Does childbirth experience affect infant behaviour? Exploring the perceptions of maternity care providers

The voice of memory in hospital birth: A phenomenological study

OBJECTIVE

To examine the perception of the hospital birth experience in women at 8 weeks and 8 months after the birth and to determine if there have been any changes in that perception.

DESIGN

This was a prospective qualitative study with a phenomenological approach based on semi-structured, individual and in-depth interviews at 8 weeks and 8 months after childbirth as well as participant's observations. The data were transcribed and analysed thematically using ATLAS.ti 8 software.

PARTICIPANTS

43 women participated in the first interview, and 33 of those participated in the second interview.

SETTING

Donostia University Hospital, Gipuzkoa, Spain, 2016-2017.

FINDINGS

Two main topics emerged from the data analysis which summarize the women's perception of childbirth: (1) memory allows us to recall the experience of hospital birth in time and space; (2) some moments are specially remembered. In the second topic, three subtopics were distinguished: fondest memory: meeting the newborn for the first time; highlighted positive memories: support from partners and professionals; and the worst memories were marked by feelings of worry and fear.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

In the perception of the birth experience, positive and negative memories remain in intensity and continuity for at least up to 8 months. Their creation and evocation are highly influenced by the emotional experience and the initial visual impact of meeting the newborn for the first time, which constitutes a milestone in women's lives. The emotions experienced in childbirth and during the postpartum period shape the awareness, memory and new identity of being a mother.

Women's experiences throughout the birthing process in health facilities in Arab countries: a systematic review

BACKGROUND

Mistreatment of women during facility-based childbirth has become a significant public health issue globally and is gaining worldwide attention. This systematic review of quantitative studies aimed to estimate the prevalence of mistreatment women may experience throughout the birthing process in health facilities in Arab countries. The review also aimed to identify the types of mistreatment, terminology, tools, and methods used to address this topic.

METHODOLOGY

The search was conducted using three electronic databases: "PubMed," "Embase," and "CINAHL" in May 2020. Studies meeting the inclusion criteria were included and assessed for risk of bias. The analysis was conducted based on the evidence-based typology developed by Bohren et al. as a guide to try to estimate the prevalence of mistreatment.

RESULTS

Eleven studies out of 174 were included. The included studies belonged to only seven Arab countries out of 22 Arab countries. The mistreatment of women during childbirth is still new in the region. Searching within the included studies yielded diverse and indirect terms that were a proxy for the word mistreatment. These terms were not comprehensive to cover different aspects of the topic. The tools that were used to measure the terms widely varied.. Moreover, it was not possible to estimate the prevalence of mistreatment of women due to high heterogeneity among the 11 studies.

CONCLUSION

The topic of mistreatment of women in Arab countries was not adequately addressed in the studies included in this review. More research on this topic is recommended due to its importance in improving maternal health in the region. However, a standardized and comprehensive terminology for mistreatment of women, a standardized tool, and a standardized methodology are recommended to enable comparability between results and allow pooling to estimate the prevalence.

Physical and Psychological Childbirth Experiences and Early Infant Temperament

Objective

To examine how physical and psychological childbirth experiences affect maternal perceptions and experiences of early infant behavioural style (temperament).

Background

Unnecessary interventions may disturb the normal progression of physiological childbirth and instinctive neonatal behaviours that facilitate mother-infant bonding and breastfeeding. While little is known about how a medicalised birth may influence developing infant temperament, high impact interventions which affect neonatal crying and cortisol levels could have longer term consequences for infant behaviour and functioning.

Methods

A retrospective Internet survey was designed to fully explore maternal experiences of childbirth and her postnatal perceptions of infant behaviour. Data collected from 999 mother-infant dyads were analysed using Pearson's correlations and multiple analyses of covariance, employing the Bonferroni method of correction to establish initially significant variables. Multiple linear regressions were conducted to determine major perinatal contributors to perceived early infant temperament.

Results

Multiple regression analyses on each of the eight Mother and Baby Scales outcome variables indicated that early infant behavioural style (0-6 months) was largely predicted by subjective maternal states during and post-childbirth, postnatal depression scores, maternal personality traits and infant age. For example, infant age (Beta = 0.440, p = 0.000) was the most significant predictor of Alert-Responsive infant behaviour, followed by maternal Postnatal Positive experience (Beta = 0.181, p = 0.000). In contrast, depression (EPDS) scores (Beta = 0.370, p = 0.000) were the most significant predictor of Unsettled-Irregular infant behaviour, followed by Anxious-Afraid Birth Emotions (Beta = 0.171, p = 0.000) and infant age (Beta = -0.196, p = 0.000). Mothers also perceived their infants as more Alert-Responsive (Beta = 0.080, p = 0.010) and Easier overall (Beta = 0.085, p = 0.008) after a Supported birth experience.

Conclusion

Maternal and infant outcomes were influenced by multiple physical and psychological perinatal variables. The mother's subjective experience appeared to be of equal significance to more objective factors (e.g. birthplace/mode). Social support enhanced the mother's childbirth experience, benefitting her perceptions of her baby's early temperament. These findings provide further support for current World Health Organisation intrapartum guidelines (2018) on the importance of making childbirth a 'positive experience' for women.

Predictive factors of women's subjective perception of childbirth experience: a systematic review of the literature

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.