Women's Childbirth Experiences Research Articles

Childbirth experience in women at high risk in facing the delivery process at UGM academic hospital

Background: High-risk pregnancy is a severe threat to the health and life of pregnant women and babies, considering that this can increase the risk of complications during pregnancy, childbirth and puerperium. About 20 million women worldwide have high-risk pregnancies, and it is known that more than 800 die each day. Pregnant women have potential risks during pregnancy, childbirth and the puerperium. The mother's lack of knowledge about pregnancy health problems and health service providers can increase inappropriate handling risk by health workers. So, women should understand the concept of high-risk pregnancies to reduce these risks. Research Objectives: To determine the childbirth experiences in mothers at high risk in the delivery process at UGM Academic Hospital. Method: Qualitative Research with Descriptive-Narrative Design. Results: The mothers knew the risks of pregnancy, but they were less aware of the risks of other pregnancies. Mothers’ experience in choosing a place of delivery was influenced by personal experiences, family, friends, or other people. The availability of adequate hospital facilities, service flow, and ownership of insurance coverage were also other factors in choosing a maternity hospital. Conclusion: Mothers are aware of the risks of pregnancy, but they are less aware of other pregnancy risks. Suggestion: Mothers should be aware of the risks of pregnancy and need to learn more about other pregnancy risks. It is hoped that they will be better prepared if a high-risk pregnancy occurs.

Cultural adaptation of the person-centered maternity care scale at governmental health facilities in Cambodia.

In Cambodia, the importance of valuing women's childbirth experiences in improving quality of care has been understudied. This is largely because of absence of reliable Khmer tools for measuring women's intrapartum care experiences. Generally, cross-cultural development of those tools often involves translation from a source language into a target language. Yet, few earlier studies considered Cambodian cultural context. Thus, we developed the Cambodian version of the Person-Centered Maternity Care (PCMC) scale, by culturally adapting its original to Cambodian context for ensuring cultural equivalence and content validity. Three rounds of cognitive interviewing with 20 early postpartum women were conducted at two governmental health facilities in Cambodia. Cognitive interviewing was composed of structured questionnaire pretesting and qualitative probing. The issues identified in the process of transcribing and translating audio-recorded cognitive interviews were iteratively discussed among study team members, and further analyzed. A total of 14 issues related to cultural adaptations were identified in the 31 translated questions for the Cambodian version of the PCMC scale. Our study identified three key findings: (i) discrepancies between the WHO recommendations on intrapartum care and Cambodian field realities; (ii) discrepancies in recognition on PCMC between national experts and local women; and (iii) challenges in correctly collecting and interpreting less-educated women's views on intrapartum care. Not only women's verbal data but also their non-verbal data and cultural contexts should be comprehensively counted, when reflecting Cambodian women's intrapartum practice realities in the translated version. This is the first study that attempted to develop the tool for measuring Cambodian women's experiences during childbirth, by addressing cross-cultural issues.

Childbirth experiences for women in a Kenyan county referral hospital

Background/Aims A woman's experience of childbirth can be positive or negative, although pregnant women have the right to a positive experience. A woman's experience should be fulfilling, and meet expectations that may be informed by personal and sociocultural beliefs. This study aimed to explore women's childbirth experiences at a county referral hospital. Methods This study used a transcendental phenomenological design. A total of 11 postnatal women were recruited until data saturation was achieved. Data were collected using semi-structured interviews and responses were recorded. Data were transcribed and manually coded, and major themes and sub-themes were identified using thematic analysis. Results Women reported unbearable and traumatic labour pain with little intervention from caregivers. The majority of women had friendly and caring midwives as well as a clean and spacious postnatal ward. This experience shaped their courage, self-belief and the desire for a subsequent pregnancy and birth. Conclusions Generally, most women had a positive and satisfying childbirth experience despite labour pains. To ensure an optimally positive childbirth experience for all women, there is a need to promote privacy, comfort and respectful maternity care while offering alternative labour pain management.

Insights into women's experiences of giving birth during the coronavirus disease-19 pandemic in Jordan, a cross-sectional survey.

Since 2019, the coronavirus disease-19 pandemic and its consequences from restrictions to risks have impacted our lives in all aspects. Pregnant women are especially vulnerable to the changes that were implemented as a result of the shift in healthcare priorities and the medical and social implications of the lockdown. This study aimed to assess the experience of giving birth during the pandemic, how this is affected by acquiring coronavirus disease-19 infection, and its effect on postnatal mood. A cross-sectional study was conducted which involved 490 women who gave birth during the pandemic across the Hashemite Kingdom of Jordan. An electronic questionnaire was distributed among women experiencing childbirth during this period in Jordan by advertising it on social media platforms targeting pregnant women and mothers. The sample size was statistically determined to be representative of the population. Statistical analysis was performed using Statistical Package for the Social Sciences for Windows v.27. The study demonstrated that getting infected with the virus throughout the pregnancy did not affect the childbirth experience with respect to the parameters measured, but other factors during the pandemic such as the type of hospital and mode of delivery did. Positive interaction with staff in the delivery suite was a major determinant of a positive birth experience. Women associated low mood post-delivery with giving birth in pandemic circumstances, and it affected first-time mothers more than multiparous women. Although the acquisition of coronavirus disease-19 infection did not have a significant impact on women's childbirth experience, several pandemic-related factors did. Given the importance of a woman's perception and evaluation of events surrounding her birth experience in determining her postnatal physical and psychological well-being, having to give birth during the pandemic circumstances, especially for first-time mothers, can have potentially detrimental consequences that may affect her health and reproductive choices in the future. The results of this study offer a better understanding of the effect of pandemic and lockdown circumstances on the perceived experience of mothers during childbirth and postnatally and factors that should be taken into consideration when planning healthcare provision to this population in future similar conditions.

Women's Childbirth Experiences During COVID-19 Pandemic in Indonesia.

Explore in depth the experiences of women giving birth during the COVID-19 pandemic in Indonesia. Qualitative research with a descriptive phenomenological. A total of 16 participants did not suffer from COVID-19 and gave birth during the COVID-19 pandemic in the community setting area. There are five themes: 1: Feelings of anxiety and fear of giving birth in hospitals are experienced by women giving birth during the COVID-19 pandemic, 2. Screening for COVID and health protocols applied in hospitals during the COVID-19 pandemic, 3. Support from husbands, families, and health workers is needed when giving birth during the COVID-19 pandemic, 4. Lack of family visits hours is an obstacle during childbirth, particularly during the COVID-19 pandemic, and 5: Bonding attachment between mother and baby while at the hospital. Optimal maternity nursing care and supporting health facilities and public policies will help mothers give birth during the COVID-19 pandemic in Indonesia.

Intrapartum pudendal nerve block analgesia and childbirth experience in primiparous women with vaginal birth: Acohort study.

A negative childbirth experience has short- and long-term consequences for both mother and child. This study aimed to investigate the association between intrapartum pudendal nerve block (PNB) analgesia and childbirth experience. Primiparous women with a singleton cephalic vaginal live births at term at Oslo University Hospital from January 1, 2017, to June 1, 2019, were eligible for inclusion. The main outcome was total score on a childbirth experience questionnaire (range 1.0-4.0, higher score indicates better childbirth experience). An absolute risk difference of 0.10 was considered clinically relevant. Propensity score matching was used to adjust for differences in baseline characteristics between women with and without PNB. The analyses were stratified by spontaneous vs instrumental birth. Subanalyses of the questionnaire's domains (own capacity, professional support, perceived safety, and participation) were performed. Of 979 participating women, mean age was 32 years. Childbirth experience did not differ between women with and without PNB, either in spontaneous (absolute risk difference of the mean: -0.05, P value 0.36) or in instrumental birth (absolute risk difference of the mean: 0.03, P value 0.61). There were no statistically significant differences between PNB group scores for the separate domains. Women's childbirth experiences did not differ between birthing people with or without PNB, either in spontaneous or in instrumental births.The clinical implications of our study should be interpreted in light of the pain-relieving effects of PNB.PNB should be provided on clinical indication, including for individuals with severe labor pain.

Iranian women's birth experiences: a cross-sectional study

Background/Aims Women's childbirth experiences are an essential measure of childbirth and have a significant role in evaluating and improving the quality of care given during birth. This study's aim was to evaluate women's experiences during labour and childbirth in a teaching hospital in Iran. Methods This cross-sectional study was conducted in a public hospital in Guilan from July to August 2018. The study recruited 126 low-risk postpartum women. The childbirth experience questionnaire and a researcher-developed questionnaire were used for data collection. Linear regression was used to assess the effect of factors on birth care experience (significance level: P<0.05). Results Women's experiences of childbirth were not optimal. Women's overall experience score was 2.56±0.42. The desire to have a normal birth (P<0.001), the freedom to drink, change position or walk during labour (P=0.01), receiving respectful care (P<0.001) and emotional support (P=0.009) were contributing factors to women's perceptions of their experiences. Conclusions Quality improvement strategies are needed to implement evidence-based care in Iran. Interventions to ensure that healthcare professionals’ behaviour promotes women's psychological wellbeing and creates a respectful birth environment are required to promote high-quality childbirth care and improve birth experiences in Iran.

Passing the test of motherhood? Self-esteem development and birth experience in the transition to motherhood: A longitudinal mixed methods study in Finland.

To investigate women's childbirth experiences and their relation to self-esteem development in the postpartum year. A mixed methods study. Women (N=125) completed survey questionnaires regarding their self-esteem and childbirth experiences at three time points in 2020-2021: third trimester of pregnancy (T1), 4-8 weeks postpartum (T2) and 1 year postpartum (T3). The survey results were analysed using qualitative thematic and quantitative path analyses with latent change factors. The open-ended answers of the women who demonstrated a change in self-esteem between T2 and T3 were then compared. The STROBE checklist was used as the reporting guideline. The quantitatively measured childbirth experiences predicted statistically significantly and positively the changes in self-esteem in the following year. The women described their childbirth stories through three main themes: childbirth as a lived experience, childbirth as a relational event and childbirth as a medical event. On the basis of the thematic analysis, we propose that the relationship between childbirth experience and self-esteem development might only hold for women with extremely positive or negative childbirth experiences. There were mixed results for those women who had mixed experiences, indicating that other factors probably contributed to the changes in self-esteem. Childbirth is a pivotal event that may have lasting effects on the mother's self-esteem after childbirth. Especially women with traumatic experiences deserve attention because they are at risk of the most negative consequences. Perinatal services and policy makers must recognize the importance of childbirth experiences in women's well-being and improve their practices. Different cultural models of childbirth should be recognized and supported to facilitate good experiences and prevent traumatic ones. Service users recruited in Finnish Child Health Centers responded to surveys that were used as data for this study.

The association of a past childbirth experience with a variety of early physical and mental symptoms in subsequent pregnancies

BackgroundSome women have a perceived negative experience of childbirth due to various reasons- e.g., obstetric complications or the feeling of loss of control. We do not know enough about the effects of a perceived negative experience of a childbirth on a woman's subsequent pregnancies. The aim of this study was to investigate whether a previously perceived negative childbirth experience affects a woman's physical and mental well-being in a later pregnancy. MethodsA prospective cohort study in Danish general practice, based on information about women's childbirth experiences from the Pregnancy Health Record filled in by the general practitioner (GP) and data from an electronic questionnaire completed by the women. ResultsA total of 1288 women were included in the analysis. Women who had given birth before were found to have a significantly higher risk of experiencing nausea, varicose veins and uterine contractions, and a lower risk of pelvic cavity pain in the current pregnancy. Women having given birth before were significantly more likely to assess their physical fitness as poor and to experience poor well-being.Women with a perceived negative experience of childbirth had more sleep problems and a higher prevalence of poor self-rated health than women with unproblematic childbirth experience. ConclusionThis study showed that women with a previously perceived negative experience of childbirth are affected according to their mental health in their subsequent pregnancy

Two are better than one? The impact of lay birth companions on childbirth experiences and PTSD.

Although continuous support during childbirth is recommended by the World Health Organization (WHO) and has well-established benefits, the practice is still not routinely implemented in all maternity settings. We studied the possible effect of an additional lay companion (other than the partner) on childbirth experience and postpartum post-traumatic stress disorder (PTSD). Two hundred and forty-six women, who gave birth in maternity wards of a large tertiary health center in Israel, responded to questionnaires in person at 1–4 days (Demographic questions and the childbirth experience questionnaire) and on-line at 8–10 weeks postpartum (City Birth Trauma Scale). Obstetric data were taken from the medical files. Women who were accompanied by their partners and an additional companion were lower in birth-related PTSD symptoms (M = 1.17, SD = 2.61) than women accompanied by only their partner (M = 1.53, SD = 2.79) (F(2, 240) = 4.0, p < 0.05). Women who had a single companion (M = 1.44, SD = 2.61) showed more birth-related PTSD symptoms than women who had two or more companions (M = 1.17, SD = 2.52) (F(1, 241) = 6.4, p < 0.05). In addition, women who had a single companion were higher in general PTSD symptoms (M = 3.91, SD = 4.73) than women who had two or more companions (M = 2.31, SD = 4.29) (F(1, 241) = 4.2, p < 0.05). No differences were found in childbirth experiences of women with single or multiple companions. Allowing more than one lay companion (other than the partner) may be a simple cost-effective way of providing beneficial support in all birth settings, promoting respectful maternity care and reducing childbirth-related PTSD levels and by that future psychopathology sequela.

Immersive virtual reality on childbirth experience for women: a randomized controlled trial

ObjectiveTo evaluate the effectiveness of immersive virtual reality (VR) on patient satisfaction as a distractive tool and pain relief among laboring women.MethodsThis was a randomized, controlled clinical trial with 42 laboring women allocated to VR intervention and control groups. Among women in the VR group, patient satisfaction with the use of VR was assessed by a Virtual Reality Satisfaction Survey, measured by a Visual Analog Scale (VAS) score and evaluated by questioning them about whether they would choose VR in future labor. As a primary outcome, patient satisfaction scores regarding the overall childbirth experience were compared between women in the two groups. A secondary outcome was pain assessed by a visual pain rating scale in the early and active phases of labor in women in both groups. Psychometric information was also collected from participants in each group using the Beck Anxiety Inventory and Beck Depression Inventory.ResultsWe observed a high level of patient satisfaction with the use of immersive VR during labor. The VAS revealed a mean satisfaction score of 87.7 ± 12.9 out of a maximum of 100. Twenty out of 21 (95%) women in the VR group stated that they would like to use VR again in future labor. VR improved pain scores in early labor and contributed positively to the overall childbirth experience. The mean pain score pre-VR was 2.6 ± 1.2 compared to 2.0 ± 1.3 post-VR (p < 0.01). Anxiety and depression scores were similar in participants in the intervention and control groups (p = 0.103 and p = 0.13, respectively).ConclusionImmersive VR application during labor was associated with higher patient satisfaction based on our study findings. VR also improved participants’ pain scores in early labor before epidural administration. Immersive VR may find a place as an adjunct in labor and delivery units to improve lengthy labor experiences for women. Studies with larger groups of participants are needed to confirm these observations.Trial RegistrationClinicalTrials.gov: NCT05032456

Implementation of a midwifery model of woman-centered care in practice: Impact on oxytocin use and childbirth experiences.

INTRODUCTIONTheoretical models for midwifery have been developed in different countries, but few have been evaluated. This study evaluated the implementation of a midwifery model of woman-centered care (MiMo) in practice.METHODSA mixed method study based on an implementation of MiMo was carried out in a labor ward at a university hospital in Sweden, with another labor ward as a reference. The qualitative core component was a secondary analysis of focus groups with midwives after the implementation. The supplemental quantitative components were oxytocin use for augmentation of labor and women’s childbirth experiences before and after the implementation.RESULTSThe midwives viewed MiMo as a useful tool for comprehending the birthing woman holistically, and for identifying what might disturb the birth process. Hindering factors were a lack of organizational stability and time, and midwives’ unwillingness to understand the model. Oxytocin use decreased significantly only in the implementation ward (p=0.002) and a significant difference was found between wards in the post-implementation period (p=0.004). However, logistic regression analyses showed that the interaction between ward and time period, controlling for age, epidural use, and birth outcome, was not significant (p=0.304), indicating that the decrease was not significantly related to the implementation. Childbirth experience did not differ before and after the implementation.CONCLUSIONSBy using MiMo in practice, midwives have a tool for comprehending the woman holistically and identifying disturbing factors during the birth. However, more research is needed for further implementation that should focus on the potential as well as hindering factors.

The enduring impact of birth: Women's birth perceptions, postpartum depressive symptoms, and postpartum depression risk.

Postpartum depression (PPD) and related maternal mood disorders affect anywhere from 7% to 19% of postpartum women. Although historically a neglected issue, there has been a strong impetus in the past few decades to implement routine, universal screening and to address PPD as a major public health concern. Still, there has been relatively little analysis of how the quality of the birth experience influences subsequent maternal mental health. We examine the relationship between perceived birth experience and two PPD screeners (Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale). Data came from waves I and II of the Listening to Mothers data set. This is the only national survey of US women's childbirth and postpartum experiences. In logistic and linear regression models, we used a 12-item "feeling" index (perceived birth experience) to predict (a) overall PPD screener scores, and (b) likelihood of meeting the clinical cutoff for depression risk. We also controlled for other known socio-demographic and obstetric risk factors. Perceived birth experience strongly and consistently predicted both PPD screener measures, and in both forms-raw scores and clinical cutoffs. By contrast, other known risk factors had inconsistent results across the two screeners. Perceived birth experience should be considered more central in assessing PPD. It may also be more robust than the PPD screeners used in practice, and therefore, could be a more reliable predictor of PPD. Providers should consider how the improved social-psychological quality of women's birth experience can act as a buffer to PPD and other postpartum concerns.

The relationship between women’s childbirth experiences and their maternal attachment and the risk of postpartum depression

Introduction and aim. This descriptive study was conducted to examine the effects of the childbirth experiences of mothers on their maternal attachment and postnatal depression. Material and methods. The study was conducted with 315 mothers who agreed to participate in the study in Obstetrics and Gynecology Hospital between 2 September 2019 and 25 February 2020. A “Personal Information Form”, “Childbirth Expectation and Experience Questionnaire (CEEQ)”, “Maternal Attachment Inventory (MAI)”, and “Edinburgh Postnatal Depression Scale (EPDS)” were used to collect data. The data were analyzed with the IBM SPSS v23 program. Independent-samples t test, oneway analysis of variance (ANOVA), and Pearson’s correlation test were used in the analyses. Results. The mean postpartum depression mean score of the participants was 4.3±5.9, and 23% of them were at risk of depression. The mean maternal attachment score of participants was determined as 85.2±4.6, and their mean birth experience score was 3.0±3.1. A positive and significant relationship was found between more than half of the items of Childbirth Expectation and Experience Questionnaire and general satisfaction (p≤0.05). The childbirth experience scores of the participants were not significantly related to their maternal attachment and postpartum depression scores (p&gt;0.05). Conclusion. In this study, no significant relationship was found between the childbirth experiences of women and their maternal attachment or postpartum depression levels.

Professional learning using storytelling videos of childbirth experiences: A qualitative pilot study of student midwives' perceptions in Myanmar.

AimsTo explore and describe Myanmar student midwives' perceptions of professional learning using storytelling videos of women's childbirth experiences by conducting a qualitative study and to assess potential pedagogical uses of storytelling videos in midwifery education.MethodsThis pilot study used a qualitative content analysis study design implemented as part of the Diversity and commonalities of birth from women's voice sharing project of the Toyota Foundation. Storytelling videos of the childbirth experiences of seven Asian women (three Myanmar, three Lao, and one Japanese women) were viewed by the students. Thereafter, a semistructured interview with focus group discussion was conducted to explore and assess the students' perceptions.Setting: Kyaing Tong township, Shan State, Myanmar.Participants: Five second‐year midwifery students from a single midwifery training school in Myanmar.ResultsData analysis of their perceptions yielded four major categories: (1) deep reverence for women/mothers;; (2) respectful attitude as a midwife to support mothers; (3) wish for a safe and secure birth environment; and (4) importance of learning from the mother's voice.ConclusionsThe student midwives realized the importance of listening to the mothers' voices regardless of the nationalities or cultural background. The findings indicated that the storytelling videos broadened the students' perspectives of pregnancy and childbirth, and motivated them to provide better maternity care. Storytelling videos of childbirth experiences can be powerful educational materials for enhancing professional learning of student midwives.

Effect of Intranatal Gentle Birthing Care on Labor Outcome

Background: Birth companionship, and continuous support during labor and delivery, can improve women's childbirth experience and birth outcomes. Aims and Objective: To assess the effect of Intra-natal Gentle Birthing Care (IGBC) on Labor Outcome. Material and Methods : The post-test only control group design and a evaluate approach was used on 30 parturient mothers who were admitted in the Krishna Hospital &amp; Medical Research Centre, Karad. The Intra-Natal Gentle Birthing Care was administered in separate unit and post test for labor outcomes of parturient mothers was assessed. The informed consent was obtained from mothers. All calculations were carried out using SPSS V20. Results: Out of 30 (100%) mothers only 2(6.6%) mothers were administered injection Oxytocin and 2(6.6%) mothers' injection Drotin / Epidosin. Rest all 26(86.66%) mothers were not administered any type of analgesia and anesthesia. There was statistically significant difference found between Mean ± SD coping(with labor pain) score of the mothers who completed labor process within 6hrs, 8hrs, 10hrs and 12hrs (P&lt;0.0001). Majority parturient mothers, 27(90%) completed 1st stage within 10 hours. Intra natal gentle birthing care was having significant effect on decent of fetal head and dilatation of cervix (P&lt;0.0001). The Bonferroni multiple comparison test, 1st stage Vs 2nd and 4th stage, 2nd stage Vs 3rd and 4th stage, 3rd stage Vs 4th stage among all comparison showed significant difference(P&lt;0.001) except 1st stage Vs 3rd stage (P&gt;0.05). Conclusion: The mean coping score of parturient mothers was more and there was significant difference in mean score of duration of labor stages, cervical dilatation and decent of fetal head after administration of “Intra-natal gentle birthing care” thus the Intra-natal gentle birthing care was effective.

"I felt like it would've been perfect, if they hadn't been rushing": Black women's childbirth experiences with medical providers when accompanied by perinatal support professionals.

This study examined the nature and characteristics of Black women's interactions with medical providers during childbirth when accompanied by a perinatal support professional (PSP; similar to a doula). The design was qualitative, and a phenomenological approach was employed to examine the meaning of women's experiences. We conducted in-depth interviews with 25 Black women enrolled in a perinatal support program in Cleveland, Ohio, in late 2017 and early 2018, exploring their interactions with medical providers, the meaning of their experiences, and the roles their PSPs played. Clients broadly categorized experiences as positive or negative. When medical providers respected them, their birth plans and/or collaborated with PSPs, women reported more positive experiences. They associated negative experiences with providers having their own timelines and agendas, and women perceiving their needs were unheard and/or disrespected. The findings emphasize the need for medical providers to be patient-centred, set aside assumptions, treat their patients as experts, value women's knowledge and voice, and treat patients and their supports as part of the team. Findings support the importance of having a knowledgeable but non-medical support person present during birth. We discuss implications for how empowerment may be a tool to achieving better birth outcomes.

Efficacy and safety of oral misoprostol vs transvaginal balloon catheter for labor induction: An observational study within the SWEdish Postterm Induction Study (SWEPIS).

Induction of labor is increasing. A common indication for induction of labor is late term and postterm pregnancy at 41 weeks or more. We aimed to evaluate if there are any differences regarding efficacy, safety, and women's childbirth experience between oral misoprostol and transvaginal balloon catheter for cervical ripening in women with a low-risk singleton pregnancy and induction of labor at 41+0 to 42+0 to 1 weeks of gestation. In this observational study, based on data from the Swedish Postterm Induction Study (SWEPIS), a multicenter randomized controlled trial, a total of 1213 women with a low-risk singleton pregnancy at 41 to 42 weeks of gestation were induced with oral misoprostol (n=744) or transvaginal balloon catheter (n=469) at 15 Swedish delivery hospitals. The primary efficacy outcome was vaginal delivery within 24h and primary safety outcomes were neonatal and maternal composite adverse outcomes. Secondary outcomes included time to vaginal delivery and mode of delivery. Women's childbirth experience was assessed with the Childbirth Experience Questionnaire (CEQ 2.0) and visual analog scale. We present crude and adjusted mean differences and relative risks (RR) with 95% CI. Adjustment was performed for a propensity score based on delivery hospital and baseline characteristics including Bishop score. Vaginal delivery within 24h was significantly lower in the misoprostol group compared with the balloon catheter group (46.5% [346/744] vs 62.7% [294/469]; adjusted RR 0.76 95% CI 0.640.89]). Primary neonatal and maternal safety outcomes did not differ between groups (neonatal composite 3.5% [36/744] vs 3.2% [15/469]; adjusted RR 0.77 [95% CI 0.31-1.89]; maternal composite 2.3% [17/744] vs 1.9% [9/469]; adjusted RR 1.70 [95% CI 0.58-4.97]). Adjusted mean time to vaginal delivery was increased by 3.8h (95% CI 1.3-6.2h) in the misoprostol group. Non-operative vaginal delivery and cesarean delivery rates did not differ. Women's childbirth experience was positive overall and similar in both groups. Induction of labor with oral misoprostol compared with a transvaginal balloon catheter was associated with a lower probability of vaginal delivery within 24h and a longer time to vaginal delivery. However, primary safety outcomes, non-operative vaginal delivery, and women's childbirth experience were similar in both groups. Therefore, both methods can be recommended in women with low-risk postdate pregnancies.

Descriptive survey of women's childbirth experiences in two state hospitals in KwaZulu-Natal.

BackgroundGiving birth is one of the most important events in a woman’s life and is a highly individualistic and unique experience.ObjectivesThe study aimed to describe women’s childbirth experiences in two state hospitals in KwaZulu-Natal.MethodA non-experimental, quantitative, descriptive survey of low-risk mothers was conducted in two state hospitals by using the Childbirth Experience Questionnaire (CEQ).ResultsWith a response rate of 96%, 201 questionnaires were completed and returned. The highest mean score of the four dimensions of the CEQ was for the dimension of Professional Support (3.1). The results of the individual dimension items scoring the highest positive response were: I felt that I handled the situation well (147; 74%) (Own Capacity); I felt very well cared for by my midwife (165; 82%) (Professional Support); 151 respondents (76%) scored the item My impression of the team’s medical skill made me feel secure as the highest positive experience (Perceived Safety); and I felt I could have a say in the choice of pain relief (105; 52%) (Participation). The relationship between demographic variables (age, level of education, parity, antenatal clinic attendance, induction of labour, augmentation and duration of labour) and respondents’ scores of the CEQ dimensions was calculated, and only the dimension of Perceived Safety and duration of labour (≥ 12 hours) were found to be significant (p = 0.026).ConclusionFrom the women perspectives, the study results described childbirth experience as multi-dimensional experience and subjective. Both positive and negative experiences coexisted in all dimensions of the CEQ, with the dimension of Professional Support scoring the highest positive response. To maintain a positive birth experience, the study suggests that women should be involved and equipped with knowledge on the process of childbirth.

Predictors of Negative Childbirth Experiences Among French Women

ObjectivesTo describe the prevalence of negative childbirth experiences and to identify potential predictors, including demographic, prenatal, obstetric, and psychological factors, of these experiences among French women. DesignDescriptive, correlational, cross-sectional study. SettingA maternity ward in a hospital located near Paris, France. ParticipantsA total of 256 women between the ages of 18 and 46 years were recruited while hospitalized in the maternity ward 1 to 6 days after childbirth. MethodsParticipants completed a personal information form and five self-report scales: the Dyadic Adjustment Scale, the General Self-Efficacy Scale, the State–Trait Anxiety Inventory, the Relationship Scales Questionnaire, and the Questionnaire Assessing the Childbirth Experience. We performed linear regression analyses and used scores on the Questionnaire Assessing the Childbirth Experience as the dependent variable. We considered prenatal, psychological, and obstetric factors as independent variables and adjusted results for covariates. ResultsThe prevalence of a negative childbirth experience was 23.3% among our participants. We identified primiparity, high anxiety trait scores, and an anxious attachment style as the prenatal variables that contributed significantly to negative perceptions of childbirth based on the first step of the regression analysis (R2 = .18; p < .001). We evaluated objective birth-related variables during the second step and found that mode of birth and use of epidural analgesia were significative predictors of the negative childbirth experience (R2 = 0.36; p < .001). The last set of variables included subjective birth-related factors, such as absence of the partner during birth and low perceived sense of control; these variables increased the explained variance from 36% to 69% (p < .001) and showed that these aspects were powerful predictors of a negative childbirth experience. ConclusionsGiven that some prenatal factors influence women’s perceptions of their birth experiences, preventive measures can be implemented by health professionals to support women with risk factors. In the early postpartum period, health care professionals should focus on subjective variables of childbirth because they strongly predict the overall childbirth experience for women.