Perceptions Of Childbirth Research Articles

Autonomous and dependent–The dichotomy of birth: A feminist analysis of birth plans in Sweden

ObjectiveTo elicit pregnant women's perceptions of childbirth as expressed in their birth plans, and through a feminist lens analyse their wishes, fears, values, and beliefs about childbirth, as well as their expectations on partner and midwife. DesignThis study used qualitative content analysis, identifying subcategories, categories, and an overall theme in data gathered from women's written birth plans. A feminist theoretical framework underpinned the research. SettingA middle-sized city in northern Sweden. Participants132 women who gave birth in an obstetrician-led hospital labour ward between March and June 2016 and consented to grant access to their birth plans and antenatal and intrapartum electronic medical records. FindingsThree categories emerged: ‘Keeping integrity intact through specific requests and continuous dialogue with the midwife', ‘A preference towards a midwife-supported birth regardless of method of pain relief", and ‘"Help my partner help me" - Women anticipating partner involvement.' The overall theme linking the categories together was: ‘Autonomous and dependent - The dichotomy of birth', portraying women's ambiguity before birth -expressing a wish to remain in control while simultaneously letting go of control by entrusting partner and midwifewith decision-making regarding their own bodies. Key conclusions and implications for practiceWomen primarily desired a natural, midwife-supported birth and favoured a relationship-based, woman-centred model of care, based on the close interaction between woman, partner, and midwife. Midwives need to be aware of women's ambiguous reliance on them and the power they have to influence women's birth choices and birth experiences. Feminist theory and values in midwifery practice may be useful to inspire a maternity care based on women's wishes and expectations, acknowledging and valuing women's voices, and embracing the sanctity of birth and of the birthing woman's body.

Reconcilable differences? Portuguese obstetricians’ and midwives’ contrasting perspectives on childbirth, and women’s birthing experiences

Based on recent ethnographic research in Portugal, this paper examines contrasting perspectives of doctors and midwives regarding their roles in childbirth, the institutional contexts in which these divergent perspectives are enacted and sustained, and the inter-related experiences of birthing women. It was found that obstetricians’ rhetoric around birth focused on potential risk; interventions were often explicated through a perception of childbirth as a risk-laden, and potential emergency, situation. Within this discourse, hospital-based birth was presented as a triumph of progress. Technical measures were justified using institutional rationales, such as the use of anaesthetic pain relief during labour to ensure tranquillity within the maternity units and the induction of labour to guarantee “throughput” and free up hospital beds. Midwives, contrastingly, described their philosophy of care as one focused on offering women presence, guidance, and a range of informed choices in the management of birth, and professed their commitment to an ideal model of normal birth founded on minimal intervention, except in cases of clinical necessity. Both professional groups expressed mutual respect for each other´s skills and respective roles. However, the co-existence of different professional rationales within the same hospital setting, they admitted, resulted in tensions. These were found to be exacerbated by historical power dynamics and the present spatial and organisational separation of the two groups. Selected extracts from Portuguese women´s birth narratives from the same study are utilised to elucidate the variegated experiences of women, and the modes by which authoritative knowledge is reproduced. The potential ramifications of the current situation for the provision of effective maternity care are discussed, and the conceptualisation of women as autonomous consumers of services is challenged.

Choosing caesareans? The perceptions and experiences of childbirth among mothers from higher socio-economic households in Dhaka

In this paper, we examine the perceptions and experiences of childbirth among a group of wealthier women in Dhaka through in-depth interviews. We find that a number of factors including preference for Caesarean Section (CS), socio-economic position, family structure, and perceptions of modern childbirth contributed to the women’s overuse of medical childbirth services. Furthermore, women’s capacity to purchase modern maternal health care in the private sector did not necessarily ensure high quality care in a health system which approaches maternal healthcare as a profit-making enterprise rather than as an essential human right.

Mode of delivery, childbirth experience and postpartum sexuality.

Although childbirth has been studied extensively with regard to postpartum sexuality, the association between the psychological aspects of childbirth and postpartum sexuality has rarely been examined. This research is aimed at studying the possible association of mode of delivery, childbirth experience, sexual functioning, and sexual satisfaction. Three hundred seventy-six primiparous and nulliparous women completed this web-based survey 100-390days postpartum. The participants completed a socio-demographic and delivery details questionnaire, the Childbirth Perception Questionnaire (CPQ), the Index of Sexual Satisfaction (ISS) and the Sexual Function Questionnaire's Medical Impact Scale (SFQ-MIS). Structural equation modeling showed that there are indirect effects of mode of delivery on sexual functioning and sexual satisfaction through childbirth experience. Specific significant indirect paths were found: mode of delivery to sexual functioning through childbirth experience [B=- 0.26, p=0.023, 95% CI=(- 0.40, - 0.10)] and from mode of delivery to sexual satisfaction through childbirth experience [B=0.11, p=0.013, 95% CI=(0.05, 0.21)]. No significant direct effects were found between mode of delivery and sexual functioning or sexual satisfaction. The results point to the association of the psychological experience of childbirth, sexual functioning and sexual satisfaction. In addition, we found a possible indirect link between mode of delivery and postpartum sexuality. It can be concluded that the psychological factors associated with childbirth are important to the understanding of postpartum sexuality.

Continuity of care is an important and distinct aspect of childbirth experience: findings of a survey evaluating experienced continuity of care, experienced quality of care and women\u2019s perception of labor

BackgroundTo compare experienced continuity of care among women who received midwife-led versus obstetrician-led care. Secondly, to compare experienced continuity of care with a. experienced quality of care during labor and b. perception of labor.MethodsWe conducted a questionnaire survey in a region in the Netherlands in 2014 among 790 women after they gave birth. To measure experienced continuity of care, the Nijmegen Continuity Questionnaire was used. Quality of care during labor was measured with the Pregnancy and Childbirth Questionnaire, and to measure perception of labor we used the Childbirth Perception Scale.ResultsThree hundred twenty five women consented to participate (41%). Of these, 187 women completed the relevant questions in the online questionnaire. 136 (73%) women were in midwife-led care at the onset of labor, 15 (8%) were in obstetrician-led care throughout pregnancy and 36 (19%) were referred to obstetrician-led care during pregnancy. Experienced personal and team continuity of care during pregnancy were higher for women in midwife-led care compared to those in obstetrician-led care at the onset of labor. Experienced continuity of care was moderately correlated with experienced quality of care although not significantly so in all subgroups. A weak negative correlation was found between experienced personal continuity of care by the midwife and perception of labor.ConclusionThis study suggests that experienced continuity of care depends on the care context and is significantly higher for women who are in midwife-led compared to obstetrician-led care during labor. It will be a challenge to maintain the high level of experienced continuity of care in an integrated maternity care system.Experienced continuity of care seems to be a distinctive concept that should not be confused with experienced quality of care or perception of labor and should be considered as a complementary aspect of quality of care.

Multigravidas' perceptions of traumatic childbirth: Its relation to some factors, the effect of previous type of birth and experience

To investigate the relationship between multigravidas’ perceptions of traumatic childbirth (PTC) and their socio-demographic characteristics and the effect of their previous types of birth and experiences on PTC. This descriptive study was conducted in a state hospital in Northern Turkey. The universe of the study consisted of multigravidas. The sample of the study comprised 161 pregnant women determined with G power analysis. The data were collected using the “Pregnant Introductory Information Form” and “Perception of Traumatic Childbirth Scale”. The age, gestational week and the number of pregnancy of the participants were 28.27 ± 5.13, 30.45 ± 7.71 and 1.94 ± 1.07 respectively. The average PTC score was 70.57 ± 21.89. 1.9%, 28.6%i 39.1% and 23.6% of the pregnant women perceived their birth as “very low”, “low”, “moderate” and as “high” traumatic respectively. There was a negative correlation between the average PTC score and the gestational age, the number of pregnancies and the duration of the adverse events and positive correlation between the average PTC score and the number of hospital visits during pregnancy (p

Perceptions of the effects of childbirth on sexuality among nulliparous individuals.

Media representations of sexuality after childbirth depict vaginal birth as harmful and cesarean delivery as protective, although research does not support these depictions. The objective of the current study was to investigate perceptions of the effects of mode of delivery on sexuality. Nulliparous participants who were able to and interested in giving birth (N=1428) completed an online survey about their preferences for mode of delivery and their perceptions of childbirth as they specifically relate to sexuality. Participants provided demographic information, rated how influential different sources of information about childbirth were, and completed the Attitudes Toward Women's Genitals Scale. Up to half (16-48%), the participants agreed with different statements about vaginal birth as harmful to, and cesarean delivery as protective of, future sexuality. Participant characteristics that were independently predictive of endorsing these beliefs were: self-identifying as heterosexual, holding negative attitudes toward women's genitals, and reporting that reality media, nonreality media, and online media sources are influential sources of childbirth information. Participants who rated health care professionals as an influential source of information were less likely to endorse these beliefs. Given that there is no clear evidence in the empirical literature to support the claim that vaginal births are harmful and cesarean delivery is protective to one's future sexual life, it is important to dispel the existing misconceptions. Various media sources likely play a role in the perpetuation of this misinformation.

A Qualitative Assessment of Adolescent Girls' Perception of Living with Congenital Heart Disease: Focusing on Future Pregnancies and Childbirth

PurposeCongenital heart disease (CHD) is the most common birth anomaly in Japan, occurring in approximately 10.6 of every 1,000 live births. Advancements in medical and surgical care have increased births by women diagnosed with CHD. The study's purpose was to examine the perceptions of pregnancy and childbirth among adolescent girls with CHD. Design and MethodsTwelve semi-structured interviews were conducted, and the data were analyzed using a modified grounded-theory approach. ResultsThree categories and 16 subcategories were extracted. Adolescent girls with CHD reported feelings of distress and anxiety while struggling with their disease, and feared how their disease might negatively influence their future pregnancy. These concerns were related to a desire to become familiar with CHD. The girls also explored how their disease would be managed during pregnancy and childbirth. Overall, these perceptions were influenced by the girls' acceptance of their disease, and support from family, friends, and healthcare professionals. ConclusionsHealthcare professionals might assess adolescent girls' awareness of their disease before discussing pregnancy and childbirth risks. To encourage them to understand and cope with their disease, healthcare professionals might provide interventions tailored to the timing, stage, and degree of pregnancy and childbirth awareness. This could allow safer life planning, especially concerning pregnancy and childbirth decisions. Practice ImplicationsTo address adolescent girls' needs, healthcare professionals should continuously assess their awareness of pregnancy and childbirth as well as their psychological status, alongside CHD issues.

P.7.a.007 - Psychosocial determinants of poor quality of life of children with congenital heart disease

Congenital heart disease (CHD) is the most common birth anomaly in Japan, occurring in approximately 10.6 of every 1,000 live births. Advancements in medical and surgical care have increased births by women diagnosed with CHD. The study's purpose was to examine the perceptions of pregnancy and childbirth among adolescent girls with CHD.Twelve semi-structured interviews were conducted, and the data were analyzed using a modified grounded-theory approach.Three categories and 16 subcategories were extracted. Adolescent girls with CHD reported feelings of distress and anxiety while struggling with their disease, and feared how their disease might negatively influence their future pregnancy. These concerns were related to a desire to become familiar with CHD. The girls also explored how their disease would be managed during pregnancy and childbirth. Overall, these perceptions were influenced by the girls' acceptance of their disease, and support from family, friends, and healthcare professionals.Healthcare professionals might assess adolescent girls' awareness of their disease before discussing pregnancy and childbirth risks. To encourage them to understand and cope with their disease, healthcare professionals might provide interventions tailored to the timing, stage, and degree of pregnancy and childbirth awareness. This could allow safer life planning, especially concerning pregnancy and childbirth decisions.To address adolescent girls' needs, healthcare professionals should continuously assess their awareness of pregnancy and childbirth as well as their psychological status, alongside CHD issues.

INDEKS MENTAL-KOGNITIF ISLAM: SATU PENANDA ARAS PSIKOSPIRTUAL ISLAM REMAJA BERISIKO

The purpose of this study was to describe the Islamic Mentalcognitive index on risk youth. Islamic Mental-cognitive termed a structure depths of human childbirth perception, introspection, memory, creativity, imagination, conception, belief, reasoning, volition, and emotions as a unified way of thinking based on Islam, is an attempt to predict and as approaches to identify the problem and solve psychological risk youth. Six recovery centers have been chosen for this study, involving busy as 490 coaches and 128 students of a secondary school of nationality as a collection of the convoy. Background to the economic status of parents of respondents also identified and data collection is done using inquired about the accreditation forms which contains a measurement of Islamic Mental-cognitive. Data were analyzed using a mathematical formula to form the Islamic Mental-cognitive index that consists of multiple domains. Decision of the study showed an index of Islamic Mental-cognitive is at the stage of a low (score 51.56). The discovery of this study backs up one module coaching intervention and prevention against socio-psychological symptoms teens through the principles of the concept of Islamic Mental-cognitive, Islamic psychosocial and sunnah behavior.

Women’s experiences of routine care during labour and childbirth and the influence of medicalisation: A qualitative study from Iran

Objectiveto understand women’s experiences of routine care during labor and childbirth in a medicalised context. Designtwenty-six in-depth interviews were conducted during the late postpartum period and thematic analysis was applied. Settingfour public hospitals in Tehran with a high rate of births, providing services to low and middle income families. Participantswomen who had a low risk pregnancies and gave a birth to a healthy infant by normal vaginal delivery. Findingstwo main themes emerged: ‘An ethos of medicalisation’ which indicates that women’s perception of childbirth was influenced by the medicalised context of childbirth. And ‘The reality of fostered medicalisation’ which illustrates the process by which interventions during labor affected women’s pathway through childbirth, and how the medicalisation resulted in a birth experience which often included a preference for Caesarean Section rather than vaginal birth with multiple interventions. Implications for practicecontextual factors such as legal issues, state’s regulations and the organisational framework of maternity services foster medicalised childbirth in Tehran public hospitals. These factors influence the quality of care and should be considered in any intervention for change. The aim should be a high quality birth experience with minimal interventions during normal vaginal delivery. A midwifery model of care combining scientific evidence with empathy may address this need for change.

Associations between perceptions of care and women\u2019s childbirth experience: a population-based cross-sectional study in Rwanda

BackgroundIn recent years Rwanda has achieved remarkable improvement in quality of maternity care services but there is evidence of deficiencies in care quality in terms of disrespectful care. Women’s overall childbirth experience is an important outcome of childbirth and a factor in assessing quality of care. The aim of this study was to investigate how women’s overall childbirth experience in Rwanda was related to their perceptions of childbirth care.MethodsA cross-sectional household study of women who had given birth 1–13 months earlier (n = 921) was performed in the Northern Province and in the capital city. Data was collected via structured interviews following a questionnaire. Significant variables measuring perceptions of care were included in a stepwise forward selection logistic regression model with overall childbirth experience as a dichotomised target variable to find independent predictors of a good childbirth experience.ResultsThe majority of women (77.5%) reported a good overall childbirth experience. In a logistic regression model five factors of perceived care were significant independent predictors of a good experience: confidence in staff (Adjusted OR 1.73, 95% CI 1.20–2.49), receiving enough information (AOR 1.44, 95% CI 1.03–2.00), being treated with respect (AOR 1.69, 95% CI 1.18–2.43), getting support from staff (AOR 1.75, 95% CI 1.20–2.56), and having the baby skin-to-skin after birth (AOR 2.21, 95% CI 1.52–3.19).ConclusionsTo further improve childbirth care in Rwanda and care for women according to their preferences, it is important to make sure that the childbirth care includes the following quality aspects in national and clinical guidelines: build confidence, provide good information, treat women and families with respect, provide good professional support during childbirth and put the newborn baby skin-to-skin with its mother early after birth.

Honoring Motherhood: The Meaning of Childbirth for Tongan Women.

The purpose of this ethnographic study was to describe the meaning of childbirth for Tongan women. In this qualitative descriptive study, 38 Tongan women, 18 from Tonga and 20 from the United States, who had given birth in the past year were invited to share their perceptions of childbirth. Themes were generated collaboratively by the research team. The overarching theme was honoring motherhood; other themes include using strength to facilitate an unmedicated vaginal birth, describing the spiritual dimensions of birth, adhering to cultural practices associated with childbearing, and the influence of the concept of respect on childbearing. Understanding the value Tongan women and their families place on motherhood can help nurses to give culturally sensitive nursing care. Tongan beliefs and cultural practices should be respected. Nurses should assess women's personal preferences for their care and advocate for them as needed. Sensitivity to stoicism is important, especially on pain control and patient education. Nurses should be aware of Tongan values regarding modesty and respect, and provide an appropriate care environment. A culturally competent nurse understands the importance of sociocultural influences on women's health beliefs and behaviors and generates appropriate interventions.

Barriers to access in maternal healthcare services in the Northern Bangladesh

Poor women, in both rural and urban areas in the northern region of Bangladesh, experience high maternal mortality rate (MMR), and compared to other regions, this group also has a low proportion of receiving antenatal care (ANC) and of births assisted by the skilled health personnel. One of the prime factors for this situation is the lack of the poor mothers’ access to maternal health care (MHC) services. Finding out physical, social and organisational access barriers to MHC services and exploring how these barriers caused three delays in healthcare seeking behaviour were therefore the main objectives of the paper. The study used both primary and secondary data to meet its objectives. The primary data was collected from October to December in 2010 interviewing 160 mothers who were pregnant or delivered at least one baby during the last ten years and the heads of seven relevant health centres, administering eight focus group discussions and observing the field. An assortment of articles, reports, theses and books were consulted in complementing and substantiating the argument. The study found social (early marriage, perception of pregnancy and childbirth, high financial cost) and organizational (lack of female health staff, lack of a guiding principle in the health sector, in/exclusion errors in benefit distribution, low quality services) barriers more acute than physical (distance and waiting time) barriers. As concluded, all these barriers seem to have caused delays in seeking healthcare, reaching facility centres at the right time and receiving adequate services. The findings of the current study suggest that rescheduling official time of the service centre, recruiting and posting female health workers, following a guiding path and providing emergency obstetric care at free of costs are the feasible ways of getting better maternal health situation in the study areas.South East Asia Journal of Public Health Vol.6(2) 2016: 23-36

Childbirth and New Mother Experiences of Arab Migrant Women.

To explore the experience of childbirth and becoming a new mother for Arab migrant women in the United Kingdom. Hermeneutic phenomenology design was used to investigate the childbirth and early mothering experience of migrant Arab Muslim women from several countries to United Kingdom. Purposive sampling was chosen. Data collection was conducted through in-depth interviews. The emerging theme "displacement and reformation of the self" includes four subthemes from analyses of participants' interviews. These were the emerging dominance of the nuclear family over the extended family: self-contained/self-worth; moving from dependence: self-governing/self-reliance; freedom from cultural constraints: self-determination; and achieving peace of mind: self-satisfaction. Exploring the perception of migrant Muslim women's childbirth and new mother experiences in a foreign land may help caregivers better understand their healthcare needs.

Perception of Sex role and Marriage and Childbirth in Undergraduate Students

Background/Objectives: This study was conducted to analyze the sex role and the perception of marriage and childbirth in undergraduate students. Methods/Statistical analysis: A questionnaire survey was conducted on 155 undergraduate students from March to April, 2016. The data was collected from 147 undergraduate students by structural questionnaire. Data were analyzed using SPSS 18.0. The sex role and perception of marriage and childbirth was analyzed using at-test, ANOVA, the post hoc Scheffe’s test and Correlation of the sex role and marriage and childbirth was analyzed using Pearson’s correlation coefficient. Findings: The result showed that there was significant difference of the sex role in the religion (F=3.163, p=.027). With regard to the religion, Christian, catholic and no religion showed a higher sex role than buddhism. And there were significant differences of the marriage and childbirth in the gender (t=3.502, p=.001) and the religion (F=4.273, p=.006). Male students showed a higher degree of the sex role than female students and ‘Christian’ and , ‘Catholic’ and ‘Buddhism’ students showed a higher degree of the perception of the marriage and childbirth than , ‘catholic’ and ‘no religion’ students. There was not the correlation of the sex role and marriage and childbirth in undergraduate students (r=.490, p<.05). Improvements/Applications: Therefore, there is an urgent need to strengthen public relations and education with the support of governmental policies to establish favorable values related to marriage and childbirth among undergraduate students.

Perceptions of Adolescent Pregnancy Among Teenage Girls in Rakai, Uganda

The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited. This qualitative study explored the social and contextual factors shaping the perceptions of adolescent pregnancy and childbirth among a sample of 12 currently pregnant and 14 never pregnant girls living in the rural Rakai District of Uganda. Interviews were conducted to elicit perceived risk factors for pregnancy, associated community attitudes, and personal opinions on adolescent pregnancy. Findings indicate that notions of adolescent pregnancy are primarily influenced by perceptions of control over getting pregnant and readiness for childbearing. Premarital pregnancy was perceived as negative whereas postmarital pregnancy was regarded as positive. Greater understanding of the individual and contextual factors influencing perceptions can aid in development of salient, culturally appropriate policies and programs to mitigate unintended adolescent pregnancies.

한 자녀를 둔 어머니의 자녀가치와 부부친밀감, 분만경험지각, 부부공동양육이 부모역할만족도에 미치는 영향

한 자녀를 둔 어머니의 자녀가치와 부부친밀감, 분만경험지각, 부부공동양육이 부모역할만족도에 미치는 영향

일부 여대생의 취업스트레스, 무망감 및 우울이 출산인식에 미치는 융복합적 영향 분석

일부 여대생의 취업스트레스, 무망감 및 우울이 출산인식에 미치는 융복합적 영향 분석

Negative impressions of childbirth in a North-West England student population

Background: Sociocultural childbirth representations can influence the perceptions of childbirth negatively. In this paper we report on a survey study to explore the factors associated with negative impressions of childbirth in a North-West England University student sample. We also explored whether different sources and perceptions of childbirth information were linked to fear of childbirth.Methods: All students received a survey link via an online messaging board and/or direct e-mail. Female students who were 18–40 years of age and childless (but planned to have children in the future) were invited to participate. Demographics, birth preferences, a fear of birth and general anxiety measures were included as well as questions about what sources of information shaped students’ attitudes toward pregnancy and birth (i.e. visual/written media, experiences of friends/family members, school-based education and other) and impressions of birth from these sources (i.e. positive, negative, both positive and negative and not applicable).Results: Eligible students (n = 276) completed the online questionnaire. The majority were Caucasian (87%) with a mean age of 22.6 years. Ninety-two students (33.3%) reported negative childbirth impressions through direct or vicarious sources. Students with negative birth impressions were significantly more likely to report higher fear of birth scores. Negatively perceived birth stories of friends/family members, and mixed perceptions of visual media representations of birth were associated with higher fear of birth scores. Having witnessed a birth first-hand and describing the experience as amazing was linked to lower fear scores.Conclusion: First-hand observations of birth, especially positive experiences, had implications for salutary outcomes. Negative or conflicting perceptions of vicarious experiences were associated with increased levels of childbirth fear. While further research is needed, these insights suggest a need for positive birth stories and messages to be disseminated to mitigate any negative effects of indirect accounts.