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Alcaraz-Vidal L, Escuriet R, Palau-Costafreda R, Leon-Larios F, Robleda G. Midwife-attended planned home births versus planned hospital births in Spain: Maternal and neonatal outcomes. Midwifery 2024; 136:104101. [PMID: 39002394 DOI: 10.1016/j.midw.2024.104101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 06/10/2024] [Accepted: 07/03/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND The debate on the safety and outcomes of home versus hospital births highlights the need for evidence-based evaluations of these birthing settings, particularly in Catalonia where both options are available. AIM To compare sociodemographic characteristics and maternal and neonatal outcomes between low-risk women opting for home versus hospital births in Catalonia, Spain. METHODS This observational cross-sectional study analysed 3,463 low-risk births between 2016 and 2018, including 2,713 hospital and 750 home births. Researchers collected sociodemographic data, birthing processes, and outcomes, using statistical analysis to explore differences between the settings. FINDINGS Notable differences emerged: Women choosing home births typically had higher education levels and were predominantly Spanish. They were 3.43 times more likely to have a spontaneous birth and significantly less likely to undergo instrumental births than those in hospitals. Home births were associated with higher utilization of non-pharmacological analgesia and a more pronounced tendency to iniciate breastfeeding within the first hour post birth and stronger inclination towards breastfeeding. Hospital births, conversely, showed higher use of the lithotomy position and epidural analgesia. There were no significant differences in neonatal outcomes between the two groups. CONCLUSIONS AND IMPLICATION FOR PRACTICE Home births managed by midwives offered better obstetric and neonatal outcomes for low-risk women than hospital births. These results suggest home birth as a safe, viable option that promotes natural birthing processes and reduces medical interventions. The study supports the integration of midwife-led home birth into public health policies, affirming its benefits for maternal and neonatal health.
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Affiliation(s)
- Lucia Alcaraz-Vidal
- Department of Obstetrics and Gynecology, University Hospital Germans Trias i Pujol, Badalona, Spain; Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), Barcelona 08007, Spain; Catalan Association of home birth Midwives, Barcelona, Spain; Sexual and Reproductive Healthcare, Catalan Health Institute, Spain
| | - Ramon Escuriet
- Head of the Affective, Sexual and Reproductive Health Plan of the Ministry of Health, Government of Catalonia, Spain; Global Health, Gender and Society Research Group, Facultat de Ciències de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Roser Palau-Costafreda
- ESIMar (Mar Nursing School), Parc de Salut MAr, Universitat Pompeu Fabra -affilliated, Barcelona, Spain; SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Sevilla, Spain.
| | - Gemma Robleda
- School of Medicine, Universitat de Vic- Universitat Central de Catalunya, Vic, Spain; Centro Cochrane Iberoamericano, Barcelona, Spain
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Alcaraz-Vidal L, Leon-Larios F, Robleda G, Vila-Candel R. Exploring home births in Catalonia (Spain): A cross-sectional study of women's experiences and influencing factors. J Adv Nurs 2024; 80:2363-2378. [PMID: 38012827 DOI: 10.1111/jan.15989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
AIM The study explores the experiences of women with low-risk pregnancies and no complications who planned a home birth. DESIGN A cross-sectional study was conducted using an online questionnaire. METHODS The questionnaire included socio-demographic, obstetric and perinatal variables. Birth satisfaction was evaluated via the Spanish version of the childbirth experience questionnaire. The study group comprised home-birthing women in Catalonia, Spain. Data were collected from 1 January 2019 to 31 December 2021. Statistical analysis was performed using SPSS. RESULTS A total of 236 women responded. They reported generally positive experiences, with professional support and involvement being the most highly rated dimensions. Better childbirth experiences were associated with labour lasting less than 12 h, no perineal injuries, no intrapartum transfers to hospital, euthocic delivery and the presence of a midwife. CONCLUSIONS Women's positive home birth experiences were linked to active participation and midwife support. Multiparous women felt safer. Medical interventions, especially transfers to hospitals, reduced satisfaction, highlighting the need for improved care during home births. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Home births should be included among the birthplace options offered by public health services, given the extremely positive feedback reported by women who gave birth at home. IMPACT Home birth is not an option offered under Catalonia's public health system only as a private service. The experience of home-birthing women is unknown. This study shows a very positive birth experience due to greater participation and midwife support. The results help stakeholders assess home birth's public health inclusion and understand valued factors, supporting home-birthing women. REPORTING METHOD The study followed the STROBE checklist guidelines for cross-sectional studies. PUBLIC CONTRIBUTION Women who planned a home birth participated in the pilot test to validate the instrument, and their contributions were collected by the lead researcher. The questionnaire gathered the participants' email addresses, and a commitment was made to disseminate the study's results through this means.
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Affiliation(s)
- Lucia Alcaraz-Vidal
- Department of Obstetrics and Gynecology, University Hospital Germans Trias i Pujol, Badalona, Spain
- Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), Barcelona, Spain
- Catalan Association of Home Birth Midwives, Barcelona, Spain
| | - Fatima Leon-Larios
- Nursing Department. Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Sevilla, Spain
| | - Gemma Robleda
- Campus Docent Fundació Privada Sant Joan de Déu, School of Nursing, University of Barcelona, Barcelona, Spain
- Centro Cochrane Iberoamericano, Barcelona, Spain
| | - Rafael Vila-Candel
- Faculty of Health Sciences, International University of Valencia -VIU, Valencia, Spain
- Department of Primary Health, Foundation for Promoting of Health and Biomedical Research in the Valencian Region (FISABIO-SP), Valencia, Spain
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Mei X, Du P, Li Y, Mei R, Wang X, Chen Q, Ye Z. Fear of childbirth and sleep quality among pregnant women: a generalized additive model and moderated mediation analysis. BMC Psychiatry 2023; 23:931. [PMID: 38082243 PMCID: PMC10712172 DOI: 10.1186/s12888-023-05435-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/03/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES This study aims to examine the associations among fear of childbirth, psychological distress, resilience, and sleep quality among Chinese pregnant women. METHODS A cross-sectional survey was carried out between January 2022 to March 2022 among pregnant women who met the inclusion criteria and sought healthcare services at The First Affiliated Hospital of Guangzhou University of Chinese Medicine in Guangdong Province, Southern China. Data was collected using a structured questionnaire that included sociodemographic characteristics, childbirth attitudes questionnaires (CAQ), hospital anxiety and depression scale (HADS), Connor-Davidson resilience scale (CD-RISC), and Pittsburgh sleep quality index (PSQI). A generalized additive model and moderated mediation analysis were employed for data analysis. RESULTS A non-linear and negative association between fear of childbirth and sleep quality was found in the second trimester and antenatal period. Psychological distress significantly mediated the relationship between fear of childbirth and sleep quality (first trimester: β = 0.044, 95%CI:0.022-0.071; second trimester: β = 0.029, 95%CI:0.009-0.056; third trimester: β = 0.064, 95%CI:0.046-0.088; antenatal period: β = 0.050, 95%CI:0.037-0.063). The moderating role of resilience between fear of childbirth and sleep quality was significant (second trimester: β=-0.006, 95%CI:-0.012-0.001, P = 0.025; antenatal period: β=-0.004, 95%CI:-0.007--0.001, P = 0.014), as well as between fear of childbirth and psychological distress (first trimester: β=-0.016, 95%CI:-0.026--0.005, P = 0.004; antenatal period: β=-0.005, 95%CI:-0.009--0.001, P = 0.014). CONCLUSIONS Fear of childbirth, psychological distress, and resilience are three important factors affecting sleep quality in Chinese pregnant women.
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Affiliation(s)
- Xiaoxiao Mei
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Ping Du
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Li
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Ranran Mei
- Breast Oncology Department, Guangzhou Medical University Cancer Hospital, Guangzhou, China
| | - Xinqin Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qianwen Chen
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zengjie Ye
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China.
- School of Nursing, Guangzhou Medical University, Guangzhou, China.
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Arthuis C, LeGoff J, Olivier M, Coutin AS, Banaskiewicz N, Gillard P, Legendre G, Winer N. The experience of giving birth: a prospective cohort in a French perinatal network. BMC Pregnancy Childbirth 2022; 22:439. [PMID: 35619093 PMCID: PMC9134581 DOI: 10.1186/s12884-022-04727-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/30/2022] [Indexed: 11/18/2022] Open
Abstract
Background To assess women's positive and negative perceptions after giving birth. The secondary objectives were to identify the women who had a negative perception of their delivery, define the risk factors, and propose actions that maternity units can take to improve their management. Methods/design This study was a multicenter, prospective cohort, conducted in 23 French maternity units constituting one perinatal network, in 2019. All adult women who understood French and gave birth between February 1 and September 27, 2019, were eligible. The exclusion criterion was the woman's objection to participation. Validated self-administered questionnaire (QACE) was sent by email 6 weeks after the child's birth. The main outcome was the experience of childbirth, assessed on a scale of 0 to 10. A good experience was defined by a score ≥ 8/10, and a poor experience by a score < 5. A multinomial logistic regression model, expressed by cumulative proportional odds ratios, were used to determine the factors that might have affected women's experiences during childbirth. Results Two thousand one hundred and thirty-fifth women completed the questionnaire, for a participation rate of 49.6%. Overall, 70.7% (n = 1501/2121) of the women reported a good experience, including 38% (n = 807/2121) who graded their experience with the maximum score of 10. On the other hand, 7.3% (n = 156) of the women reported a poor experience. Vaginal delivery (aOR 3.93, 95%CI, 3.04–5.08) and satisfactory management (aOR 11.35 (7.69–16.75)) were the principal determining factors of a positive experience. Epidural analgesia increased the feeling of failure (aOR 5.64, 95%CI, 2.75–13.66). Receiving information and being asked for and agreeing to consent improved the global experience (P = 0.03). Conclusion The Identikit picture of the woman associated with a poor experience of childbirth shows a nullipara who had a complication during her pregnancy, gave birth after induction of labor, or by cesarean or operative vaginal delivery, with the newborn transferred for pediatric care, and medical management considered unsatisfactory.
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Affiliation(s)
- Chloé Arthuis
- Service de Gynécologie Obstétrique, UMR 1280, Centre Hospitalier Universitaire de Nantes, CIC Et Hôpital Mère-Enfant-Adolescent, NUN, INRAE, PhAN, 44000, Nantes, France. .,Université de Nantes, Physiologie des Adaptations Nutritionnelles 38 boulevard Jean Monnet, 44000, Nantes, France.
| | - Juliette LeGoff
- Service de Gynécologie Obstétrique, UMR 1280, Centre Hospitalier Universitaire de Nantes, CIC Et Hôpital Mère-Enfant-Adolescent, NUN, INRAE, PhAN, 44000, Nantes, France.,Université de Nantes, Physiologie des Adaptations Nutritionnelles 38 boulevard Jean Monnet, 44000, Nantes, France
| | - Marion Olivier
- Réseau Sécurité Naissance - Naître Ensemble, Réseau de Santé Périnatale Des Pays de La Loire, 3 rue Marguerite Thibert, 44200, Nantes, France
| | - Anne-Sophie Coutin
- Réseau Sécurité Naissance - Naître Ensemble, Réseau de Santé Périnatale Des Pays de La Loire, 3 rue Marguerite Thibert, 44200, Nantes, France
| | - Nathalie Banaskiewicz
- Réseau Sécurité Naissance - Naître Ensemble, Réseau de Santé Périnatale Des Pays de La Loire, 3 rue Marguerite Thibert, 44200, Nantes, France
| | - Philippe Gillard
- Réseau Sécurité Naissance - Naître Ensemble, Réseau de Santé Périnatale Des Pays de La Loire, 3 rue Marguerite Thibert, 44200, Nantes, France.,Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49933, Angers, France
| | - Guillaume Legendre
- Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, 49933, Angers, France
| | - Norbert Winer
- Service de Gynécologie Obstétrique, UMR 1280, Centre Hospitalier Universitaire de Nantes, CIC Et Hôpital Mère-Enfant-Adolescent, NUN, INRAE, PhAN, 44000, Nantes, France.,Université de Nantes, Physiologie des Adaptations Nutritionnelles 38 boulevard Jean Monnet, 44000, Nantes, France
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Preis H, Mahaffey B, Heiselman C, Lobel M. The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women. Women Birth 2021; 35:458-465. [PMID: 34736888 PMCID: PMC8501233 DOI: 10.1016/j.wombi.2021.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/15/2021] [Accepted: 10/05/2021] [Indexed: 02/03/2023]
Abstract
PROBLEM Birth satisfaction is an important health outcome that is related to postpartum mood, infant caretaking, and future pregnancy intention. BACKGROUND The COVID-19 pandemic profoundly affected antenatal care and intrapartum practices that may reduce birth satisfaction. AIM To investigate the extent to which pandemic-related factors predicted lower birth satisfaction. METHODS 2341 women who were recruited prenatally in April-May 2020 and reported a live birth between April-October 2020 were included in the current analysis. Hierarchical linear regression to predict birth satisfaction from well-established predictors of birth satisfaction (step 1) and from pandemic-related factors (step 2) was conducted. Additionally, the indirect associations of pandemic-related stress with birth satisfaction were investigated. FINDINGS The first step of the regression explained 35% of variance in birth satisfaction. In the second step, pandemic-related factors explained an additional 3% of variance in birth satisfaction. Maternal stress about feeling unprepared for birth due to the pandemic and restrictions on companions during birth independently predicted lower birth satisfaction beyond the non-pandemic variables. Pandemic-related unpreparedness stress was associated with more medicalized birth and greater incongruence with birth preference, thus also indirectly influencing birth satisfaction through a mediation process. DISCUSSION Well-established contributors to birth satisfaction remained potent during the pandemic. In addition, maternal stress and restriction on accompaniment to birth were associated with a small but significant reduction in birth satisfaction. CONCLUSION Study findings suggest that helping women set flexible and reasonable expectations for birth and allowing at least one intrapartum support person can improve birth satisfaction.
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Affiliation(s)
- Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States.
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, United States
| | - Cassandra Heiselman
- Department of Obstetrics and Gynecology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, United States
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States
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Alcaraz-Vidal L, Escuriet R, Sàrries Zgonc I, Robleda G. Planned homebirth in Catalonia (Spain): A descriptive study. Midwifery 2021; 98:102977. [PMID: 33751929 DOI: 10.1016/j.midw.2021.102977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/17/2021] [Accepted: 03/01/2021] [Indexed: 12/23/2022]
Affiliation(s)
- L Alcaraz-Vidal
- PhD candidate, Biomedicine Programme, Department of Experimental and Health Sciences, University Pompeu Fabra. Barcelona, Spain; Midwife Coordinator Birth Centre Project, Germans Trias i Pujol Hospital, Carretera del Canyet S/N 08, Badalona, Spain; Sexual and Reproductive Health Research Group, (GRASSIR), Catalan Health Institute Barcelona, Spain; Catalan Association of Homebirth Midwives, Spain.
| | - R Escuriet
- Faculty of Health Sciences, Universitat Ramon Llull. Global Health Gender and Society (GHenderS) Research Group. Barcelona, Spain; Catalan Health Service. Government of Catalonia, Spain
| | - I Sàrries Zgonc
- Catalan Association of Homebirth Midwives, Spain; Independent RM, Spain
| | - G Robleda
- Campus Docent Fundació Privada Sant Joan de Déu, School of Nursing, University of Barcelona. Spain; Iberoamerican Cochrane Centre. Barcelona, Spain
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Chabbert M, Rozenberg P, Wendland J. Predictors of Negative Childbirth Experiences Among French Women. J Obstet Gynecol Neonatal Nurs 2021; 50:450-463. [PMID: 33676911 DOI: 10.1016/j.jogn.2021.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To 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. DESIGN Descriptive, correlational, cross-sectional study. SETTING A maternity ward in a hospital located near Paris, France. PARTICIPANTS A 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. METHODS Participants 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. RESULTS The 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. CONCLUSIONS Given 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.
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Associations of rooming-in with maternal postpartum bonding: the impact of mothers' pre-delivery intentions. Midwifery 2021; 95:102942. [PMID: 33607604 DOI: 10.1016/j.midw.2021.102942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/22/2020] [Accepted: 02/02/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Full rooming-in, that is, mother and baby staying together for 24 hours per day after birth in the hospital, has been suggested as beneficial for positive maternal bonding. However, it has never been studied directly. We aimed to examine the association of full versus partial rooming-in and maternal bonding to her infant during the post-childbirth hospital stay. STUDY DESIGN Longitudinal questionnaire study. SETTING Maternity ward of a large tertiary health care center in Israel. PARTICIPANTS The sample consisted of postpartum women (N = 293) in a maternity ward of a tertiary health care center who were fully or partially rooming-in. MEASUREMENTS AND FINDINGS Questionnaires were administered at two time points, immediately after childbirth (T1; days 1-4) and 2 months postpartum (T2). The Childbirth Experience Questionnaire (CEQ), breastfeeding questions, and the Postpartum Bonding Questionnaire (PBQ) were administered at T1; the PBQ was repeated at T2. Regression analysis revealed that the rooming-in mode did not significantly predict bonding at 1-4 days postpartum. However, the rooming-in mode was a significant predictor of bonding at two months postpartum only for women who practiced the rooming-in mode they had initially planned (Beta = 0.12, p < .05), while controlling for other demographic as well as obstetric variables. Women who chose and practiced partial rooming-in manifested more bonding difficulties than those who chose and practiced full rooming-in. These distinctions in bonding were not manifested when including in the analysis women who partially rooming-in, but not in accordance with their intentions. CONCLUSIONS Mother-infant bonding may be optimally supported when women's pre-labor desires to participate in full rooming-in are fulfilled. IMPLICATIONS FOR PRACTICE Hospital staff should be aware of the mothers' intentions regarding full rooming-in requests and make sincere efforts to accommodate and support their wishes.
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Van Haeken S, Braeken MAKA, Nuyts T, Franck E, Timmermans O, Bogaerts A. Perinatal Resilience for the First 1,000 Days of Life. Concept Analysis and Delphi Survey. Front Psychol 2020; 11:563432. [PMID: 33224056 PMCID: PMC7670043 DOI: 10.3389/fpsyg.2020.563432] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/09/2020] [Indexed: 02/02/2023] Open
Abstract
Background The ability to cope with challenges and stress in life is generally understood as resilience. Pregnancy and parenthood are challenging times. The concept of resilience is receiving increasing interest from researchers, clinicians, and policy staff because of its potential impact on health, well-being, and quality of life. Nevertheless, the concept is less studied during the perinatal period. Objectives The aim of this study is to understand the concept of perinatal resilience, including the underlying processes and more specifically for the first 1,000 days of life. Methods A concept analysis according to the Walker and Avant (2011) framework was used, to investigate the basic elements of the concept. Concurrently, a two-round Delphi survey involving researchers, clinicians, epidemiologists, mothers, and fathers (N = 21), was conducted to prioritize the terms associated with perinatal resilience. Data collection took place between January and April 2019. Results Through concept analysis and Delphi survey, five defining attributes for perinatal resilience were identified: social support, self-efficacy, self-esteem, sense of mastery and personality. The additional terms, rated important by the Delphi survey, were linked to the consequences of being resilient during the perinatal period for the individual and his/her family. Specifically, highlighted were the experiences of families in personal growth and achieving family balance, adaptation, or acceptance. Conclusion Based on the results of the concept analysis and Delphi survey, we describe perinatal resilience for the first 1,000 days as a circular process towards a greater well-being in the form of personal growth, family balance, adaptation or acceptance, when faced with stressors, challenges or adversity during the perinatal period. The presence of resiliency attributes such as social support, sense of mastery, self-efficacy, and self-esteem enhance the capacity to be resilient and probably prevent mental health problems.
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Affiliation(s)
- Sarah Van Haeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Diepenbeek, Belgium.,Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Marijke A K A Braeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Diepenbeek, Belgium.,Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Tinne Nuyts
- Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Erik Franck
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
| | - Olaf Timmermans
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Professorship Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Annick Bogaerts
- Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
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Skrondal TF, Bache-Gabrielsen T, Aune I. All that I need exists within me: A qualitative study of nulliparous Norwegian women's experiences with planned home birth. Midwifery 2020; 86:102705. [DOI: 10.1016/j.midw.2020.102705] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/19/2020] [Accepted: 03/11/2020] [Indexed: 11/29/2022]
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Atukunda EC, Mugyenyi GR, Obua C, Musiimenta A, Agaba E, Najjuma JN, Ware NC, Matthews LT. Women's Choice to Deliver at Home: Understanding the Psychosocial and Cultural Factors Influencing Birthing Choices for Unskilled Home Delivery among Women in Southwestern Uganda. J Pregnancy 2020; 2020:6596394. [PMID: 32566299 PMCID: PMC7290878 DOI: 10.1155/2020/6596394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/11/2020] [Accepted: 04/30/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Utilization of perinatal services in Uganda remains low, with correspondingly high rates of unskilled home deliveries, which can be life-threatening. We explored psychosocial and cultural factors influencing birthing choices for unskilled home delivery among postpartum women in rural southwestern Uganda. METHODS We conducted in-depth qualitative face-to-face interviews with 30 purposively selected women between December 2018 and March 2019 to include adult women who delivered from their homes and health facility within the past three months. Women were recruited from 10 villages within 20 km from a referral hospital. Using the constructs of the Health Utilization Model (HUM), interview topics were developed. Interviews were conducted and digitally recorded in a private setting by a native speaker to elicit choices and experiences during pregnancy and childbirth. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive categories using inductive content analytic approach. RESULTS Eighteen women (60%) preferred to deliver from home. Women's referent birth location was largely intentional. Overall, the data suggest women choose home delivery (1) because of their financial dependency and expectation for a "natural" and normal childbirth, affecting their ability and need to seek skilled facility delivery; (2) as a means of controlling their own birth processes; (3) out of dissatisfaction with facility-based care; (4) out of strong belief in fate regarding birth outcomes; (5) because they have access to alternative sources of birthing help within their communities, perceived as "affordable," "supportive," and "convenient"; and (6) as a result of existing gender and traditional norms that limit their ability and freedom to make family or health decisions as women. CONCLUSION Women's psychosocial and cultural understandings of pregnancy and child birth, their established traditions, birth expectations, and perceptions of control, need, and quality of maternity care at a particular birthing location influenced their past and future decisions to pursue home delivery. Interventions to address barriers to healthcare utilization through a multipronged approach could help to debunk misconceptions, increase perceived need, and motivate women to seek facility delivery.
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Affiliation(s)
| | | | - Celestino Obua
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Edgar Agaba
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Norma C. Ware
- Global Health and Social Medicine, Harvard Medical School, MA, USA
| | - Lynn T. Matthews
- Massachusetts General Hospital, Division of Infectious Diseases and Center for Global Health, Boston, Massachusetts, USA
- University of Alabama at Birmingham, Division of Infectious Disease, Birmingham, AL, USA
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Chabbert M, Panagiotou D, Wendland J. Predictive factors of women's subjective perception of childbirth experience: a systematic review of the literature. J Reprod Infant Psychol 2020; 39:43-66. [PMID: 32475156 DOI: 10.1080/02646838.2020.1748582] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Up to 33% of women report a negative or traumatic childbirth experience. Given this high prevalence and its consistent association with adverse postpartum and child outcomes, it is essential to identify predictive factors and to improve the management of the childbirth experience. Objective: This systematic review explores and identifies risk and protective factors for women's subjective childbirth experience and birth satisfaction by reviewing original research. Methods: A systematic search was performed for childbirth experience literature on three online databases. Reviewed papers focused on women's subjective childbirth experience and its predictive factors. The articles were assessed with the Mixed Methods Appraisal Tool (MMAT). Results: Risk and protective factors are notably different depending on the study design, the country, or the method employed. The main risk factors are obstetric, such as emergency caesarean and highly perceived labour pain, and women's dissatisfaction with social support. The main protective factors are: obstetric, including highly perceived control during labour or satisfaction regarding partner's support. However, overall results are inconclusive for methodological or conceptual reasons. Conclusions: Several risk factors can be identified through pregnancy or childbirth. This underlines the importance of the quality of maternal interpersonal and professional relationships, especially with first-line perinatal health-care professionals, such as midwives.
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Affiliation(s)
- Margaux Chabbert
- Laboratory of Psychopathology and Health Processes, Université De Paris , Paris, France
| | - Danaé Panagiotou
- Laboratory of Psychopathology and Health Processes, Université De Paris , Paris, France.,Laboratory of Psychology, University of Bourgogne Franche Comté , Besançon, France
| | - Jaqueline Wendland
- Laboratory of Psychopathology and Health Processes, Université De Paris , Paris, France
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Dencker A, Bergqvist L, Berg M, Greenbrook JTV, Nilsson C, Lundgren I. Measuring women's experiences of decision-making and aspects of midwifery support: a confirmatory factor analysis of the revised Childbirth Experience Questionnaire. BMC Pregnancy Childbirth 2020; 20:199. [PMID: 32252679 PMCID: PMC7137445 DOI: 10.1186/s12884-020-02869-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/09/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Women's experiences of labour and birth can have both short- and long-term effects on their physical and psychological health. The original Swedish version of the Childbirth Experience Questionnaire (CEQ) has shown to have good psychometric quality and ability to differentiate between groups known to differ in childbirth experience. Two subscales were revised in order to include new items with more relevant content about decision-making and aspects of midwifery support. The aim of the study was to develop new items in two subscales and to test construct validity and reliability of the revised version of CEQ, called CEQ2. METHOD A total of 11 new items (Professional Support and Participation) and 14 original items from the first CEQ (Own capacity and Perceived safety), were answered by 682 women with spontaneous onset of labour. Confirmatory factor analysis was used to analyse model fit. RESULTS The hypothesised four-factor model showed good fit (CMIN = 2.79; RMR = 0.33; GFI = 0.94; CFI = 0.94; TLI = 0.93; RMSEA = 0.054 and PCLOSE = 0.12) Cronbach's alpha was good for all subscales (0.82, 0.83, 0.76 and 0.73) and for the total scale (0.91). CONCLUSIONS CEQ2, like the first CEQ, yields four important aspects of experience during labour and birth showing good psychometric performance, including decision-making and aspects of midwifery support, in both primiparous and multiparous women.
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Affiliation(s)
- Anna Dencker
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden.
| | - Liselotte Bergqvist
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Department of Obstetrics, Sahlgrenska University hospital, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Department of Obstetrics, Sahlgrenska University hospital, Gothenburg, Sweden
| | - Josephine T V Greenbrook
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Mason Institute of Medicine, Life Science and the Law, University of Edinburgh, Edinburgh, UK
| | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Ingela Lundgren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
- Department of Obstetrics, Sahlgrenska University hospital, Gothenburg, Sweden
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Thies-Lagergren L, Ólafsdóttir ÓÁ, Sjöblom I. Being in charge in an encounter with extremes. A survey study on how women experience and work with labour pain in a Nordic home birth setting. Women Birth 2020; 34:122-127. [PMID: 32057663 DOI: 10.1016/j.wombi.2020.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 11/17/2022]
Abstract
PROBLEM There is a knowledge gap regarding women's experiences of coping with labour pain when not soliciting or not having access to pharmacological pain relief. BACKGROUND How women manage labour pain is complex, multifaceted and only the woman giving birth can assess the experienced pain. Women in the Nordic countries planning for a homebirth have little or no access to pharmacologic pain relief during labour. AIM The aim of this study was to explore how women experience and work with labour pain when giving birth in their own home. METHODS Quantitative and qualitative data was prospectively collected and altogether 1649 women with a planned homebirth answered closed and open-ended questions about labour pain and birth experience. RESULTS While labour pain was often experienced as positive or very positive, the intensity was experienced as severe or the worst imaginable pain. Two main themes arose from the womens´ descriptions of their birth experience regarding labour pain: An encounter with extremes and Being in charge at home. DISCUSSION Women perceived labour pain as severe but manageable and were dedicated to completing the birth at home. Being at home enabled the women to exercise autonomy and work with labour pain on their own terms, together with the midwife and support persons. CONCLUSIONS This study provides knowledge about women's experiences of labour pain in a home birth setting who used varying strategies to work with labour pain. This is a subject that should be explored further since results could also apply to facility-based birth settings.
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Affiliation(s)
- Li Thies-Lagergren
- Department of Midwifery Research - Reproductive, Perinatal and Sexual health, Lund University, Sweden; Department of Obstetrics and Gynaecology, Helsingborg Lasarett, Sweden.
| | - Ólöf Ásta Ólafsdóttir
- Department of Midwifery, Faculty of Nursing, University of Iceland, Reykjavík, Iceland
| | - Ingela Sjöblom
- Department of Midwifery Research - Reproductive, Perinatal and Sexual health, Lund University, Sweden
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Zamani P, Ziaie T, Lakeh NM, Leili EK. The correlation between perceived social support and childbirth experience in pregnant women. Midwifery 2019; 75:146-151. [PMID: 31125906 DOI: 10.1016/j.midw.2019.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 05/03/2019] [Accepted: 05/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE In recent years, the role of social support on different aspects of health especially pregnancy and childbirth has been emphasized. Social support facilitates individual access to necessary resources during stressful periods of life like pregnancy and childbirth. Present evidence of effects of social support on birth experience is inconsistent, Therefore, this study aimed to determine the correlation between perceived social support in pregnant women and their childbirth experience. DESIGN Analytic-cross sectional survey. SETTING Al-Zahra maternity hospital in Rasht, Iran. PARTICIPANTS 185 pregnant women who were in latent phase of labor entered the study and finally, 89.18% (n = 165) completed the study. MEASUREMENTS To measure perceived social support, the Multidimensional Scale of Perceived Social Support was used at latent phase of labor and to measure childbirth experience, the Childbirth Experience Questionnaire was used within 2 h after childbirth until the mother was discharged. RESULTS Mean score of perceived social support by significant others (4.18 ± 0.79) was higher than other dimensions of social support. Total mean score of childbirth experience was 58.13 ± 10.72 (score range: 22-88). Logistic regression results showed that support by significant others (P = 0.042, OR = 1.56), gestational age (P = 0.003, OR = 1.56) and mode of delivery (P = 0.004, OR = 0.33) are predictor variables of childbirth experience. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Perceived social support by significant others (spouse) during pregnancy has an important effect on woman`s childbirth experience. Therefore, providing training programs for family especially for spouse in order to increase maternal support during pregnancy is recommended, which can lead to a positive childbirth experience.
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Affiliation(s)
- Parisa Zamani
- Department of Midwifery, Faculty of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| | - Tahereh Ziaie
- Department of Midwifery, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Nasrin Mokhtari Lakeh
- Department of Community Health Nursing, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad Leili
- Department of Biostatistics, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Abstract
Childbirth is a pivotal event for many women, and evidence suggests that women possess strong expectations regarding this experience. In a longitudinal study of 330 Israeli first-time mothers, we distinguished between physical, emotional, and cognitive factors and used them to assess the underlying mechanism of satisfaction, based on theoretical frameworks of stress and control. Women completed questionnaires during pregnancy and two months postpartum. The negative association between a more medicalized birth and birth satisfaction was partially mediated by perceived control. In turn, specific emotions mediated the association between perceived control and satisfaction: Greater perceived control over the birth environment predicted more positive emotions, less fear, and better perceived care; while greater perceived control over the birth process predicted more positive emotions, less fear, and less guilt. Greater incongruence between the planned and actual birth experience predicted lower satisfaction, mediated by perceived care and feelings of guilt. This investigation unraveled the association between women’s lived birth experience and their birth satisfaction. The findings underscore the value of helping women achieve satisfying births by discussing their expectations with them, providing them with experiences that meet their needs, and supporting those with a gap between their expectations and experience. Respecting individual preferences while lowering blame may improve women’s health and well-being. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684318779537 .
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Preis H, Eisner M, Chen R, Benyamini Y. First-time mothers' birth beliefs, preferences, and actual birth: A longitudinal observational study. Women Birth 2018; 32:e110-e117. [PMID: 29753684 DOI: 10.1016/j.wombi.2018.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 04/13/2018] [Accepted: 04/24/2018] [Indexed: 10/16/2022]
Abstract
PROBLEM Birth preferences, such as mode and place of birth and other birth options, have important individual and societal implications, yet few studies have investigated the mechanism which predicts a wide range of childbirth options simultaneously. BACKGROUND Basic beliefs about birth as a natural and as a medical process are both predictive factors for childbirth preferences. Studies investigating birth beliefs, preferences, and actual birth are rare. AIM To test a predictive model of how these beliefs translate into birth preferences and into actual birth related-options. METHODS Longitudinal observational study including 342 first-time expectant mothers recruited at women's health centres and natural birth communities in Israel. All women filled out questionnaires including basic birth beliefs and preferred birth options. Two months postpartum, they filled out a questionnaire including detailed questions regarding actual birth. FINDINGS Stronger beliefs about birth being natural were related to preferring a more natural place and mode of birth and preferring more natural birth-related options. Stronger beliefs about birth being medical were associated with opposite options. The preferences mediated the association between the birth beliefs and actual birth. The beliefs predicted the preferences better than they predicted actual birth. DISCUSSION Birth beliefs are pivotal in the decision-making process regarding preferred and actual birth options. In a medicalized obstetric system, where natural birth is something women need to actively seek out and insist on, the predictive powers of beliefs and of preferences decrease. CONCLUSION Women's beliefs should be recognized and birth preferences respected.
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Affiliation(s)
- Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, 6997801, Israel.
| | - Michal Eisner
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Rony Chen
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, 6997801, Israel
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Patterson J, Foureur M, Skinner J. Remote rural women's choice of birthplace and transfer experiences in rural Otago and Southland New Zealand. Midwifery 2017; 52:49-56. [PMID: 28600971 DOI: 10.1016/j.midw.2017.05.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/14/2017] [Accepted: 05/23/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Birth in primary midwife-led maternity units has been demonstrated to be a safe choice for well women anticipating a normal birth. The incidence of serious perinatal outcomes for these women is comparable to similarly low risk women, who choose to birth in hospital. New Zealand women have a choice of Lead Maternity Carer (LMC) and birthplace; home, primary birthing unit, or a base hospital, though not all women may have all these choices available locally. Women in rural and rural remote areas can also choose to birth in their rural primary maternity unit. A percentage of these women (approx. 15-17%) will require transfer during labour, an event which can cause distress and often loss of midwifery continuity of care. OBJECTIVE To explore retrospectively the choice of birth place decisions and the labour and birth experiences of a sample of women resident in remotely zoned, rural areas of the lower South Island of New Zealand. DESIGN A purposive sample of women living in remote rural areas, recruited by advertising in local newspapers and flyers. Individual semi-structured interviews were digitally recorded using a pragmatic interpretive approach. The data (transcripts and field notes) were analysed using thematic and content analysis. Ethical approval was obtained from the Health and Disability Ethics Committee (HEDC) MEC/06/05/045. PARTICIPANTS Thirteen women consented to participate. Each was resident in a remote rural area having given birth in the previous 18 months. The women had been well during their pregnancies and at the onset of labour had anticipated a spontaneous vaginal birth. SETTING Rural remote zoned areas in Otago and Southland in the South Island of New Zealand FINDINGS: Five women planned to birth in a regional hospital and eight chose their nearest rural primary maternity unit. All of the women were aware of the possibility of transfer and had made their decision about their birthplace based on their perception of their personal safety, and in consideration of their distance from specialist care. Themes included, deciding about the safest place to give birth; making the decision to transfer; experiencing transfer in labour, and reflecting on their birth experience and considering future birthplace choices. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE AND POLICY The experiences of the women show that for some, distance from a base hospital influences their place of birth decisions in remote rural areas of New Zealand and increases the distress for those needing to transfer over large distances. These experiences can result in women choosing, or needing to make different choices for subsequent births; the consequences of which impact on the future sustainability of midwifery services in remote rural areas, a challenge which resonates with maternity service provision internationally. While choices about birth place cannot be reliably predicted, creative solutions are needed to provide rural midwifery care and birth options for women and more timely and efficient transfer services when required.
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Affiliation(s)
- Jean Patterson
- School of Midwifery, Otago Polytechnic, Forth Street, Private Bag 1910, 9054 Dunedin, New Zealand.
| | - Maralyn Foureur
- Centre for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Level 8, Building 10, City Campus, PO Box 123, Broadway, NSW 2007, Australia.
| | - Joan Skinner
- Commonlife Ltd, 10A London d, Korokoro, Lower Hutt 5012, New Zealand.
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