemically suppressed over the course of birth as a result of the conditions of care provision, various forms of coercion and women’s surrendering of their autonomy. Women used other care practices, such as alternative medicine and spiritual care, to counteract experiences of limited autonomy during intrapartum care.ConclusionsThe results pointed to women’s experiences of limited patient autonomy and their use of alternative and spiritual care practices to reclaim their patient autonomy. This study identified spiritual autonomy as an emergent dimension of patient autonomy. Increasing women’s autonomy during childbirth may improve their experiences of childbirth, and the provision of quality and respectful maternity care.

The effect of Rebozo technique on perceived labour pain and childbirth experience: A randomized controlled trial.

Pain, stress, and anxiety experienced during childbirth can have detrimental effects on labor and delivery. The rebozo technique is an ancestral method used to minimize pain and enhance relief during gestation. This study aimed to investigate the effects of the rebozo technique on the birth process and its probable benefits on the birth experience. This survey was conducted from January to May 2021 in a randomized and controlled manner. A total of 113 pregnant women with their first children were surveyed. Women between 37 and 41 weeks of gestation without complications who were admitted to the delivery room with a cervical dilation of 4 cm or more were chosen as participants. In the Rebozo group, subjects were randomly selected by trained personnel to apply the standardized method, while the control group received a relaxing massage. Cervical dilation, fetal position, contraction patterns, and measures related to the birth experience were key indicators. Women in the rebozo group had lower pain levels during birth and greater birth satisfaction. Mean cervical dilation in the latent phase was 5.61 cm in the rebozo group and 5.71 cm in the control group. In the active phase, cervical dilatation was 6.03 cm in the rebozo group and 6.68 cm in the control group, and this difference was statistically significant (P < .001). In the transition phase, the birth time was 46.29 minutes in the rebozo group and 68.71 minutes in the control group (P = <.007**). In the total birth experience score, the rebozo group received an average of 68.52 points, while the control group received 51.58 points (P < .001). This research has established that the use of the rebozo technique throughout labor helps enhance her feelings about being pregnant, as well as heightening fulfillment with delivery.