John Lind memorial symposium

Releasing and relieving encounters: experiences of pregnancy and childbirth

The experience of childbirth is an important life event for women, memories of which may follow them throughout life. The aim of the study reported here was to synthesize the results from four selected studies describing these experiences by focusing on women's and midwives' experiences of the encounter during childbirth, as well as experiences of pregnancy from the women's perspective. The setting was the Alternative Birth Care Centre (Sahlgrenska University Hospital, Goteborg) and Karolinska Hospital (Stockholm, Sweden). A qualitative method grounded in phenomenology and hermeneutics was used as a basis for the studies and synthesis. The essential structure may be conceptualized under the heading 'releasing and relieving encounters', which, for the woman, constitutes an encounter with herself as well as with the midwife, and includes stillness as well as change. Stillness is expressed as presence and being one's body. Change is expressed as transition to the unknown and to motherhood. In the releasing and relieving encounter, for the midwife stillness and change equals being both anchored and a companion. To be a companion is to be an available person who listens to and follows the woman through the process of childbirth. To be anchored is to be the person who respects the limits of the woman's ability as well as her own professional limits in the transition process. A releasing and relieving encounter implies a sharing of responsibility and participation for women. This may be understood as a unique feature, which differs from other caring encounters and should be further studied.

Social support in labor--a selective review

Support during labor has been offered by a variety of different people, including fathers, professional medical staff, trained labor coaches and monitrices, untrained lay supporters and family and friends. A comparison of the various findings shows that support given by trained or lay untrained female supporters, who are not necessarily known to the laboring woman, yields the most extensive, methodologically sound, and consistently positive effects on obstetric and psychosocial outcomes. Although trained labor coaches have been shown to exert a positive effect on outcome, the results of doula support are the most impressive when both methodology and outcome effects are considered. Studies of father support have yielded contradictory findings, although women do appear to value their presence in most studies. Family and friends have not been shown to influence outcomes. Support from professional medical staff is rare, but when given, has, in some cases, had a positive effect. These findings are important for the field, since the use of lay supporters constitutes a low-cost preventive intervention. The inclusion of lay supportive women is also consistent with traditional practices in most countries in the world.