M.Cur. / This dissertation studies the labour experiences of parents who received childbirth preparation. At the moment, the extended family is no longer prevalent, and the teachings mothers passed to daughters has decreased dramatically. As more medical interventions alter the labour process, couples need to be more aware of what to expect. The trend for first time parents is to attend some kind of formal antenatal preparation. How relevant is this preparation? A qualitative study design was utilised to allow for exploration and description of the experience of labour. An audio recording was done as well as the subjects filling in a questionnaire. A pilot study with one couple was completed initially. Mothers in the Northern Suburbs of Johannesburg were studied. They had given birth in private clinics in the area. The interviews were unstructured and conducted in English. The data once collected, was transcribed and analysed using cross case data analysis and classification according to common themes. Nursing for the Whole Person Theory was used as the paradigm and guide for analysis. The results are compared with the relevant literature which is presented in The results are displayed in various forms in the study and show a positive experience in women and men who attended antenatal preparation. Recommendations are made for the medical profession and presented in with the conclusions.

Stress reduction techniques have been used to assist people in coping with stressful medical procedures and events. Labor and delivery training classes have utilized techniques to assist women with the childbirth process. The classes generally included basic education of labor and delivery, respiration behavior, relaxation of muscles, and participation of a coach. Reducing the amount of pain experienced in labor and delivery has been suggested for facilitating the process and decreasing the amount of medication received. The painful experience changed from an uncontrollable situation into a positive one, allowing women to feel more resourceful, less anxious, and less threatened.

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Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

The partograph, developed over 50 years ago and based on research conducted by Friedman (1954, 1955 & 1956), has been promoted by the World Health Organisation as the “gold” standard for assessing progress in labour. The basic premise of the partograph is that regular vaginal examinations throughout labour that calculate the extent and rate of cervical dilation will be the most reliable indicator of labour progress. A review of the medical and midwifery literature suggested that the progress of labour can also be assessed by observing women’s behavioural responses to labour. This study set out to describe and test the reliability and consistency of these behavioural cues. These cues were derived from published literature and used to construct a “Labour Assessment Tool” (LAT). The LAT was tested and modified using an expert reference group and results of a pilot test. Inter-rater reliability was established during the pilot study and verified with other experienced midwives as data collectors. The LAT recorded partograph observations as well as labour behaviours. The study was undertaken in two Australian hospitals between 1999 and 2002. Women were given information on the study during regular antenatal visits to the hospitals from 30 weeks gestation and invited to participate during one of their antenatal visits between 37 weeks and 42 weeks of pregnancy. There were 21 women of the 225 women approached who declined to participate. The LAT observations were recorded on 203 participants however only 179 participants (94 nulliparous and 85 multiparous women) who generated 47,768 individual observations were suitable for analysis. There were 59 participants (31 nulliparous and 28 multiparous women) who were induced into labour or had their labours augmented. Women excluded from the study included those with complications of pregnancy and labour. Women were also withdrawn from the study at the time an epidural was commenced but their data to that point were retained for analysis. The data were examined from three perspectives. The first was from a ‘phases of labour’ perspective based on the work of Friedman (1954; 1955). Data obtained at the time the women had an internal cervical assessment were allocated to early labour, active labour, transition or full dilation, based on the results of the cervical measurements. The second perspective examined all the descriptors over the course of labour from admission to hospital or the beginning of an induction of labour, to second stage of labour. Frequencies were again generated for each behaviour from admission to hospital until full dilation. They were compared to the mean dilation generated for both parity groups based on the 279 cervical examinations that were performed on the participants. The third perspective examined behavioural patterns observed within each woman’s labour unrelated to the time to full dilation or Friedman’s phases of labour model. Results indicate that specific behavioural descriptors associated with progress were observed before cervical dilation increased. Descriptors indicating cervical dilation was occurring, or had occurred, and descriptors indicating impending second stage as well as second stage itself, were identified. Differences were observed between the labours of multiparous and nulliparous women and induced labours and non induced labours.