1
|
Strachan-Whaley MR, Scruton S, Blennerhassett CJ, Urquhart R. Impact of no publicly accessible prenatal education programming on patients and their care providers: a descriptive qualitative study in Nova Scotia, Canada. BMJ Open 2024; 14:e085140. [PMID: 38816061 PMCID: PMC11138280 DOI: 10.1136/bmjopen-2024-085140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVE Patients in Nova Scotia do not have access to public prenatal education programming. This study aimed to explore whether care providers find patients are uninformed or misinformed, and the impact of that on patients and their care providers with a focus on clinical outcomes, time, resources and informed decision-making. METHODS Semistructured interviews were conducted with 13 care providers around Halifax and Cape Breton. An interview guide (supplemental) of open-ended questions was used for consistency. A descriptive qualitative approach was employed to describe the contents of the interviews. Each interview was audio-taped and transcribed verbatim by an interdependent transcriber. Transcripts were analysed using established techniques in qualitative descriptive research including coding, grouping, detailing and comparing the data using NVivo V.12 software. A co-coder (SS) independently coded two interviews for inter-rater reliability. RESULTS The study revealed six themes: (1) concern for a significant population of Nova Scotians experiencing pregnancy, birth and postpartum uninformed and misinformed, (2) consequences for patients who are uninformed and misinformed, (3) more time and resources spent on care for patients who are uninformed or misinformed, (4) patients and their care providers need a publicly available education programme, particularly vulnerable populations, (5) emphasis on programme quality and disappointment with the programme previously been in place and (6) recommendations for an effective prenatal education programme for Nova Scotians. CONCLUSIONS This study shows care providers believe a public prenatal education programme could improve health literacy in Nova Scotia. Patients are seeking health education, but it is not accessible to all and being uninformed or misinformed negatively impacts patients' experiences and outcomes. This study revealed excess time and resources are being spent on individualised prenatal education by care providers with high individual and system-wide cost and explored the complicated process of providing patient-centred care for people who are uninformed or misinformed.
Collapse
Affiliation(s)
| | - Sarah Scruton
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - C J Blennerhassett
- IWK Health Centre, Halifax, Nova Scotia, Canada
- Association of Nova Scotia Midwives, Halifax, Nova Scotia, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
2
|
Pilewska-Kozak AB, Dziurka M, Bałanda-Bałdyga A, Monist MJ, Kopiel E, Jurek K, Łęcka AF, Dobrowolska B. Factors conditioning pain control and reduction in post-cesarean section parturients: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:382. [PMID: 38778256 PMCID: PMC11112804 DOI: 10.1186/s12884-024-06579-9] [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: 01/03/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Pain experienced by women in the perinatal period constitutes a complex and multifaceted phenomenon. The aim of the study was to assess conditions of pain locus of control and pain reduction in post-cesarean section parturients. MATERIALS AND METHODS A cross-sectional quantitative study with convenience sampling was performed among 175 hospitalized post-cesarean section women in hospitals in Eastern Poland in accordance with the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) statement. A self-design questionnaire regarding general information and obstetrics/gynaecology medical interview, The Pain Coping Strategies Questionnaire (CSQ) and The Beliefs about Pain Control Questionnaire (BPCQ) were used. The inclusion criteria were as follows (1) age of ⩾18 years old; (2) cesarean section (CS); (3) period from the 13th hour to the end of the 72nd hour after the procedure; and (4) informed consent. The data was analyzed with IBM SPSS Statistics. RESULTS Internal locus of control (M = 14.02) was provided the highest value by the parturients and followed by chance events (M = 12.61) and doctors' power (M = 12.18). Dominant coping with pain strategies in the post-cesarean parturients were coping self-statements (M = 19.06), praying or hoping (M = 18.86). The parturients assessed their pain coping (M = 3.31) strategies along with pain reduction (M = 3.35) at the moderate level. Higher pain control was correlated with cognitive pain coping strategies (β = 0.305; t = 4.632; p < 0.001), internal pain control β = 0.191; t = 2.894; p = 0.004), cesarean section planning (β = -0.240; t = -3.496; p = 0.001) and past medical history of CS (β = 0.240; t = 3.481; p = 0.001). The skill of reduction of pain was positively associated with cognitive pain coping strategies (β = 0.266; t = 3.665; p < 0.001) and being in subsequent pregnancy (β = 0.147; t = 2.022; p = 0.045). Catastrophizing and hoping were related to lower competences of coping with pain (B = - 0.033, SE = 0.012, β = - 0.206, T = -2.861). CONCLUSIONS The study allowed for identification and better comprehension of factors conditioning pain control and pain reduction in parturients after the cesarean section. Furthermore, a stronger belief that pain can be dealt with is found in the parturients characterized by cognitive pain coping strategies and internal pain locus of control. The skill of reduction of pain is related to cognitive coping strategy and procreation status.
Collapse
Affiliation(s)
- Anna Bogusława Pilewska-Kozak
- Department of Obstetrics and Gynaecology Nursing, Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University in Lublin, Lublin, Poland
| | - Magdalena Dziurka
- Department of Holistic Care and Nursing Management, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland.
| | - Agnieszka Bałanda-Bałdyga
- Integrated Medical Care Department, Medical Faculty, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, Warsaw, Poland
| | - Marta Joanna Monist
- 2nd Chair and Clinic of Gynecology, Faculty of Medicine, Medical University in Lublin, Lublin, Poland
| | - Ewelina Kopiel
- The Neonatal Unit of the University Clinical Hospital, No. 1 in Lublin, Lublin, Poland
| | - Krzysztof Jurek
- Sociology of Culture, Religion and Social Participation Institute of Sociological Sciences, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Anna Francesca Łęcka
- Saint Lazarus Hospice, The Society of Friends to People in Disease, Cracow, Poland
| | - Beata Dobrowolska
- Department of Holistic Care and Nursing Management, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| |
Collapse
|
3
|
Leela TK, Baboo S. Need of integrated care model for positive childbirth experience in Indian maternity care services. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:86. [PMID: 38720691 PMCID: PMC11078459 DOI: 10.4103/jehp.jehp_1015_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/02/2023] [Indexed: 05/12/2024]
Abstract
BACKGROUND Integrated care (IC) models are an emerging trend in healthcare reforms worldwide, especially in the maternal healthcare system. This research focuses on the scope of an integrated model for intrapartum care of women and explores the experience of birth under two intrapartum care models-biomedical and midwifery models, respectively. The term positive childbirth experience (PCE) is a concept defined by the World Health Organization (WHO) in the recommendations on intrapartum care for a PCE. MATERIALS AND METHOD This study is convinced to employ a qualitative approach to explore how birth is experienced by women under maternity healthcare services in Kerala. A semi-structured interview was conducted to tap into the lived reality of birthing of sixteen first-time mothers (primipara) aged between 20 and 30 years under these two models. Furthermore, five participants have been specifically interviewed after their vaginal birth after a C-section (VBAC) experience. To achieve a systematic cross-case thematic analysis, systematic text condensation (STC) has been employed as a data analysis method. RESULTS Four main categories were identified through the analysis as follows: (1) information and knowledge, (2) confidence, (3) quality of care, and (4) health-promoting perspective. These central themes evolved from 11 subthemes. CONCLUSION The data analysis reveals both negative and positive experiences under two care models. It emphasizes the urgent need to reframe the biomedical-focused care model and adopt an integrated approach that aligns with the global intrapartum care model proposed by the World Health Organization (WHO) in 2018 and the definition of IC mentioned in the paper.
Collapse
Affiliation(s)
- Thaniya K. Leela
- Department of Psychology, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Smitha Baboo
- Department of Psychology, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| |
Collapse
|
4
|
Neerland CE, Delkoski SL, Skalisky AE, Avery MD. Prenatal care in US birth centers: Midwives' perceptions of contributors to birthing People's confidence in physiologic birth. Birth 2023; 50:535-545. [PMID: 36226921 DOI: 10.1111/birt.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 07/19/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to describe US freestanding birth center models of prenatal care and to examine how the components of this care contribute to birthing people's confidence in their ability to have a physiologic birth. DESIGN This was a qualitative descriptive study utilizing semi-structured interviews with birth center midwives. Data were analyzed using thematic analysis, constant comparative method and consensus coding to ensure rigor. SETTING AND PARTICIPANTS Midwives from six urban and rural freestanding birth centers in a Midwestern US state were interviewed. Twelve birth center midwives participated. FINDINGS Six themes emerged: the birth center physical space and organization of care, dimensions of midwifery care within the birth center, continuity of care and seamless service, the empowered birthing person, physiologic birth as normative, and the hospital paradigm and US cultures of birth. KEY CONCLUSIONS We identified significant components of birth center models of prenatal care that midwives believe enhance birthing people's confidence for physiologic childbirth. These components may be considered for application to other settings and may improve perinatal care and outcomes.
Collapse
Affiliation(s)
- Carrie E Neerland
- The University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | | | - Arielle E Skalisky
- The University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| | - Melissa D Avery
- The University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
| |
Collapse
|
5
|
Hulsbosch LP, Nyklíček I, Potharst ES, Boekhorst MG, Pop VJ. Development of the Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p). BMC Pregnancy Childbirth 2020; 20:718. [PMID: 33228637 PMCID: PMC7686754 DOI: 10.1186/s12884-020-03415-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/12/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Receiving epidural analgesia during labor can possibly have negative consequences for mother and child. Yet, the use of epidural analgesia rapidly increased in the Netherlands over the last decade. Since antenatal plans for labor pain relief have been related to epidural analgesia use during labor, the aim of the current study was to develop a Labor Pain Relief Attitude Questionnaire for pregnant women (LPRAQ-p). METHODS Three focus group interviews were conducted with pregnant women, new mothers and caregivers and 13 candidate items were derived. Psychometric properties were tested with explorative factor analysis in sample I (N = 429) and a subsequent confirmatory factor analysis in a different sample II (N = 432). RESULTS The explorative factor analysis suggested a two-factor seven-item solution: a 'women's perception' and 'social environment' subscale. The confirmatory factor analysis confirmed an excellent six-item model fit with appropriate internal consistency. Higher scores on the six-item LPRAQ-p indicate greater willingness for request of pain relief medication during labor. Two-tailed t-tests showed that women with elevated levels of depression and pregnancy-specific distress symptoms, nulliparous women and multiparous women with complications during a previous delivery had greater willingness for request of pain relief medication during labor. Linear regression showed that the most important association with higher scores on the LPRAQ-p were high pregnancy-specific distress symptoms. CONCLUSIONS This study showed the LPRAQ-p to be a valid instrument to evaluate attitude towards labor pain relief in pregnant women. High scores on this questionnaire are associated with high levels of pregnancy-specific distress symptoms.
Collapse
Affiliation(s)
- Lianne P Hulsbosch
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, 5000 LE, Tilburg, the Netherlands.
| | - Ivan Nyklíček
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, 5000 LE, Tilburg, the Netherlands
| | - Eva S Potharst
- UvA minds, University of Amsterdam, Amsterdam, the Netherlands.,Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Myrthe Gbm Boekhorst
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, 5000 LE, Tilburg, the Netherlands
| | - Victor Jm Pop
- Center of Research in Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, P.O. BOX 90153, 5000 LE, Tilburg, the Netherlands
| |
Collapse
|
6
|
McKelvin G, Thomson G, Downe S. The childbirth experience: A systematic review of predictors and outcomes. Women Birth 2020; 34:407-416. [PMID: 33039281 DOI: 10.1016/j.wombi.2020.09.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/26/2020] [Accepted: 09/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Birth is often viewed as a pathological event, consequently, there has been an increase in literature focusing on predictors, experience and implications of traumatic childbirth and childbirth-related posttraumatic stress. However, to fully understand childbirth experiences a salutogenic perspective is required. This enables an understanding of what facilitates a positive childbirth experience besides what places women at risk of experiencing traumatic childbirth. OBJECTIVE To identify the psychosocial factors that could contribute to or be influenced by women's subjective accounts of childbirth. METHOD An in-depth literature search across four databases was undertaken. Quality appraisal based on internal and external validity was conducted and a combined numerical summary and categorical description were undertaken. FINDINGS Nineteen papers were included in the review and the variables grouped into three categories. The variables relate to 'Measures of labour and birth experience' (discussing the impact of events and perceptions during labour and birth). The second category discusses how 'support and relationships' can potentially shape the birth experience or be altered by it and finally, 'Psychological variables: influence and impact' is examined extensively. DISCUSSION The results of the review highlight significant contradictory evidence of what influences birth experiences. The findings confirm the dearth of available literature concerning positive birth experiences and most variables identified were pathogenic. This review suggests that such factors for PTSD may differ from those that influence birth experiences and should be examined separately. An enhanced understanding of the range of experiences is required to support women's rights in achieving a positive birth.
Collapse
Affiliation(s)
| | - Gillian Thomson
- School of Community Health and Midwifery, University of Central Lancashire, UK
| | - Soo Downe
- School of Community Health and Midwifery, University of Central Lancashire, UK
| |
Collapse
|
7
|
Nahaee J, Mohammad-Alizadeh-Charandabi S, Abbas-Alizadeh F, Martin CR, Hollins Martin CJ, Mirghafourvand M, Hassankhani H. Pre- and during-labour predictors of low birth satisfaction among Iranian women: a prospective analytical study. BMC Pregnancy Childbirth 2020; 20:408. [PMID: 32664943 PMCID: PMC7362575 DOI: 10.1186/s12884-020-03105-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Maternal childbirth dissatisfaction has short- and long-term negative effects on the mothers' health and life, as well as on relation with her child and family. Due to lack of studies in Iran and other counties, we aimed to determine pre- and during- labour predictors of low birth satisfaction. METHODS Seven hundred women with low risk singleton pregnancy participated in this prospective analytical study. The participants were hospitalized for vaginal delivery with fetus in cephalic presentation and gestational age of 370-416 at two teaching centers in Tabriz (Iran). Woman characteristics, anxiety state (using Spielberger inventory) and dehydration were assessed at cervical dilatation of 4-6 cm. Iranian (Persian) birth satisfaction scale-revised was applied 12-24 h after birth. Multiple linear regression was used to determine the predictors. RESULTS Excluding 26 women who were outliers, 674 women were analyzed. The mean birth satisfaction score was 23.8 (SD 6.5) from an attainable score of 0-40. The during-labour predictors of low birth satisfaction score were severe and moderate anxiety, labour dystocia, insufficient support by staff, vaginal birth with episiotomy and tear, emergency cesarean section, labour induction and labour augmentation with oxytocin, and woman dehydration. The pre-labour predictors included being primiparous, sexual and emotional violence during pregnancy, gestational age of 400-416, preference for cesarean section, no attendance at pregnancy classes, and insufficient household income. The proportion of the variance explained by the during-labour variables was 75%, by pre-labour variables was 14% and by overall was 76%. CONCLUSIONS The controllable during-labour predictors explains most of the variance of the satisfaction score. It seems that responding to women's physical and psychological needs during labour and applying less interventions could improve women's childbirth satisfaction.
Collapse
Affiliation(s)
- Jila Nahaee
- Students' Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Fatemeh Abbas-Alizadeh
- Women's Reproductive Health Research CenterTabriz University of Medical Sciences, Tabriz, Iran
| | - Colin R Martin
- Institute for Clinical and Applied Health Research (ICAHR), University of Hull, Hull, UK
| | | | - Mojgan Mirghafourvand
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Hassankhani
- Department of Medical and Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
8
|
Baljon KJ, Romli MH, Ismail AH, Khuan L, Chew BH. Effectiveness of breathing exercises, foot reflexology and back massage (BRM) on labour pain, anxiety, duration, satisfaction, stress hormones and newborn outcomes among primigravidae during the first stage of labour in Saudi Arabia: a study protocol for a randomised controlled trial. BMJ Open 2020; 10:e033844. [PMID: 32540887 PMCID: PMC7299053 DOI: 10.1136/bmjopen-2019-033844] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Labour pain is among the severest pains primigravidae may experience during pregnancy. Failure to address labour pain and anxiety may lead to abnormal labour. Despite the many complementary non-pharmacological approaches to coping with labour pain, the quality of evidence is low and best approaches are not established. This study protocol describes a proposed investigation of the effects of a combination of breathing exercises, foot reflexology and back massage (BRM) on the labour experiences of primigravidae. METHODS AND ANALYSIS This randomised controlled trial will involve an intervention group receiving BRM and standard labour care, and a control group receiving only standard labour care. Primigravidae of 26-34 weeks of gestation without chronic diseases or pregnancy-related complications will be recruited from antenatal clinics. Eligible and consenting patients will be randomly allocated to the intervention or the control group stratified by intramuscular pethidine use. The BRM intervention will be delivered by a trained massage therapist. The primary outcomes of labour pain and anxiety will be measured during and after uterine contractions at baseline (cervical dilatation 6 cm) and post BRM hourly for 2 hours. The secondary outcomes include maternal stress hormone (adrenocorticotropic hormone, cortisol and oxytocin) levels, maternal vital signs (V/S), fetal heart rate, labour duration, Apgar scores and maternal satisfaction. The sample size is estimated based on the between-group difference of 0.6 in anxiety scores, 95% power and 5% α error, which yields a required sample size of 154 (77 in each group) accounting for a 20% attrition rate. The between-group and within-group outcome measures will be examined with mixed-effect regression models, time series analyses and paired t-test or equivalent non-parametric tests, respectively. ETHICS AND DISSEMINATION Ethical approval was obtained from the Ethical Committee for Research Involving Human Subjects of the Ministry of Health in the Saudi Arabia (H-02-K-076-0319-109) on 14 April 2019, and from the Ethics Committee for Research Involving Human Subjects (JKEUPM) Universiti Putra Malaysia on 23 October 2019, reference number: JKEUPM-2019-169. Written informed consent will be obtained from all participants. Results from this trial will be presented at regional, national and international conferences and published in indexed journals. TRIAL REGISTRATION NUMBER ISRCTN87414969, registered 3 May 2019.
Collapse
Affiliation(s)
- Kamilya Jamel Baljon
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- Department of Nursing, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Muhammad Hibatullah Romli
- Department of Nursing & Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Adibah Hanim Ismail
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Lee Khuan
- Department of Nursing & Rehabilitation, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Boon How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| |
Collapse
|
9
|
Neerland CE, Avery MD, Looman WS, Saftner MA, Rockwood TH, Gurvich OV. Development and Testing of the Preparation for Labor and Birth Instrument. J Obstet Gynecol Neonatal Nurs 2020; 49:200-211. [PMID: 32035974 DOI: 10.1016/j.jogn.2019.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To develop and assess the reliability and validity of a new instrument used during the third trimester of pregnancy to measure women's confidence in their ability to achieve physiologic birth, the Preparation for Labor and Birth (P-LAB) instrument. DESIGN Two-phase instrument development study that consisted of item generation and a prospective field test. SETTING Field testing occurred in five midwestern U.S. prenatal clinics. PARTICIPANTS Participants in the field test were 203 nulliparous and parous pregnant women who intended to give birth vaginally. METHODS Psychometric testing consisted of test-retest reliability testing and assessments of content validity, face validity, and construct validity. We measured construct validity using exploratory factor analysis and correlation with the Sense of Coherence Scale. RESULTS The 22-item P-LAB showed good content validity, good internal consistency, and stability over time. All items had content validity index scores greater than or equal to 0.8, and the total instrument content validity index was 0.95. We identified four factors related to women's confidence in their ability to achieve physiologic birth: Planned Use of Pain Medication, Relationship With Care Provider and Supportive Birth Environment, Beliefs About Labor, and Labor Support (social and professional). Cronbach's alpha coefficient for the four extracted factors were .93, .76, .73 and .74, respectively. Intraclass correlation [95% confidence interval] for the total questionnaire was .92 [.88, .94]. We found no linear association between total P-LAB scores and sense of coherence. CONCLUSION Our findings demonstrate acceptable initial psychometric properties for the P-LAB instrument. Additional testing is required to evaluate the instrument's construct, convergent, and divergent validity.
Collapse
|
10
|
Neerland CE, Avery MD, Saftner MA, Gurvich OV. Maternal confidence for physiologic birth: Associated prenatal characteristics and outcomes. Midwifery 2019; 77:110-116. [PMID: 31319365 DOI: 10.1016/j.midw.2019.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/18/2019] [Accepted: 07/08/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Pregnancy, labor, and birth are normal, physiologic processes. Women often seek information during pregnancy to enhance their confidence for physiologic birth. Little is known about confidence for physiologic birth and associated prenatal characteristics and birth outcomes such as provider type, source of labor and birth information, mode of birth, and use of pain medication in labor. The purpose of this study was to examine prenatal confidence for physiologic birth and associated prenatal characteristics and birth outcomes. DESIGN This study was completed as part of a multi-phased instrument development study, the Preparation for Labor and Birth (P-LAB) instrument. P-LAB confidence scores were examined for their relationship with variables including labor type, provider type, source of labor support, pain medication use, and birth mode. SETTING AND PARTICIPANTS Women (N = 192) from five prenatal clinics in the Midwestern United States who had completed the P-LAB instrument participated in postpartum telephone interviews. FINDINGS Women with previous birth experience had higher confidence than nulliparous women. Prenatal care providers were reported as main source of labor and birth information. Confidence for birth was associated with intention to not use pain medication in labor. Women's overall intention to use or not use pain medication was consistent with use. Prenatal confidence was not associated with mode of birth. IMPLICATIONS FOR FUTURE RESEARCH Special emphasis should be paid to nulliparous women when developing interventions to enhance confidence for physiologic birth. Women rely on their care providers for information regarding labor and birth, therefore one area to strengthen confidence for physiologic birth is within the provider-patient relationship.
Collapse
Affiliation(s)
- Carrie E Neerland
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA.
| | - Melissa D Avery
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA
| | - Melissa A Saftner
- University of Minnesota, 1035 University Dr, SMed 351, Duluth, MN 55812, USA
| | - Olga V Gurvich
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA
| |
Collapse
|
11
|
Brubaker LH, Paul IM, Repke JT, Kjerulff KH. Early maternal-newborn contact and positive birth experience. Birth 2019; 46:42-50. [PMID: 30144141 PMCID: PMC6377287 DOI: 10.1111/birt.12378] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND In recent years, there has been increasing recognition of the importance of early maternal-newborn contact for the health and well-being of the newborn and promotion of breastfeeding. However, little research has investigated the association between early maternal-newborn contact and the mother's birth experience. METHODS As part of a large-scale prospective, cohort study (the First Baby Study [FBS]), nearly 3000 women who delivered in Pennsylvania (2009-2011) reported how soon after delivery they first saw, held, and fed their newborns. Birth experience was measured via telephone interview 1 month postpartum, using the FBS Birth Experience Scale, a 16-item scale which addresses women's feelings about the delivery. General linear models were used to measure associations between time to first maternal-newborn contact and birth experience, controlling for relevant confounders, including maternal age, race/ethnicity, insurance coverage, delivery mode, gestational age, and pregnancy and delivery complications. RESULTS The sooner that new mothers first saw, held, and fed their newborns after delivery the more positive their childbirth experiences (all P-values < 0.001). Women who delivered by cesarean were less likely to see, hold and feed their newborns shortly after delivery than those who delivered vaginally (all P-values < 0.001), and reported less positive birth experiences (P < 0.001). However, if they first saw, held, and fed their newborns shortly after delivery, they reported more positive birth experiences than those who delivered vaginally (P = 0.010). DISCUSSION Early maternal-newborn contact after delivery was associated with positive birth experiences for new mothers, particularly those who delivered by cesarean.
Collapse
Affiliation(s)
- Laura H. Brubaker
- Department of Obstetrics and Gynecology, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Ian M. Paul
- Department of Pediatrics, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - John T. Repke
- Department of Obstetrics and Gynecology, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Kristen H. Kjerulff
- Departments of Public Health Sciences and Obstetrics and Gynecology, College of Medicine, Penn State University, Hershey, Pennsylvania
| |
Collapse
|
12
|
Passarelli VC, Lopes F, Merighe LS, Araujo RS, Nomura RMY. Satisfaction of adolescent mothers with childbirth care at a public maternity hospital. J Obstet Gynaecol Res 2018; 45:443-449. [DOI: 10.1111/jog.13841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 09/20/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Victor C. Passarelli
- Department of Obstetrics, Escola Paulista de Medicina; Universidade Federal de São Paulo; Sao Paulo Brazil
| | - Fernanda Lopes
- Department of Obstetrics, Escola Paulista de Medicina; Universidade Federal de São Paulo; Sao Paulo Brazil
| | - Lecy S. Merighe
- Amparo Maternal - Associação Congregação de Santa Catarina; Sao Paulo Brazil
| | - Regina S. Araujo
- Amparo Maternal - Associação Congregação de Santa Catarina; Sao Paulo Brazil
| | - Roseli M. Y. Nomura
- Department of Obstetrics, Escola Paulista de Medicina; Universidade Federal de São Paulo; Sao Paulo Brazil
| |
Collapse
|
13
|
Neerland CE. Maternal Confidence for Physiologic Childbirth: A Concept Analysis. J Midwifery Womens Health 2018; 63:425-435. [DOI: 10.1111/jmwh.12719] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 11/30/2022]
|
14
|
Sheen K, Slade P. Examining the content and moderators of women's fears for giving birth: A meta‐synthesis. J Clin Nurs 2018; 27:2523-2535. [DOI: 10.1111/jocn.14219] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Kayleigh Sheen
- Department of Psychological Sciences Institute of Psychology, Health& Society University of Liverpool Liverpool UK
| | - Pauline Slade
- Clinical Psychology Institute of Psychology, Health and Society University of Liverpool Liverpool UK
| |
Collapse
|
15
|
How does delivery method influence factors that contribute to women's childbirth experiences? Midwifery 2016; 43:21-28. [DOI: 10.1016/j.midw.2016.10.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/26/2016] [Accepted: 10/07/2016] [Indexed: 11/18/2022]
|
16
|
Smarandache A, Kim THM, Bohr Y, Tamim H. Predictors of a negative labour and birth experience based on a national survey of Canadian women. BMC Pregnancy Childbirth 2016; 16:114. [PMID: 27193995 PMCID: PMC4870779 DOI: 10.1186/s12884-016-0903-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 05/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A negative birth experience has been shown to have a significant impact on the well-being and future choices of mothers. The objective of this study was to assess the prevalence of, and identify the risk factors associated with a negative birth experience for women in Canada. METHODS The study was based on secondary data analysis of the Maternity Experiences Survey (MES), a Canadian population database administered to 6,421 Canadian women in 2006. The examined outcome - negative birth experience - was derived from mothers' self-report of overall labour and birth experience. Independent variables were maternal demographics, health characteristics, pregnancy-related characteristics, and birth characteristics. Multivariable logistic regression analysis was performed to determine the significant predictors of negative birth experience. Adjusted Odds Ratios (AOR) and 95 % Confidence Intervals (CI) are reported. RESULTS Negative birth experience was reported among 9.3 % of women. The main significant predictors of a negative birth experience included older age (AOR 2.29, 95 % CI, 1.03-5.07), violence experienced in the past two years (AOR, 1.62, 95 % CI, 1.21-2.18), poor self-perceived health (adjusted OR, 1.95, 95 % CI, 1.36-2.80), prenatal classes attended (adjusted OR, 1.36, 95 % CI, 1.06-1.76), unintended pregnancy (adjusted OR, 1.30, 95 % CI, 1.03-1.63), caesarean birth (AOR, 1.65, 95 % CI, 1.32-2.06), and neonate admission to intensive care (AOR, 1.40, 95 % CI, 1.08-1.82). CONCLUSION Significant predictors of a negative labour and birth experience were identified through this study, a first in the Canadian context. These findings suggest future research directions and provide a basis for the design and evaluation of maternal health policy and prevention programs.
Collapse
Affiliation(s)
- Andrei Smarandache
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Theresa H M Kim
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Yvonne Bohr
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| |
Collapse
|
17
|
Darra S, Murphy F. Coping and help in birth: An investigation into 'normal' childbirth as described by new mothers and their attending midwives. Midwifery 2016; 40:18-25. [PMID: 27428094 DOI: 10.1016/j.midw.2016.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/01/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE to investigate how 'normal' childbirth is described by new mothers and their attending midwives. DESIGN a qualitative, reflexive, narrative study was used to explore birth stories using in-depth, un-structured interviews. SETTING 21 new mothers and their 16 attending midwives were recruited from the locality surrounding a district general hospital in South Wales, United Kingdom (UK). FINDINGS the findings identified that the mothers wanted to cope with labour and birth, by breathing through it and using some birth interventions with the help of knowledgeable midwives. Midwives aimed to achieve 'normality' in birth but also commonly utilised birth interventions. Consequently the notion of 'normal' birth as not involving interventions in birth was not found to be a useful defining concept in this study. Furthermore, current dichotomous models and theories of birth and midwifery in particular those relating to pain management did not fully explain the perspectives of these women and their midwives. IMPLICATIONS FOR PRACTICE dichotomous models and theories for birth and midwifery practice and those which incorporate the term 'normal' birth are shown to be not entirely useful to fully explain the contemporary complexity of childbirth in the UK. Therefore it is now necessary to consider avoiding using dichotomous models of birth and midwifery in the UK and to instead concentrate on developing integrated models that reflect the real life current experiences of women and their midwives.
Collapse
Affiliation(s)
- Susanne Darra
- College of Human and Health Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, United Kingdom.
| | - Fiona Murphy
- Department of Nursing and Midwifery, University of Limerick, Castletroy, Limerick. Ireland
| |
Collapse
|
18
|
Gosselin P, Chabot K, Béland M, Goulet-Gervais L, Morin AJS. [Fear of childbirth among nulliparous women: Relations with pain during delivery, post-traumatic stress symptoms, and postpartum depressive symptoms]. Encephale 2016; 42:191-6. [PMID: 26924001 DOI: 10.1016/j.encep.2016.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 03/02/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Fear of childbirth is common in women who are pregnant with their first child and is associated with important consequences such as abortions and miscarriages. Twenty percent of nulliparous women seem to exhibit a mild or moderate fear, while 6% present an excessive and irrational fear known as tocophobia. Tocophobia is suggested to be associated with many negative consequences such as postpartum depression (PPD) and Post-traumatic stress (PTS). However, there is little empirical evidence to support these relationships. Recently, Fairbrother and Woody (2007) did not observe a link between the fear of childbirth and symptoms of PPD and PTS in nulliparous women. Some results, near the significance level, could be explained by a lack of statistical power. The present study focused on the link between the fear of childbirth and the process of delivery, the perception of pain, PPD and PTS. More specifically, it aimed to test three hypotheses: (i) fear of childbirth will be linked to the process of delivery, especially regarding the perception of pain, the use of anaesthesia and the use of Caesarean section; (ii) a high level of fear of childbirth will be associated with more negative postpartum consequences (namely PPD/PTS symptoms); (iii) the process of delivery and pain will also be related to post-delivery symptoms. Mediation effects were tested. METHOD Data from a longitudinal study were used to meet the hypotheses. A total of 176 nulliparous pregnant women responded to questionnaires at two time measurements (during pregnancy and at 5weeks postpartum). RESULTS Fear of childbirth is related to the perception of pain at birth among women delivering vaginally, in the absence of anaesthesia. It is also linked to symptoms of PPD and PTS, regardless of whether or not anaesthesia was used. Fear of childbirth also appears to be strongly associated to symptoms of PTS in women who have experienced an unplanned caesarean section. Thus, symptoms of postpartum PTS could play a mediating role in the link between fear of childbirth and PPD. CONCLUSIONS These results support the relevance of taking into account the fear of childbirth and perception of pain in connection with symptoms of PTS and PPD in nulliparous women. The unplanned caesarean section (including emergency caesarean) also appears to be important in the study of the relationship between fear and symptoms of PTS. Fear of childbirth could render the experience of childbearing more negative and predispose to PTS and PPD. Enabling psychological vulnerabilities could also be an interesting avenue for understanding these links. Limitations are discussed.
Collapse
Affiliation(s)
- P Gosselin
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada.
| | - K Chabot
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada
| | - M Béland
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada
| | - L Goulet-Gervais
- Département de psychologie, université de Sherbrooke, Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS), Sherbrooke, Canada
| | - A J S Morin
- Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australie
| |
Collapse
|
19
|
Ji H, Jiang H, Yang L, Qian X, Tang S. Factors contributing to the rapid rise of caesarean section: a prospective study of primiparous Chinese women in Shanghai. BMJ Open 2015; 5:e008994. [PMID: 26567254 PMCID: PMC4654304 DOI: 10.1136/bmjopen-2015-008994] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To identify factors contributing to the rapid rise of caesarean section in Shanghai through the prospective observation of changes in the preferred mode of delivery in pregnancy among primiparous Chinese women. DESIGN Prospective study. SETTING Two general hospitals in Shanghai. PARTICIPANTS A cohort of 832 low-risk primiparous women participated in the investigation from 2010-2012 three consecutive times, from their second to third trimester and, finally, 1-2 days post partum. METHODS Participants were interviewed, using standard questionnaires, for information on demographic characteristics, maternal childbirth self-efficacy, their preference of delivery mode before childbirth and on the people most influential to them when making decisions on delivery mode. Caesarean section indications in the medical records were extracted by the investigators and assessed against clinical guidelines. Caesarean sections were categorised into three groups: guideline-defined indications, doctor-defined indications and maternal request. MAIN OUTCOME MEASURES Preferred mode of delivery; indications for caesarean section; actual mode of delivery; determinants of caesarean section. RESULTS Of 832 pregnant women enrolled, 13.2% preferred caesarean section in the second trimester. This figure rose to 17.0% in the third trimester among 599 followed women. Of 523 women completing all three interviews, 58.1% underwent caesarean section. However, 34.9% of women undergoing caesarean section did not have any indications listed in the clinical guidelines nor based on maternal request. Multinomial regression analysis showed that doctors' influence was one of the significant risk factors of undergoing caesarean section, with doctor-defined indications. Participants with low maternal childbirth self-efficacy were more likely to request caesarean sections themselves. CONCLUSIONS When deciding to deliver via caesarean section without justified clinical indications in the guideline, Chinese doctors played an important role in decision-making. Among primiparous Chinese women, decisions to use caesarean sections were often made during the third trimester or during the process of labour.
Collapse
Affiliation(s)
- Honglei Ji
- Department of Epidemiology and Social Science, Shanghai Institute of Planned Parenthood Research/WHO Collaborating Center for Research in Human Reproduction, Shanghai, China
- Department of Maternal, Child and Adolescent Health, School of Public Health and Global Health Institute, Fudan University, Shanghai, China
| | - Hong Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health and Key Laboratory of Public Health Safety (Ministry of Health), Fudan University, Shanghai, China
| | - Limin Yang
- Maternity and Child Health Institution of Zhabei District, Shanghai, China
| | - Xu Qian
- Department of Maternal, Child and Adolescent Health, School of Public Health and Global Health Institute, Fudan University, Shanghai, China
| | - Shenglan Tang
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| |
Collapse
|
20
|
Gourounti K, Kouklaki E, Lykeridou K. Childbirth efficacy: Validating the childbirth self-efficacy inventory in a Greek sample of pregnant women. Midwifery 2015; 31:742-9. [PMID: 25896370 DOI: 10.1016/j.midw.2015.03.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 02/09/2015] [Accepted: 03/29/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE childbirth self-efficacy has been found to be a factor that influences women's decision about their choice of delivery. Greece is a country with a high caesarean section rate and the validation of the Childbirth Self-Efficacy Inventory (CBSEI) would help explore Greek pregnant women's emotional preparation of childbirth. The aim of the study was to translate the CBSEI to Greek and to examine its psychometric properties. DESIGN a cross-sectional study. SETTING private hospital in Athens, Greece. PARTICIPANTS 145 pregnant women, in late pregnancy, attending routine antenatal visit between April 2014 and June 2014. MEASUREMENTS the CBSEI was 'forward-backward' translated from English to Greek language. Descriptive statistics and non-parametric tests were used to describe and compare the scales. Factor structure was investigated using principal axis factoring. Measures of self-esteem and optimism were used to assess the convergent validity of the CBSEI. Cronbach's α was used to measure internal consistency reliability. FINDINGS the factor analysis suggested the existence of a three-factor structure with meaningful groupings. Greek women were able to distinguish between outcome expectancy and self-efficacy expectancy and between the two labour stages, active phase of the first stage and the second stage of labour. Construct validity was confirmed by computing correlations between the CBSEI subscales and conceptually similar constructions of self-esteem and optimism. Internal consistency reliability was satisfactory. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE the Greek version of the CBSEI is a reliable and valid measure. The clinical use of CBSEI may enable midwives and other health care professionals to identify pregnant women with low childbirth self-efficacy. The clinical use of CBSEI may also give the opportunity to provide information and support for preparing and empowering women for childbirth in order to improve their childbirth experience.
Collapse
Affiliation(s)
- Kleanthi Gourounti
- Department of Midwifery, Technological Educational Institution of Athens, Greece.
| | | | - Katerina Lykeridou
- Department of Midwifery, Technological Educational Institution of Athens, Greece
| |
Collapse
|
21
|
Attanasio LB, McPherson ME, Kozhimannil KB. Positive childbirth experiences in U.S. hospitals: a mixed methods analysis. Matern Child Health J 2015; 18:1280-90. [PMID: 24072597 DOI: 10.1007/s10995-013-1363-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Research on maternity care quality in the US often focuses on avoiding adverse events. Positive birth experiences receive less attention. This analysis used a mixed methods approach to identify factors associated with confidence and positive experiences during birth among a national sample of U.S. mothers. Data are from a nationally representative survey of women who delivered a singleton baby in a US hospital in 2005 (N = 1,573). We explored the relationship between confidence, positive birth experiences and socio-demographic characteristics as well as factors related to the clinical encounter and health systems, including common obstetric procedures and interventions. Self-reported confidence during birth was the outcome in quantitative analyses. We used logistic regression analysis and qualitative analysis of open-ended survey responses. Approximately 42% of mothers reported feeling confident during birth. Confidence going into labor was the strongest predictor of confidence during birth (adjusted odds ratio 12.88 for nulliparous women, 8.54 for parous women). Black and Hispanic race/ethnicity (compared to white) and having partner support were positively associated with confidence during birth for nulliparous women. Qualitative analyses revealed that positive experiences were related to previous birth experiences, communication between women and their clinicians, perceptions of shared decision-making, and communication among clinicians related to the timing and logistics of managing complications and coordinating care. For clinicians who care for women during pregnancy and childbirth, thoughtful, deliberate attention to factors promoting positive birth experiences may help create circumstances amenable to enhancing the quality of obstetric care and improving outcomes for mothers and infants.
Collapse
Affiliation(s)
- Laura B Attanasio
- Division of Health Policy and Management, University of Minnesota School of Public Health, 720 Delaware St. SE, MMC 729, Minneapolis, MN, 55455, USA,
| | | | | |
Collapse
|
22
|
Shepherd J. Minimizing harm via psychological intervention: response to Glannon. JOURNAL OF MEDICAL ETHICS 2014; 40:662-663. [PMID: 24763221 DOI: 10.1136/medethics-2014-102073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In a recent discussion, Walter Glannon discusses a number of ways we might try to minimise harm to patients who experience intraoperative awareness. In this response, I direct attention to a possibility that deserves further attention. It might be that a kind of psychological intervention--namely, informing patients of the possibility of intraoperative awareness and of what to expect in such a case--would constitute a unique way to respect patient autonomy, as well as minimise the harm that typically follows intraoperative awareness events.
Collapse
|
23
|
Guittier MJ, Cedraschi C, Jamei N, Boulvain M, Guillemin F. Impact of mode of delivery on the birth experience in first-time mothers: a qualitative study. BMC Pregnancy Childbirth 2014; 14:254. [PMID: 25080994 PMCID: PMC4132899 DOI: 10.1186/1471-2393-14-254] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 07/09/2014] [Indexed: 12/19/2022] Open
Abstract
Background The birth of a first child is an important event in a woman’s life. Delivery psychological impacts vary depending on whether delivery has been positively or negatively experienced. Delivery experience determinants have been identified but the understanding of their expression according to the mode of delivery is poorly documented. The purpose of the study was to determine important elements associated with women’s first delivery experience according to the mode of delivery: vaginal or caesarean section. Methods Qualitative approach using thematic content analysis of in-depth interviews conducted between 4 and 6 weeks’ postpartum, in 24 primiparous women who delivered at Geneva University Hospital in 2012. Results Perceived control, emotions, and the first moments with the newborn are important elements for the experience of childbirth. Depending on the mode of delivery these are perceived differently, with a negative connotation in the case of caesarean section. Other elements influencing the delivery experience were identified among all participants, irrespective of the mode of delivery. They included representations, as well as the relationship with caregivers and the father in the delivery room, privacy, unexpected sensory experiences, and ownership of the maternal role. Women’s and health professionals’ representations sometimes led to a hierarchy based on the mode of delivery and use of analgesia. Conclusions The mode of delivery directly impacts on certain key delivery experience determinants as perceived control, emotions, and the first moments with the newborn. The ability/inability of the woman to imagine a second pregnancy is a good indicator of the birth experience. Certain health professional gestures or attitudes can promote a positive delivery experience. We recommend to better prepare women during prenatal classes for the eventuality of a caesarean section delivery and to offer all women and, possibly, their partners, the opportunity to talk about the experience of childbirth during the postpartum period. The results of this study suggest that further research is required on the social representations of women and health professionals regarding the existence of a hierarchy associated with the mode of delivery.
Collapse
|
24
|
Carlsson IM, Ziegert K, Nissen E. Psychometric properties of the Swedish childbirth self-efficacy inventory (Swe-CBSEI). BMC Pregnancy Childbirth 2014; 14:1. [PMID: 24383788 PMCID: PMC3893383 DOI: 10.1186/1471-2393-14-1] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 12/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has reported that women who are admitted to delivery wards in early labour process before an active stage of labour has started run an increased risk of instrumental deliveries. Therefore, it is essential to focus on factors such as self-efficacy that can enhance a woman's own ability to cope with the first stage of labour. However, there was no Swedish instrument measuring childbirth self-efficacy available. Thus, the aim of the study was to translate the Childbirth Self-efficacy Inventory and to psychometrically test the Swedish version on first- time mothers within the Swedish culture. METHODS The method included a forward-backward translation with face and content validity. The psychometric properties were evaluated using a Principal Component Analysis and by using Cronbach's alpha coefficient and inter-item correlations. Descriptive statistics and non-parametric tests were used to describe and compare the scales. All data were collected from January 2011 to June 2012, from 406 pregnant women during the gestational week 35-42. RESULTS The Swedish version of the Childbirth Self-Efficacy Inventory indicated good reliability and the Principal Component Analysis showed a three-component structure. The Wilcoxon Signed-Ranks Test indicated that the women could differentiate between the concepts outcome expectancy and self-efficacy expectancy and between the two labour stages, active stage and the second stage of labour. CONCLUSIONS The Swedish version of Childbirth Self-efficacy Inventory is a reliable and valid instrument. The inventory can act as a tool to identify those women who need extra support and to evaluate the efforts of improving women's self-efficacy during pregnancy.
Collapse
Affiliation(s)
- Ing-Marie Carlsson
- Department of Women's and Children's health at Karolinska Institutet, SE-171 77 Stockholm, Sweden.
| | | | | |
Collapse
|
25
|
Montague E, Winchester W, Valdez R, Vaughn-Cooke M, Perchonok J. Considering Culture in the Design and Evaluation of Health IT for Patients. ACTA ACUST UNITED AC 2013. [DOI: 10.1177/1541931213571242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the context of health care, culture can influence the way a patient understands health information, what they consider a health problem, how they express symptoms, who should provide them treatment, and what type of treatment they should be provided. This panel will discuss why human factors professionals should consider the patient’s culture when designing and evaluating health information technology and approaches to developing culturally informed technologies. The discussion will begin by highlighting work from a general cultural group: racial and ethnic minorities. It will then become more specific by looking at cultural groups within a certain disease: Black female college students and HIV/AIDS, Hispanic and African American diabetes patients, and lesbians during pregnancy and childbirth. The panelists will focus on lessons learned from previous research within each of these cultural groups that can be applied to the overall design of culturally-informed health IT.
Collapse
|
26
|
Blüml V, Stammler‐Safar M, Reitinger AK, Resch I, Naderer A, Leithner K. A Qualitative Approach to Examine Women's Experience of Planned Cesarean. J Obstet Gynecol Neonatal Nurs 2012; 41:E82-90. [DOI: 10.1111/j.1552-6909.2012.01398.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
27
|
Abstract
Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an increased dependency on their mothers and a lack of their own intuition contiguous to the birth process. These findings contribute understanding to how expectant mothers know birth, suggesting that their knowing does not diminish conflict surrounding the event and may even exacerbate it when not combined with learning skills to manage conflict. Childbirth educators may want to include instruction on negotiating power differential in relationships encountered during childbirth in order to strengthen a first-time mother's ability to receive the care she wants. Educators may also want to assess the expectant mother's view of birth and her expectations for birth. Schools of nursing should consider the inclusion of women-centered care curricula at both the undergraduate and graduate levels. The mothers' responses in this study clearly reveal that the politics surrounding birthing remain in place and must be removed in order to provide a supportive environment for normal birth.
Collapse
Affiliation(s)
- Jane Staton Savage
- JANE SAVAGE is an assistant professor of clinical nursing in the School of Nursing at Louisiana State University Health Sciences Center in New Orleans
| |
Collapse
|
28
|
Abstract
Patient satisfaction is frequently used to evaluate the quality of medical care and to guide the development of health care services. Improved satisfaction is a goal recommended by the Institute of Medicine and the government of the United Kingdom for health care reform. During the perinatal period, dynamic changes in physical and psychological state impose unique challenges in the assessment of satisfaction. This article reviews the measurement of satisfaction with care, together with factors that may influence satisfaction and its measurement during the perinatal period. Recommendations are also provided for further research and development of satisfaction instruments and potential interventions to improve satisfaction with perinatal care.
Collapse
|
29
|
Lang AJ, Sorrell JT, Rodgers CS, Lebeck MM. Anxiety sensitivity as a predictor of labor pain. Eur J Pain 2012; 10:263-70. [PMID: 15987671 DOI: 10.1016/j.ejpain.2005.05.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2004] [Accepted: 05/08/2005] [Indexed: 11/30/2022]
Abstract
Psychosocial factors have been implicated in the pain experience during childbirth, which can have both short- and long-term consequences on the mother's health and her relationship with her infant. The present study evaluated important demographic, social, and psychological factors as predictors of multiple dimensions of labor pain among 35 mothers during childbirth. The results indicated that anxiety sensitivity (AS), as measured by the Anxiety Sensitivity Index, shared a significant relation with maximum pain during labor as well as sensory and affective components of pain as measured by the McGill Pain Questionnaire. AS predicted both maximum pain during labor and sensory aspects of pain above and beyond demographic and social factors as well as other theoretically important psychological factors (e.g., depression and state anxiety). These data replicate previous research that has demonstrated the significant impact of AS on pain responding in other areas (e.g., chronic pain) and extend knowledge in this literature to demonstrate the important role that AS serves among women and their experience of labor pain. Clinical implications are highlighted and discussed.
Collapse
Affiliation(s)
- Ariel J Lang
- University of California San Diego and the VA San Diego Healthcare System, San Diego, CA, United States.
| | | | | | | |
Collapse
|
30
|
Catling-Paull C, Dahlen H, Homer CC. Multiparous women's confidence to have a publicly-funded homebirth: A qualitative study. Women Birth 2011; 24:122-8. [DOI: 10.1016/j.wombi.2010.09.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 09/03/2010] [Accepted: 09/06/2010] [Indexed: 11/30/2022]
|
31
|
Affiliation(s)
- Joanne O’Hare
- Joanne O’Hare Lecturer in Midwifery, School of Nursing and Midwifery, University College, Dublin
| | - Anne Fallon
- Anne Fallon Lecturer in Midwifery, School of Nursing and Midwifery, National University of Ireland, Galway
| |
Collapse
|
32
|
Christiaens W, Verhaeghe M, Bracke P. Pain acceptance and personal control in pain relief in two maternity care models: a cross-national comparison of Belgium and the Netherlands. BMC Health Serv Res 2010; 10:268. [PMID: 20831798 PMCID: PMC2944275 DOI: 10.1186/1472-6963-10-268] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Accepted: 09/10/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A cross-national comparison of Belgian and Dutch childbearing women allows us to gain insight into the relative importance of pain acceptance and personal control in pain relief in 2 maternity care models. Although Belgium and the Netherlands are neighbouring countries sharing the same language, political system and geography, they are characterised by a different organisation of health care, particularly in maternity care. In Belgium the medical risks of childbirth are emphasised but neutralised by a strong belief in the merits of the medical model. Labour pain is perceived as a needless inconvenience easily resolved by means of pain medication. In the Netherlands the midwifery model of care defines childbirth as a normal physiological process and family event. Labour pain is perceived as an ally in the birth process. METHODS Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004-2005. Two questionnaires were filled out by 611 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth either at home or in a hospital. However, only women having a hospital birth without obstetric intervention (N = 327) were included in this analysis. A logistic regression analysis has been performed. RESULTS Labour pain acceptance and personal control in pain relief render pain medication use during labour less likely, especially if they occur together. Apart from this general result, we also find large country differences. Dutch women with a normal hospital birth are six times less likely to use pain medication during labour, compared to their Belgian counterparts. This country difference cannot be explained by labour pain acceptance, since - in contrast to our working hypothesis - Dutch and Belgian women giving birth in a hospital setting are characterised by a similar labour pain acceptance. Our findings suggest that personal control in pain relief can partially explain the country differences in coping with labour pain. For Dutch women we find that the use of pain medication is lowest if women experience control over the reception of pain medication and have a positive attitude towards labour pain. In Belgium however, not personal control over the use of pain relief predicts the use of pain medication, but negative attitudes towards labour. CONCLUSIONS Apart from individual level determinants, such as length of labour or pain acceptance, our findings suggest that the maternity care context is of major importance in the study of the management of labour pain. The pain medication use in Belgian hospital maternity care is high and is very sensitive to negative attitudes towards labour pain. In the Netherlands, on the contrary, pain medication use is already low. This can partially be explained by a low degree of personal control in pain relief, especially when co-occurring with positive pain attitudes.
Collapse
Affiliation(s)
| | | | - Piet Bracke
- Department of Sociology, Ghent University, Ghent, Belgium
| |
Collapse
|
33
|
Mccrea H, Wright M, Stringer M. The development of a scale to assess control in pain management during labour. J Reprod Infant Psychol 2010. [DOI: 10.1080/02646830050008350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
34
|
Dahlen HG, Barclay L, Homer CS. ‘Reacting to the unknown’: experiencing the first birth at home or in hospital in Australia. Midwifery 2010; 26:415-23. [DOI: 10.1016/j.midw.2008.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 05/27/2008] [Accepted: 07/24/2008] [Indexed: 10/21/2022]
|
35
|
Denis A, Callahan S. État de stress post-traumatique et accouchement classique : revue de littérature. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.jtcc.2009.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
36
|
Berentson‐Shaw J, Scott KM, Jose PE. Do self‐efficacy beliefs predict the primiparous labour and birth experience? A longitudinal study. J Reprod Infant Psychol 2009. [DOI: 10.1080/02646830903190888] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
37
|
Oz Y, Sarid O, Peleg R, Sheiner E. Sense of coherence predicts uncomplicated delivery: a prospective observational study. J Psychosom Obstet Gynaecol 2009; 30:29-33. [PMID: 19308780 DOI: 10.1080/01674820802546196] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The present study aimed to investigate factors predicting uncomplicated deliveries and specifically whether a sense of coherence (SOC) and perceived stress can predict such deliveries. A prospective observational study was conducted employing self-administered SOC and perceived stress scale (PSS) questionnaires with pregnant women attending the outpatient clinic for routine surveillance. Following delivery, data regarding maternal and fetal delivery complications were collected from the participants' medical records. Of one hundred forty-five women completing the study, 43.4% completed the delivery process without complications. Women experiencing delivery complications, on average, had lower SOC scores (67.7 +/- 1.19 vs. 72.2 +/- 1.32, p = 0.014). Maternal complications (as opposed to fetal complications) accounted for this divergence and were related to lower SOC scores (67.74 +/- 1.19 vs. 72.18 +/- 1.32, p = 0.01). PSS was not associated with uncomplicated delivery (18.82 +/- 0.59 vs. 17.98 +/- 0.62, p = 0.341). Nulliparity, however, was associated with higher occurrence of complicated delivery (31.9% of complicated vs. 13.2% of uncomplicated deliveries, p = 0.007). Multivariable analysis demonstrated that high SOC (OR = 1.042; 95% CI = 1.004-1.08; p = 0.03) and nulliparity (OR = 0.293; 95% CI = 0.113-0.758; p = 0.011) both were independent predictors of uncomplicated delivery, directly and inversely, respectively. In conclusion, higher SOC scores are an independent protective factor for the prediction of uncomplicated delivery.
Collapse
Affiliation(s)
- Yasmin Oz
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | | | | |
Collapse
|
38
|
Oladokun A, Eyelade O, Morhason-Bello I, Fadare O, Akinyemi J, Adedokun B. Awareness and desirability of labor epidural analgesia: a survey of Nigerian women. Int J Obstet Anesth 2009; 18:38-42. [DOI: 10.1016/j.ijoa.2008.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2007] [Revised: 07/07/2008] [Accepted: 07/22/2008] [Indexed: 11/27/2022]
|
39
|
Christiaens W, Verhaeghe M, Bracke P. Childbirth expectations and experiences in Belgian and Dutch models of maternity care. J Reprod Infant Psychol 2008. [DOI: 10.1080/02646830802350872] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
40
|
Edworthy Z, Chasey R, Williams H. The role of schema and appraisals in the development of post‐traumatic stress symptoms following birth. J Reprod Infant Psychol 2008. [DOI: 10.1080/02646830801918422] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
41
|
Hug I, Chattopadhyay C, Mitra GR, Kar Mahapatra RM, Schneider M. Maternal expectations and birth-related experiences: a survey of pregnant women of mixed parity from Calcutta, India. Int J Obstet Anesth 2008; 17:112-7. [DOI: 10.1016/j.ijoa.2007.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Revised: 07/01/2007] [Accepted: 10/01/2007] [Indexed: 10/22/2022]
|
42
|
Bryanton J, Gagnon AJ, Johnston C, Hatem M. Predictors of Women’s Perceptions of the Childbirth Experience. J Obstet Gynecol Neonatal Nurs 2008; 37:24-34. [PMID: 18226154 DOI: 10.1111/j.1552-6909.2007.00203.x] [Citation(s) in RCA: 137] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Janet Bryanton
- School of Nursing at the University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada.
| | | | | | | |
Collapse
|
43
|
Christiaens W, Bracke P. Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective. BMC Pregnancy Childbirth 2007; 7:26. [PMID: 17963491 PMCID: PMC2200649 DOI: 10.1186/1471-2393-7-26] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 10/26/2007] [Indexed: 02/08/2023] Open
Abstract
Background The fulfilment of expectations, labour pain, personal control and self-efficacy determine the postpartum evaluation of birth. However, researchers have seldom considered the multiple determinants in one analysis. To explore to what extent the results can be generalised between countries, we analyse data of Belgian and Dutch women. Although Belgium and the Netherlands share the same language, geography and political system and have a common history, their health care systems diverge. The Belgian maternity care system corresponds to the ideal type of the medical model, whereas the Dutch system approaches the midwifery model. In this paper we examine multiple determinants, the fulfilment of expectations, labour pain, personal control and self-efficacy, for their association with satisfaction with childbirth in a cross-national perspective. Methods Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first 2 weeks after childbirth either at home or in a hospital. Of these, 560 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004–2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Labour pain was rated retrospectively using Visual Analogue Scales. Personal control was assessed with the Wijma Delivery Expectancy/Experience Questionnaire and Pearlin and Schooler's mastery scale. A hierarchical linear analysis was performed. Results Satisfaction with childbirth benefited most consistently from the fulfilment of expectations. In addition, the experience of personal control buffered the lowering impact of labour pain. Women with high self-efficacy showed more satisfaction with self-, midwife- and physician-related aspects of the birth experience. Conclusion Our findings focus the attention toward personal control, self-efficacy and expectations about childbirth. This study confirms the multidimensionality of childbirth satisfaction and demonstrates that different factors predict the various dimensions of satisfaction. The model applies to both Belgian and Dutch women. Cross-national comparative research should further assess the dependence of the determinants of childbirth satisfaction on the organisation of maternity care.
Collapse
|
44
|
Ip WY, Chung TKH, Tang CS. The Chinese Childbirth Self-Efficacy Inventory: the development of a short form. J Clin Nurs 2007; 17:333-40. [PMID: 17850293 DOI: 10.1111/j.1365-2702.2006.01919.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To examine the validity and reliability of the short form of the Childbirth Self-Efficacy Inventory in a clinical Chinese pregnant population. BACKGROUND Childbirth self-efficacy has become an important psychological construct for both childbirth educators and researchers because pregnant women's perception may influence the meaning and consequences of childbirth. Assessment done by the original Childbirth Self-Efficacy Inventory limits the scientific rigor for generating additional research into the construct, as its items were repetitive and its structure is lengthy. METHODS This prospective study investigated 293 Chinese pregnant women in their third trimester of pregnancy. The women completed the short form of the Childbirth Self-Efficacy Inventory, the Chinese Self-efficacy Scale and the socio-demographic questionnaire in an interview room of the study hospital. The re-testing of the scale on the participants was carried out two weeks later in the same clinic. RESULTS Factor analysis and item-subscale correlations supported the conceptual dimensions of the short form of the Chinese Childbirth Self-Efficacy Inventory. The Cronbach's alpha coefficients for both subscales were over 0.9. The convergent validity with the Chinese Self-Efficacy Scale was reflected by a moderate correlation for the two subscales. The efficacy expectancy subscale differentiated primigravid from multigravid women (t = 2.83, P < 0.01, CI = -2.33 to 2.34). CONCLUSIONS The reliability and validity information presented in this paper supports the use of the short form of the Childbirth Self-Efficacy Inventory as a research instrument in measuring the childbirth self-efficacy among the Chinese population. Further validation of the measure is warranted. RELEVANCE TO CLINICAL PRACTICE The reliable short form of the Childbirth Self-Efficacy Inventory could be used in routine clinical practice in maternity care services to provide a point of reference for future research and development in both childbirth education and clinical practice.
Collapse
Affiliation(s)
- Wan-Yim Ip
- Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
| | | | | |
Collapse
|
45
|
Beebe KR, Humphreys J. Expectations, perceptions, and management of labor in nulliparas prior to hospitalization. J Midwifery Womens Health 2006; 51:347-353. [PMID: 16945782 DOI: 10.1016/j.jmwh.2006.02.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This ethnographic qualitative study was designed to explore the phenomenon of prehospitalization labor from the perspective of nulliparous women. Twenty-three women were interviewed in the early postpartum period using a semistructured interview guide. The participants recounted their experiences with labor onset recognition and management before being admitted to the hospital for birthing. Qualitative analyses included verbatim transcription of audiotaped interviews, line-by-line coding, and categorization of data into codes and categories. Interpretive analyses were validated with a collaborative research team and the participants themselves. The central theme that emerged from this study was confronting the relative incongruence between expectations and actual experiences. Supporting categories included: expectations about the labor experience, identifying labor onset, managing the physical and emotional responses to labor, supportive resources, and decision making about hospital admission. Early labor experiences in nulliparas offer insight into the contributions of both expectations and environment to adaptation in labor. Midwives and perinatal nurses are in a unique position to design interventions that support and reinforce laboring women's activities outside of the hospital setting.
Collapse
Affiliation(s)
- Kathleen R Beebe
- Kathleen R. Beebe, RNC, PhD, is Assistant Professor of Nursing at Dominican University of California in San Rafael, a former Post-Doctoral Fellow in the Center for Symptom Management at the University of California, San Francisco, and a Staff Nurse in the Labor and Delivery Unit at Santa Rosa Memorial Hospital, Santa Rosa, CA.Janice Humphreys, RN, PhD, CS, PNP, is Associate Professor of Nursing and Vice-Chair for Faculty Practice in the Department of Family Health Care Nursing at the University of California, San Francisco
| | - Janice Humphreys
- Kathleen R. Beebe, RNC, PhD, is Assistant Professor of Nursing at Dominican University of California in San Rafael, a former Post-Doctoral Fellow in the Center for Symptom Management at the University of California, San Francisco, and a Staff Nurse in the Labor and Delivery Unit at Santa Rosa Memorial Hospital, Santa Rosa, CA.Janice Humphreys, RN, PhD, CS, PNP, is Associate Professor of Nursing and Vice-Chair for Faculty Practice in the Department of Family Health Care Nursing at the University of California, San Francisco
| |
Collapse
|
46
|
Maggioni C, Margola D, Filippi F. PTSD, risk factors, and expectations among women having a baby: a two-wave longitudinal study. J Psychosom Obstet Gynaecol 2006; 27:81-90. [PMID: 16808082 DOI: 10.1080/01674820600712875] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION The aim of the study was to evaluate the incidence of chronic post-traumatic stress disorder (PTSD) after childbirth in relation to pre-partum variables (personality characteristics, anamnestic risk factors) and intra-partum obstetrical and neonatal variables. Since expectations before an event could modify the perceptions, reactions, and satisfaction afterward, the representations of the idealized delivery were carefully analyzed. Moreover, the real and desired help perception from physicians and family members were separately considered during pregnancy and after delivery in relation to PTSD. METHOD The study was carried out submitting a questionnaire to pregnant women twice: firstly when women were in their 38 << 42 gestational week (Time 1) and secondly after 3-6 months from childbirth (Time 2). 93 women were recruited at a University City Hospital in Milan, Italy. PTSD subscales, depression, and anxiety levels were also assessed. RESULTS 2.4% of women had a complete PTSD, while 32.1% of them resulted in having one or two positive subscales of symptoms: 15.5% (N = 13) had a positive intrusion subscale, 25.0% (N = 21) had a positive arousal subscale, while only 3.6% (N = 3) had a positive avoidance subscale. Pre-delivery depression influences PTSD, but only for the intrusion subscale. Pre-delivery physical risk factors are linked to PTSD on the avoidance subscale. At Time 2 depression and PTSD are often present simultaneously. Given the high percentage of healthy newborns, intra-partum obstetrical variables do not seem to influence PTSD. High trait anxiety distinctively coexists with a specific expected delivery and a 'deception' in desired and real support from professionals. CONCLUSIONS Childbirth is a risk condition for PTSD, depression during pregnancy influences the intrusion subscale, while having physical problems influences the arousal subscale. Expectations and support are modulated by the anxiety levels and they are not directly related to chronic PTSD.
Collapse
|
47
|
Abstract
AIM This paper reports a study to translate the Childbirth Self-efficacy Inventory into Chinese and examine its reliability and validity among pregnant Chinese women in Hong Kong. BACKGROUND Self-efficacy for childbirth has been emerged as an important psychological construct in childbearing care. A reliable and valid self-efficacy measure for pregnant women is crucial to the understanding of their psychological preparation, as well as the development of an appropriate childbirth education programme. METHODS Two experienced midwives undertook translation of the Childbirth Self-efficacy Inventory into Chinese, and another two experienced midwives independently conducted back translation. An expert panel of six healthcare professionals and 10 pregnant women examined the face and content validity of the translated instrument. A convenience sample of 148 pregnant Chinese women of not <36 weeks of gestation, and attending a regional teaching hospital in Hong Kong, were invited to complete the translated inventory and a demographic data sheet. RESULTS The Childbirth Self-efficacy Inventory indicated high internal consistency. Principal components analysis supported the fact that each of the efficacy and outcome expectancy subscales is uni-dimensional. Neither scores in the efficacy nor outcome expectancy subscales suggested any statistically significant relationships with parity, age, education and attendance at childbirth education classes. No statistically significant differences in efficacy and outcome expectancy scores were found between the active phase (when contractions are not more than 5 minutes apart) and second stage (when pushing out the baby) of labour. CONCLUSION The study provides initial support for the reliability and validity of the Childbirth Self-efficacy Inventory. Although its sensitivity in differentiating between the two stages of labour was not evident, the distinguishing role of its expectancy subscales has been identified.
Collapse
Affiliation(s)
- Wan-Yim Ip
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | | | | |
Collapse
|
48
|
|
49
|
Abstract
Pregnancy is a major life event for all women. However, when a psychiatric disorder is added to or exacerbated by the pregnancy then the problem requires expert knowledge from more than one area of medicine. This paper looks at pregnancy and the relationship with depression, eating disorders, and pathological fear of childbirth or tokophobia. It also examines the outcome for these women and their babies. Mental illness is a serious concern. It is now recognised that death from suicide is the leading cause of maternal death overall. Research in these areas is relatively sparse but an attempt is made to collate what is known.
Collapse
Affiliation(s)
- K Hofberg
- South Staffordshire Healthcare NHS Trust, St George's Hospital, Stafford, UK.
| | | |
Collapse
|
50
|
Spiby H, Slade P, Escott D, Henderson B, Fraser RB. Selected coping strategies in labor: an investigation of women's experiences. Birth 2003; 30:189-94. [PMID: 12911802 DOI: 10.1046/j.1523-536x.2003.00244.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Antenatal education classes offer women information about labor and birth and ways of coping with pain and emotional distress. The purpose of this paper was to describe women's experiences of using, starting, and discontinuing three coping strategies in labor that were taught in antenatal education classes. METHODS An exploratory research design was used in which 121 women were interviewed within 72 hours of the birth of their first child. Information was obtained on why women initiated and discontinued their use of three coping strategies (breathing technique, postural changes, relaxation technique) and the reported effects of use. RESULTS The effects of the coping strategies investigated varied widely among participants. Common aspects of care, changes of environment, and use of pharmacological pain relief affected women's discontinuation of coping strategies. CONCLUSIONS The implications of study findings for clinical practice include the need for caregivers to provide women with accurate information about the effects of coping strategies and to be alert to aspects of care that may disrupt women's use of strategies.
Collapse
Affiliation(s)
- Helen Spiby
- Mother and Infant Research Unit, University of Leeds, Leeds, United Kingdom
| | | | | | | | | |
Collapse
|