Reliving birth: maternal responses to viewing videotape of their second stage labors

Processing the first birth: journeying into 'motherland'

AIMS AND OBJECTIVES

To explore first-time mothers' experiences of birth at home and in hospital in Australia.

BACKGROUND

The first birth has unique physical and psychological impacts on women. With the first birth, women become mothers.

DESIGN

A grounded theory methodology was used. Data were generated from in-depth interviews with women in their own homes.

METHODS

Nineteen women were interviewed in Sydney, Australia. The experiences of seven women who gave birth for the first time in a public hospital and seven women who gave birth for the first time at home were contrasted with two mothers who gave birth for the first time in birth centres, one mother who gave birth for the first time in a private hospital and two women who had given birth more than once.

RESULTS

Following the birth, women 'processed the birth' by 'remembering', 'talking (storytelling)' and 'feeling'. This activity appeared to help most women resolve their feelings about the birth and understand what it actually means to be a new mother. 'Personal and social integration' occurred for most women as they entered 'motherland'.

CONCLUSION

First-time mothers appear to 'process the birth' to a greater extent than multiparous women because they are experiencing this for the first time. These women also have limited social networks in 'motherland', and these are facilitated through sharing the experiences of their labour or 'processing the birth'.

RELEVANCE TO CLINICAL PRACTICE

Identifying the novice status of first-time mothers and understanding the way they process the birth can help health providers to be sensitive to the specific needs of primiparous women. In particular, their need to tell their birth stories following birth; understanding that these stories help women to process the birth and connect to other women.

A longitudinal study of women's memory of labour pain--from 2 months to 5 years after the birth

OBJECTIVE

To investigate the memory of labour pain at 2 months, 1 year and 5 years after childbirth and its association with the use of epidural analgesia and overall evaluation of childbirth.

DESIGN

Longitudinal observational.

SETTING

All hospitals in Sweden.

POPULATION

One thousand three hundred eighty-three women, who were recruited at their first antenatal visit and who provided complete data up to 5 years after the birth.

METHODS

Postal questionnaires in the second trimester and 2 months, 1 year and 5 years after the birth.

MAIN OUTCOME MEASURES

Memory of labour pain measured by a seven-point rating scale (1 = no pain at all, 7 = worst imaginable pain).

RESULTS

Memory of labour pain declined during the observation period but not in women with a negative overall experience of childbirth. Women who had epidural analgesia reported higher pain scores at all time points, suggesting that these women remember 'peak pain'.

CONCLUSIONS

There was significant individual variation in recollection of labour pain. In the small group of women who are dissatisfied with childbirth overall, memory of pain seems to play an important role many years after the event. These findings challenge the view that labour pain has little influence on subsequent satisfaction with childbirth. In-labour pain and long-term memory of pain are discussed as two separate outcomes involving different memory systems.

Memory for labor pain: a review of the literature

BACKGROUND

Women's ability and accuracy in recalling labor pain are widely debated, even though clinicians commonly use such retrospective information in their practice. The objectives of this paper are to review the literature to establish if labor pain is forgotten, if recall is accurate, factors that affect the accuracy of recall, and consequences of recall.

METHODS

An electronic search of Medscape, Psychlit, Bath Information and Data Services, and CINAHL between 1990 and 1999 was undertaken using the key words "labor" and "labour," "pain," and "memory." Each key word produced thousands of hits, but the combination of all three was surprisingly unsuccessful. This review, therefore, used a manual and print search and a detailed knowledge of work in this and related fields.

RESULTS

The literature was relatively limited, and many studies demonstrated methodological problems. Inductive and deductive analysis suggested that women do not completely forget labor pain, and recall is often vivid but not always entirely accurate.

CONCLUSIONS

Memories of labor pain can evoke intense negative reactions in a few women, but are more likely to give rise to positive consequences related to coping, self-efficacy, and self-esteem.

Remembering an everyday pain: the role of knowledge and experience in the recall of the quality of dysmenorrhoea

The ability to describe the quality of a previous pain may be thought to be better if one had experienced that particular pain because information stored in episodic and/or semantic memory is available rather than if one had not and could only guess what the pain may be like on the basis of information stored in semantic memory. However research has shown that not only is the quality of labour pain poorly recalled by women who have given birth but also it is no better described by them than by women who have never given birth at all. In order to replicate this effect for an everyday pain, the ability to recall the quantity and the quality of dysmenorrhoea was measured in two groups of women. One group regularly experienced dysmenorrhoea, the other had never experienced it. Analysis of the pain intensity scores revealed that the 'pain' group reported significantly less pain 2 weeks later whereas the 'no-pain' group did not significantly differ in their rating over time. Analysis of the MPQ Descriptors chosen by subjects using Cohen's kappa resulted in 'fair' recall for both groups with no significant advantage for the 'pain' group. These results suggest that the episodic memory system plays a limited role in facilitating the recall of the quality of an often experienced pain. However the semantic memory system allows both previous pain sufferers and pain guessers to describe the core qualities of a pain to the same extent. Further research is required to explain why remembering the quality of a pain experience is not advantaged by episodic memory and what facilitates the transfer of a pain experience into semantic event memory.

Women and midwives in partnership: a problematic relationship?

Midwives in New Zealand have been practising independently of medicine and nursing since 1990 using the concept of partnership as a basis for their practice. This article shows, however, that the beliefs which underpin the practice of the midwives are not always the same as those of their clients. Supporting evidence is provided in the form of verbatim data provided by participants. Three major areas in which contradictions were found were in the work of midwives, the knowledge for practice and reflections on the experience. It is recommended that midwives become more visible by removing themselves from hegemonic structures, valuing alternative forms of knowledge and respecting the knowledge of their clients.

It is not harmful for patients with epilepsy to view their own seizures

Having a seizure in public is a concern to people with epilepsy and can represent a barrier to psychosocial adjustment. Seeing his or her own seizures might help the patient deal with seizures more realistically, but also could be emotionally detrimental. We therefore showed patients videos of their own seizures before their discharge from our inpatient epilepsy monitoring unit. One of the investigators was present to answer questions. The Spielberger State Trait Anxiety Scale (SSTAS) was administered before and after viewing and 1 month later together with a questionnaire related to the patients' feelings and attitudes about viewing their own seizures. Results using one-way repeated-measures multivariate analysis of variance (MANOVA) showed no differences for the items in the pre- and posttest questionnaire. For the SSTAS, no significant differences were detected among the pretest and the two posttests by one-way repeated ANOVA (p = 0.10). These results suggest that it is not harmful to view one's own seizures in a controlled setting.