A qualitative study exploring how the aims, language and actions of yoga for pregnancy teachers may impact upon women's self-efficacy for labour and birth

Women's empowerment for active labor: A qualitative study with nurse-midwives in antenatal education for childbirth

INTRODUCTION

Recognizing the positive impact of movement and positions on labor progression and maternal and neonatal outcomes, there is a strong recommendation to empower women for active labor during antenatal education. This study investigates nurse-midwives' interventions in empowering women for active labor, during antenatal education within primary healthcare settings.

METHODS

A qualitative descriptive study was conducted in Primary Healthcare Units that provide antenatal education for childbirth in Portugal. Semi-structured interviews were conducted with 10 nurse-midwives between August and October 2023. Content analysis, utilizing NVIVO software, was employed for data analysis, and the study adhered to the COREQ reporting guidelines.

RESULTS

Six themes emerged: 1) Perspective of nurse-midwives and contextual influences; 2) Assessment of women's needs; 3) Enhancing women's knowledge; 4) Enhancing women's capabilities; 5) Supporting women in decision-making; and 6) Nurse-midwives' perspective on intervention outcomes. It is necessary to create environments conducive to knowledge and skill acquisition and invest in developing body awareness and its impact on labor progression. Encouraging women's involvement in decision-making is crucial, especially in less flexible hospital environments.

CONCLUSIONS

This study highlighted the value nurse-midwives place on empowering women for active labor. Interventions featured sharing evidence-based practices and birth stories to foster reflection, emphasizing pelvic mobility training and partner involvement. Reflective practices could enable women to explore options and communicate effectively with healthcare professionals during labor.

The prevalence and predictors of fear of childbirth among pregnant Chinese women: a hierarchical regression analysis

Background

Fear of childbirth (FOC) occurs before, during and after pregnancy and is harmful to both the pregnant woman and the fetus. Identifying the prevalence and predictors of FOC can help us generate strategies for alleviating women’s FOC.

Methods

A cross-sectional study was conducted among a convenience sample of 646 pregnant women receiving antenatal care at a subordinate hospital of a university in China. Data were collected using a basic information form, the Childbirth Attitude Questionnaire, the Childbirth Self-Efficacy Inventory, and the 10-item Connor-Davidson Resilience Scale. The minimum and maximum total scores of the Childbirth Attitude Questionnaire are 16 and 64, respectively, with higher scores reflecting a greater degree of FOC. We conducted hierarchical regression analysis to explore the predictors of FOC and used a structural equation model to further examine the direct and indirect associations between FOC, resilience and childbirth self-efficacy.

Results

The total prevalence of FOC was 67.1%. The percentages of women with mild (score of 28–39), moderate (40–51), and severe FOC (52–64) were 45.4, 19.5, and 2.2%, respectively. The average score on the Childbirth Attitude Questionnaire was 32.49, indicating mild FOC. The final regression analysis revealed six variables predicting FOC that explained 64.5% of the variance in FOC: age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy. Furthermore, childbirth self-efficacy mediated the relationship between resilience and FOC, and the mediation effect rate was 53.5%.

Conclusions

A high prevalence of FOC among pregnant Chinese women was found in this study. Age, gestational age, parity, spousal support, resilience, and childbirth self-efficacy were predictors of FOC. It is suggested that healthcare professionals should pay close attention to FOC and implement targeted interventions in accordance with these predictors, especially resilience and childbirth self-efficacy.

The impact of yoga on fear of childbirth and childbirth self-efficacy among third trimester pregnants

BACKGROUND

This study was conducted to determine the effect of yoga practice on fear of childbirth and childbirth self-efficacy.

MATERIALS AND METHODS

This study was performed in a quasi-experimental model with pretest and post-test control groups. The participants of the study were women who applied to a pregnancy education class at a hospital. Ninety women participated in the study. The data used in the study were collected using the Individual Information Form, the Wijma Delivery Expectation/Experience Scale (Version A), and the Childbirth Self-Efficacy Scale.

RESULTS

After participating in yoga practice, the pregnant women in the experimental group exhibited decreased fear of childbirth and increased childbirth self-efficacy (p < .05). On the other hand, the pregnant women in the control group displayed increased fear of childbirth and decreased childbirth self-efficacy (p < .05).

CONCLUSION

Based on the results of this study, yoga practice reduces fear of childbirth and significantly increases childbirth self-efficacy.

Efficacy of yoga on physiological and psychological discomforts and delivery outcomes in Chinese primiparas

BACKGROUD AND PURPOSE

Almost every woman experiences discomforts during pregnancy. This study aimed to evaluate the efficacy of yoga on physiological and psychological discomforts and delivery outcomes in Chinese primiparas.

MATERIALS AND METHODS

A randomized controlled trial was conducted. Participants in the control group (n = 32) received routine prenatal care, whereas participants in the intervention group (n = 32) received routine prenatal care and yoga exercise three times a week for 12 weeks. Outcomes evaluated included physiological discomforts, prenatal depression, anxiety, childbirth self-efficacy and delivery outcomes. Intention-to-treat analysis was conducted.

RESULTS

Yoga decreased the symptoms of physiological discomforts during pregnancy (F = 6.966, p = 0.010), promoted childbirth self-efficacy (F = 11.900, p = 0.001), increased the rate of vaginal delivery (χ² = 4.267, p = 0.039), and shortened the length of the first (t = -2.612, p = 0.012), second (z = -3.313, p = 0.001) and third stages of labor (z = -3.137, p = 0.002).

CONCLUSION

Yoga offers beneficial effects on physiological discomforts, childbirth self-efficacy and delivery outcomes in Chinese primiparas.

A qualitative investigation of a prenatal yoga intervention to prevent excessive gestational weight gain: A thematic analysis of interviews

PURPOSE

To describe pregnant women's experiences and perceived facilitators/barriers of a prenatal yoga intervention to prevent excessive gestational weight gain (EGWG).

METHODS

Pregnant women (N = 13) were interviewed after participation in a 12-week prenatal yoga intervention to prevent EGWG. Interviews were summarized using thematic analysis.

RESULTS

Twelve themes were identified and organized into four categories: 1) experiences of prenatal yoga (positive experience/enjoyment, pain relief, connecting to body), 2) prenatal yoga and weight (increased mindfulness/self-awareness, increased physical activity, weight management), 3) barriers to prenatal yoga (physical body, commute/traffic, schedule), and 4) facilitators of prenatal yoga (healthy pregnancy, support from other pregnant women, the feeling from prenatal yoga).

CONCLUSION

Prenatal yoga may relieve pain and help women be more connected to their bodies. Prenatal yoga may also help women become more aware of their health behaviors and increases their physical activity which may have important implications for reducing EGWG.

Antenatal education for childbirth: Labour and birth

INTRODUCTION

This study aimed to identify the way information is described and presented by childbirth educators during antenatal classes for expectant parents, and analyse the language structures used when discussing labour and birth.

METHODS

This cross-sectional study of antenatal education was conducted at a single tertiary referral centre for Maternity Care in Western Sydney, Australia. All childbirth educators (n=3) were recorded whilst providing information to parents during antenatal classes. Audio data were subsequently transcribed and then analysed by two researchers, independently categorising the various language structures and types of information provided. This is the second study in a series of antenatal education topics.

RESULTS

During the labour and birth class, information statements were the predominant language structure that was spoken with 241 of 655 statements; negative statements were the next most frequent at 119 while there were 79 positive statements. The second stage of labour had a greater proportion of negative statements for two educators, followed by information and positive statements combined. Misinformation statements were minimal for this topic however, and there was an absence of any statements discussing the rest period between contractions.

CONCLUSIONS

The findings further emphasise the need to examine the language used by health professionals when educating parents. Negative statements during antenatal education are still common despite research in other contexts suggesting that these are potentially unhelpful. Further research into the language and suggestions used during antenatal education is required to determine whether improved outcomes seen in other contexts are confirmed in the childbirth setting.

Women's experiences of fear of childbirth: a metasynthesis of qualitative studies

Purpose: Women’s experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women’s experiences of fear of childbirth.

Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers.

Results: The main results demonstrate a deepened understanding of women’s experiences of fear of childbirth interpreted through the metaphor “being at a point of no return”. Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear.

Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth.

Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other’s experiences will not happen to them.

'It definitely made a difference': A grounded theory study of yoga for pregnancy and women's self-efficacy for labour

OBJECTIVE

To explore women's experience of attending yoga for pregnancy classes in order to generate a theory about which aspects, if any, are effective in enhancing self-efficacy for labour and birth.

DESIGN

A longitudinal grounded theory study.

METHODS

Semi-structured interviews were undertaken with women before they started yoga for pregnancy classes, after they had attended at least six classes, and finally, postnatally. Interview transcripts were analysed using constructive grounded theory and a self-efficacy framework.

SETTING

Three yoga for pregnancy teachers' classes in England.

PARTICIPANTS

Twenty two women attending yoga for pregnancy classes.

FINDINGS

Analysis of interviews with women at three time points led to a propositional theory that yoga for pregnancy enhances women's self-efficacy for labour by building their confidence and competence through a combination of techniques. These include repeated practice of a variety of pain management strategies, use of affirming language and the telling of positive labour stories, underpinned by yoga practice to lower somatic response to stress.