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López-Gimeno E, Falguera-Puig G, García-Sierra R, Vicente-Hernández MM, Cubero LB, Seguranyes G. Impact of shared decision-making on women's childbirth preferences: A cluster randomised controlled trial. Midwifery 2024; 133:103999. [PMID: 38643600 DOI: 10.1016/j.midw.2024.103999] [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: 05/14/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Midwives provide counselling for birth plans (BPs) to women during prenatal care; however, the impact of individualised BP counselling interventions based on shared decision-making (SDM) regarding women's preferences is unknown. METHODS This randomised cluster trial included four primary healthcare units. Midwives provided BP counselling based on SDM to women in the intervention group (IG) during prenatal care along with a handout about evidence-based recommendations. Women in the control group (CG) received standard BP counselling from midwives. The main outcome was preference changes concerning BPs. RESULTS A total of 461 (95.5 %) pregnant women received BP counselling (IG, n = 247; CG, n = 214). Women in the IG changed their BP preferences for 13 items compared with those in the CG. These items were: using an unique space during birth (81.1 % vs 51.6 %; p < 0.001), option for light graduation (63 % vs 44.7 %; p < 0.001), listening to music (57.3 % vs 43.6 %; p = 0.006), drinking fluids during labour (84.6 % vs 93.6 %; p = 0.005), continuous monitoring (59 % vs 37.8 %; p < 0.001); desire for natural childbirth (36.6 % vs 25 %; p = 0.014), epidural analgesia (55.1 % vs 43.6 %; p = 0.023); breathing techniques (65.2 % vs 50.5 %; p = 0.003), massage (74.9 % vs 55.3 %; p < 0.001); birthing ball use (81.9 % vs 56.9 %; p < 0.001), spontaneous pushing (49.3 % vs 28.7 %; p < 0.001), choosing birth position (69.6 % vs 41.5 %) and delayed umbilical cord clamping (67.8 % vs 44.1 %; p = 0.001). CONCLUSION SDM counselling, together with a handout about evidence-based recommendations on childbirth and newborn care, produced more changes in women's preferences expressed in the BP than standard counselling.
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Affiliation(s)
- Encarnación López-Gimeno
- Sexual and Reproductive Healthcare Services (ASSIR), Barcelona, Catalan Health Institute (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Hospitalet LL, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain.
| | - Gemma Falguera-Puig
- Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
| | - Rosa García-Sierra
- Research Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Spain; Nursing Department, Faculty of Medicine, Campus Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; Primary Care Group, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Multidisciplinary Research Group in Health and Society (GREMSAS) (2021-SGR-01484), Barcelona, Spain
| | - Mª Mercedes Vicente-Hernández
- Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Badalona, Catalan Health Institute (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
| | - Lucia Burgos Cubero
- Sexual and Reproductive Healthcare Services (ASSIR), Catalan Health Institute (ICS), Mollet del Vallés, Spain
| | - Gloria Seguranyes
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Hospitalet LL, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
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2
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Mlambo S, Amukugo HJ. Facilitating childbirth choice for positive postnatal mental health well-being among women: a Namibian case study. Front Glob Womens Health 2024; 5:1277611. [PMID: 38559816 PMCID: PMC10978576 DOI: 10.3389/fgwh.2024.1277611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/05/2024] [Indexed: 04/04/2024] Open
Abstract
Childbirth affects women in a myriad of ways including feelings of tiredness, being overwhelmed, stressed, and having baby blues, and if not attended to, this can lead to postpartum depression, which is a mental condition that can have disastrous effects. Childbirth can affect the mental and physical status of a woman and having supportive midwives who guide women by giving adequate information is an issue of critical concern for a positive birth experience. The World Health Organisation (WHO) has emphasised the need to facilitate childbirth choices for women as a means of having a safe and memorable experience as the experience in childbirth affects the psychological status of a woman. Some women may experience worry and anxiety during labour and childbirth, which may be exacerbated by bias and a lack of childbirth choice facilitation during pregnancy. A negative childbirth experience may lead to negative psychological distress and postpartum depression, which will interfere with the bond between the mother, baby, and family. Midwives, thus, need to understand the emotional aspects that are attached to childbirth and be able to facilitate and support the emotional as well as the psychosocial needs of women under their care. However, there is a dearth of empirical evidence within the Namibian context that can provide direction and context-specific solutions to the present challenge. The current study followed a qualitative research design with an exploratory approach with one-on-one interviews with 10 midwives who were purposively selected. The midwives' experiences in this study depicted their zeal towards the issue at hand; however, what stood out were some barriers in the facilitation of childbirth choices (theme 1) as they expressed the shortages of staff, the timing of information, information sharing, and cultural influences as some of their experiences in facilitating childbirth. Furthermore, midwives shared a lack of provision for childbirth choice (theme 2) as the rights of women were not observed, and a lack of women-centred care despite protocols and guidelines being there, and yet they are not adhered to. In conclusion, midwives as primary caregivers actively need to provide unbiased childbirth information to achieve positive postpartum health. Initiating childbirth choices early in pregnancy gives women the time to weigh options and clearing of any misconceptions relating to childbirth types as well as reducing anxiety and fear of birth, which could lead to postpartum depression and by extension, the mental well-being of the women. Facilitating childbirth choices is critical in positive birth experiences and the management of childbirth as well as crafting guidelines and policy formulation that ensure a mentally healthy woman and society.
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Affiliation(s)
- S. Mlambo
- Welwitchia Health Training Centre, Schoolof Nursing, Windhoek, Namibia
- University of Namibia School of Nursing and Public Health, Oshakati, Namibia
| | - H. J. Amukugo
- University of Namibia School of Nursing and Public Health, Oshakati, Namibia
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3
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Ratislavová K, Hendrych Lorenzová E, Hollins Martin CJ, Martin CR. Translation and validation of the Czech Republic version of the Birth Satisfaction Scale-Revised (BSS-R). J Reprod Infant Psychol 2024; 42:78-94. [PMID: 35532313 DOI: 10.1080/02646838.2022.2067837] [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: 01/17/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Satisfaction with the birth experience has been established to be critical for the wellbeing of the mother. The Birth Satisfaction Scale-Revised (BSS-R) is a brief and psychometrically robust multi-dimensional self-report tool designed to assess birth experience. The current investigation sought to translate and validate a Czech Republic version of the BSS-R (CZ-BSS-R). METHODS Following translation psychometric assessment of the CZ-BSS-R was undertaken using a cross-sectional design. A between-subjects design was incorporated in order to evaluate known-groups validity evaluation of the translated measure. Four hundred and sixty-five Czech-speaking women within the Czech Republic took part in the study. Confirmatory factor analysis was undertaken and divergent and convergent validity and internal consistency characteristics also evaluated. RESULTS The CZ-BSS-R was observed to have excellent psychometric properties and conceptually and measurement faithful to the original English-language measure. Consistent with previous investigations using the BSS-R significant differences were found in scores as a function of delivery type. CONCLUSIONS The CZ-BSS-R is a valid, robust and reliable measure of birth experience and suitable for use with Czech-speaking women in the Czech Republic. The study highlighted that instrument and emergency Caesarean section were associated with a lower level of birth satisfaction compared to vaginal delivery.
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Affiliation(s)
- Kateřina Ratislavová
- Department of Nursing and Midwifery, Faculty of Health Care Studies, University of West Bohemia, Pilsen, Czech Republic
| | - Eva Hendrych Lorenzová
- Department of Nursing and Midwifery, Faculty of Health Care Studies, University of West Bohemia, Pilsen, Czech Republic
| | | | - Colin R Martin
- Clinical Psychobiology and Applied Psychoneuroimmunology, Institute for Health and Wellbeing, University of Suffolk, Ipswich, UK
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Benyamini Y. Women's perceptions of risk, safety and autonomy drive what we (providers and society) consider non-normative choices in pregnancy and childbirth. Evid Based Nurs 2023; 26:135. [PMID: 37169522 DOI: 10.1136/ebnurs-2022-103677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Affiliation(s)
- Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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5
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Vogels-Broeke M, Daemers D, Budé L, de Vries R, Nieuwenhuijze M. Women's Birth Beliefs During Pregnancy and Postpartum in the Netherlands: A Quantitative Cross-Sectional Study. J Midwifery Womens Health 2023; 68:210-220. [PMID: 36938758 DOI: 10.1111/jmwh.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 11/30/2022] [Accepted: 12/29/2022] [Indexed: 03/21/2023]
Abstract
INTRODUCTION Women and care providers increasingly regard childbirth as a medical process, resulting in high use of medical interventions, which could negatively affect a woman's childbirth experience. Women's birth beliefs may be key to understanding the decisions they make and the acceptance of medical interventions in childbirth. In this study we explore women's beliefs about birth as a natural and medical process and the factors that are associated with women's birth beliefs. METHODS Data were obtained from a cross-sectional survey of women living in the Netherlands asking them about their experiences during pregnancy and childbirth, including their beliefs about birth as a natural and medical process. RESULTS A total of 3494 women were included in this study. Mean scores of natural birth beliefs ranged between 3.73 and 4.01 points, and medical birth belief scores ranged between 2.92 and 3.12 points. There were significant but very small changes between prenatal and postnatal birth beliefs. Regression analyses showed that (previous) childbirth experiences were the most consistent predictor of women's birth beliefs. DISCUSSION Women's high scores on natural birth beliefs and lower scores on medical birth beliefs correspond with the philosophy of Dutch perinatal care that considers pregnancy and childbirth to be natural processes. Perinatal care providers must be aware of women's birth beliefs and recognize that they as professionals influence women's birth beliefs. They make an important contribution to women's perinatal experiences, which affects both women's natural and medical birth beliefs.
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Affiliation(s)
- Maaike Vogels-Broeke
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Darie Daemers
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Luc Budé
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Raymond de Vries
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Dahan O. Navigating intensive altered states of consciousness: How can the set and setting key parameters promote the science of human birth? Front Psychiatry 2023; 14:1072047. [PMID: 36846223 PMCID: PMC9947299 DOI: 10.3389/fpsyt.2023.1072047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023] Open
Abstract
The subjective childbirth experience is crucial from a public health standpoint. There is a correlation between a negative childbirth experience and a poor mental state after birth, with effects that go far beyond the postpartum (PP) period. This paper offers a new approach as to how birthing experiences, and birth in general, can be navigated. The theory of set and setting proves that psychedelic experiences are shaped, first and foremost, by the mindset of an individual entering a psychedelic experience (set) and by the surroundings in which the experience happens (setting). In research on altered states of consciousness during psychedelic experiences, this theory explains how the same substance can lead to a positive and life-changing experience or to a traumatic and frightening experience. Because recent studies suggest that birthing women enter an altered state of consciousness during physiological birth ("birthing consciousness"), I suggest analyzing the typical modern birthing experience in terms of set and setting theory. I argue that the set and setting key parameters can help design, navigate, and explain many psychological and physiological elements of the human birth process. Thus, an operative conclusion that emerges from the theoretical analysis presented in this paper is that framing and characterizing the birth environment and birth preparations in terms of set and setting is a central tool that could be used to promote physiological births as well as subjective positive birthing experiences, which is currently a primary, yet unreached goal, in modern obstetrics and public health.
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Affiliation(s)
- Orli Dahan
- Department of Multidisciplinary Studies, Faculty of Social Sciences and Humanities, Tel-Hai College, Tel-Hai, Israel
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7
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Schaal NK, Hagenbeck C, Helbig M, Wulff V, Märthesheimer S, Fehm T, Hepp P. The influence of being pregnant during the COVID-19 pandemic on birth expectations and antenatal bonding. J Reprod Infant Psychol 2023; 41:15-25. [PMID: 34407711 DOI: 10.1080/02646838.2021.1962825] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of the present study was to compare birth expectations and antenatal bonding of women pregnant prior to and during the COVID-19 pandemic. MATERIALS AND METHODS In total, 74 pregnant women (mean age: 33.9 ± 4.1 years, gestational age: 36 ± 2 weeks) participated in the study, who were pregnant either during the the COVID-19 pandemic (corona group, N = 35, April-July 2020) or before the pandemic (control group, N = 39, October 2017-January 2019). Birth expectations were measured using the Wijma Delivery Expectancy Questionnaire (WDEQ) and Salmon's Item List (SIL) and antenatal bonding with the Maternal Antenatal Attachment Scale (MAAS). Additionally, the corona group indicated their level of worry regarding different pandemic-related aspects using visual analogue scales. RESULTS The corona group displayed significantly elevated fear of childbirth measured by the WDEQ and lower antenatal bonding quality compared to the control group. The additional items regarding COVID-19 burdens highlighted that the aspects that the partner may not be present during labour and that no visitors will be allowed in hospital were associated with the highest worries. CONCLUSIONS Midwives and gynaecologists should be aware of the negative impact of the COVID-19 pandemic on fear of childbirth and antenatal bonding .
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Affiliation(s)
- Nora K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Martina Helbig
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Verena Wulff
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Sarah Märthesheimer
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Tanja Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Philip Hepp
- Clinic for Gynecology and Obstetrics, University Clinic, Augsburg, Germany.,Clinic for Gynecology and Obstetrics, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
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8
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Raudasoja M, Vehviläinen‐Julkunen K, Tolvanen A. Passing the test of motherhood? Self-esteem development and birth experience in the transition to motherhood: A longitudinal mixed methods study in Finland. J Adv Nurs 2022; 78:4246-4260. [PMID: 36253937 PMCID: PMC9828506 DOI: 10.1111/jan.15468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/08/2022] [Accepted: 10/04/2022] [Indexed: 01/12/2023]
Abstract
AIMS To investigate women's childbirth experiences and their relation to self-esteem development in the postpartum year. DESIGN A mixed methods study. METHODS 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. RESULTS 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. CONCLUSION 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. IMPACT 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. PATIENT OR PUBLIC CONTRIBUTION Service users recruited in Finnish Child Health Centers responded to surveys that were used as data for this study.
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Affiliation(s)
| | | | - Asko Tolvanen
- Methodology Center for Human SciencesUniversity of JyväskyläJyväskyläFinland
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Akgün M, Turgut Y, Güdül Öz H, Yangin H, Boz İ. Examining the relationship between perinatal anxiety, COVID-19 phobia and birth type preferences: A cross-sectional study. J Clin Nurs 2022. [PMID: 35949166 PMCID: PMC9538442 DOI: 10.1111/jocn.16486] [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: 05/15/2022] [Revised: 06/21/2022] [Accepted: 07/21/2022] [Indexed: 01/02/2023]
Abstract
AIM To examine the relationship between the COVID-19 phobia and perinatal anxiety levels and birth type preferences of pregnant women in the third trimester. DESIGN This was designed a cross-sectional study using the non-random convenience sampling method following the STROBE checklist. METHODS The research was conducted with 315 pregnant women from April to May 2021. Data were collected using a personal information form, the COVID-19 Phobia Scale, and the Perinatal Anxiety Screening Scale (PASS). RESULTS We found a positive and moderate correlation between the total scores for perinatal anxiety and COVID-19 phobia. During the COVID-19 pandemic, 4.1% of the participants changed their birth type preferences and this change was statistically significant according to McNemar's test. During the COVID-19 pandemic, the women changed their birth type preferences in favour of caesarean section. However, there was no statistically significant difference between those who changed their birth type preferences and those who did not in terms of perinatal anxiety or COVID-19 phobia levels. Women with no access to prenatal follow-up visits due to the COVID-19 pandemic had higher mean PASS scores and higher mean scores for the perfectionism, control and trauma subscale. The scores for general worry and specific fears were lower among individuals who had obtained information about birth types in prenatal follow-up visits. Also, perinatal anxiety and COVID-19 phobia levels were higher among pregnant women who were worried about giving birth in hospital compared to those who were not worried. CONCLUSION We conclude that COVID-19 phobia has increased women's perinatal anxiety, causing them to change their birth type preferences in favour of caesarean section. RELEVANCE TO CLINICAL PRACTICE We recommended that healthcare professionals take COVID-19 phobia and perinatal anxiety into account when counselling pregnant women about birth types to improve prenatal care. NO PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection. Data were obtained from pregnant women in the third trimester, who came to a regional hospital-affiliated obstetrics polyclinic for routine prenatal follow-up visits.
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Affiliation(s)
- Mehtap Akgün
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
| | - Yasemin Turgut
- Department of Anesthesia, Vocational School of Health Services, Antalya Science University, Antalya, Turkey
| | - Hatice Güdül Öz
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Çukurova University, Adana, Turkey
| | - Hatice Yangin
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
| | - İlkay Boz
- Department of Maternity and Gynecological Nursing, Nursing Faculty, Akdeniz University, Antalya, Turkey
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Kahalon R, Yanushevsky Cnaani G, Preis H, Benyamini Y. The complex effects of maternal expectations on postpartum depressive symptoms: when does a protective factor become a risk factor? J Psychosom Obstet Gynaecol 2022; 43:74-82. [PMID: 32701018 DOI: 10.1080/0167482x.2020.1795826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
PURPOSE The present study assessed the effects of several prenatal maternal expectations on postpartum depression (PPD), while considering two relevant factors - incongruence between planned and actual birth and the rigidity of the birth plan - that can affect whether maternal expectations act as protective factors or risk factors for PPD. METHODS Primiparous women (N = 527) were recruited to a longitudinal study about women's birth choices and experiences. At time 1, during pregnancy, women completed a questionnaire assessing prenatal depression, preferred birth plan, birth plan flexibility-rigidity and maternal expectations (i.e. Natural-Fulfillment, Infant-Reflects-Mothering, Sacrifice). At time 2, two-months post-partum, they reported their actual birth mode and answered a questionnaire assessing their PPD symptoms. RESULTS Natural-fulfillment maternal expectations were negatively related to PPD symptoms. Yet, the interaction of high natural-fulfillment expectations with an unfulfilled birth plan and the rigidity of the birth plan, served as a risk factor for PPD symptomatology. CONCLUSIONS Understanding the conditions under which specific prenatal maternal expectations serve as a risk factor for PPD, can help healthcare providers identify women who are at high risk for developing PPD symptoms and plan preemptive interventions.
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Affiliation(s)
- Rotem Kahalon
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | | | - Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.,Department of Psychology, Stoney Brook University, Stoney Brook, NY, USA
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Preis H, Mahaffey B, Lobel M. The role of pandemic-related pregnancy stress in preference for community birth during the beginning of the COVID-19 pandemic in the United States. Birth 2021; 48:242-250. [PMID: 33677838 PMCID: PMC8250474 DOI: 10.1111/birt.12533] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND The COVID-19 pandemic introduced unparalleled uncertainty into the lives of pregnant women, including concerns about where it is the safest to give birth, while preserving their rights and wishes. Reports on the increased interest in community births (at home or in birth centers) are emerging. The purpose of this project was to quantitatively investigate psychological factors related to this birth preference. METHODS This study included 3896 pregnant women from the COVID-19 Pregnancy Experiences (COPE) Study who were anticipating a vaginal birth. COPE Study participants were recruited online between April 24 and May 15, 2020, and completed a questionnaire that included preference with respect to place of birth and psychological constructs: fear of childbirth, basic beliefs about birth, pandemic-related preparedness stress, and pandemic-related perinatal infection stress. RESULTS Women who preferred a community birth, on average, had less childbirth fear, had stronger beliefs that birth is a natural process, were less likely to see birth as a medical process, and were less stressed about being unprepared for birth and being infected with COVID-19. In multivariate models, higher stress about perinatal COVID-19 infection was associated with greater likelihood of preferring a community birth. The effect of perinatal infection stress on preference was stronger when preparedness stress was high. DISCUSSION Women's birth preferences during the COVID-19 pandemic are associated with psychological processes related to risk perception. Community births are more appealing to women who view being in a hospital as hazardous because of the pandemic. Policies and prenatal care aimed to increase access to safe in-hospital and out-of-hospital birth services should be encouraged.
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Affiliation(s)
- Heidi Preis
- Department of PsychologyStony Brook UniversityStony BrookNew YorkUSA
- Department of PediatricsRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral HealthRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Marci Lobel
- Department of PsychologyStony Brook UniversityStony BrookNew YorkUSA
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Alp Yilmaz F, Durgun Ozan Y. Women's birth beliefs and associated factors in an obstetrics clinic in the Southeastern Anatolian Region of Turkey. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-07-2019-0166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe impact of birth beliefs on pregnancy and delivery are universally recognized, but the factors that affect birth beliefs vary across regions depending on individual and cultural characteristics. This study aimed to determine women's birth beliefs and examine their associated factors.Design/methodology/approachThis cross-sectional study was conducted with 548 primiparas in the obstetrics clinic of a university hospital located in the Southeastern Anatolian Region of Turkey from February to June 2019. Descriptive characteristics, form and the Birth Beliefs Scale were used in data collection. To analyze the data, descriptive statistics, T-tests and ANOVA analyses were used.FindingsIt was determined that factors such as age group, income level, any problems during pregnancy and preferred delivery mode statistically affected women's birth beliefs.Originality/valueBased on the findings from this study, healthcare personnel should provide training and consultation services to pregnant women starting from the prenatal period to help ensure a positive labor experience.
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Westergren A, Edin K, Lindkvist M, Christianson M. Exploring the medicalisation of childbirth through women's preferences for and use of pain relief. Women Birth 2020; 34:e118-e127. [PMID: 32094035 DOI: 10.1016/j.wombi.2020.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Sweden, along with other countries, is facing rising intrapartum intervention rates. AIM To explore the medicalisation of childbirth through women's preferences for and use of pain relief, and to investigate whether the presence of a birth plan had any impact on use of pain relief, rate of intervention, and satisfaction with the birth experience. METHODS The study was cross-sectional, and included 129 women with birth plans and 110 without, all of whom gave birth in one hospital in Sweden between March and June 2016. Data from birth plans and medical records was analysed through descriptive statistics and logistic regression. FINDINGS Parity rather than birth plan was a greater determinant for use of pain relief, frequency of interventions, and level of satisfaction; primiparas used more pain relief, had more interventions, and were less satisfied with their birth experiences than multiparas. Epidural analgesia was associated with a two to threefold increase in interventions, but 79.5% of all women had some form of intervention during birth, regardless of having an epidural or not. Women were generally highly satisfied with their birth experiences, women without epidural analgesia and interventions slightly more so. CONCLUSION Contrary to their initial plans, especially primiparas used more pharmacological pain relief than intended, and nearly all (94.6%) had some form of intervention during labour and birth. More interventions were associated with lower levels of satisfaction. The high rate of intervention in a healthy population of birthing women is disquieting and requires further attention.
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Affiliation(s)
- Agneta Westergren
- Department of Nursing, Umeå University, Umeå, Sweden; The Graduate School of Gender Studies, Umeå University, Umeå, Sweden.
| | - Kerstin Edin
- Department of Nursing, Umeå University, Umeå, Sweden; Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Marie Lindkvist
- Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden; Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Preis H, Pardo J, Peled Y, Benyamini Y. Changes in the basic birth beliefs following the first birth experience: Self-fulfilling prophecies? PLoS One 2018; 13:e0208090. [PMID: 30475898 PMCID: PMC6258230 DOI: 10.1371/journal.pone.0208090] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 11/12/2018] [Indexed: 12/30/2022] Open
Abstract
Women's basic beliefs about birth as a natural and as a medical process are associated with childbirth choices and experience. These beliefs have only recently been quantified and not much is known about their development. In the current study, we assessed the differential effects of the objective and the subjective birth experience on changes in these beliefs. Using self-report questionnaires, we evaluated prenatal to postpartum changes among 342 Israeli first-time mothers. Participants were recruited during pregnancy, between February 2016 and January 2017, mostly in clinical settings, and followed-up two months postpartum. On average, women's beliefs about birth being natural weakened following childbirth and their belief about birth being medical strengthened. In regression models, it was either the objective or the subjective experience that was related to change in the basic birth beliefs: A more medicalized birth was associated with strengthening of the medical belief while greater birth satisfaction was related to strengthening of the natural belief. A mediation effect was observed, which indicated that the beliefs are strengthened when the lived experience fulfilled women's expectation about birth being satisfying, natural or medical. This study adds to the growing body of knowledge regarding the development and evolution of the birth beliefs. It highlights the need to view the beliefs separately and to distinctively assess the objective and subjective birth experience. It supports the need to empower mothers, especially those who had more medicalized births or unsatisfactory ones, which would help conserve their belief in their body and in the normal physiological course of birth.
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Affiliation(s)
- Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
| | - Joseph Pardo
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center–Beilinson Hospital; affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Peled
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center–Beilinson Hospital; affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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