Nowadays, women have a wide range of sources of information about childbirth. Women's attitudes toward childbirth are made by sharing experiences between women and in families but also they are based on informations from media and internet. Consequently attitudes toward childbirth influence the choice of kind of delivery and women's childbirth experience. These days we can see some trends in obstetrics - the rising interest in natural births, on the one hand, and the rising number of women delivering their babies by cesarean section on the other hand. The goal of this socio-psychologically oriented thesis is to map women's attitudes to these most striking birth trends, and also to identify the reasons for these women's attitudes. The research part is thus focused qualitatively and uses the data from the analysis of the internet discussion forums for mothers. In the previous theoretical part are presented the key information necessary to understand the studied topic, such as the issues of attitudes, the specifics of the communication on the internet discussion forums and above all the current scientific knowledge about the attitudes of women to childbirth in the Czech Republic and the world. Key words Attitudes of women, natural childbirth, assisted childbirth, homebirth, caesarean section, internet...

The thesis focuses on the analysis of a dispute regarding home birth and discourses associated with it. The thesis focuses on the analysis of a dispute regarding home birth and discourses associated with it. The thesis focuses on the analysis of a dispute regarding home birth and discourses associated with it. Choice of location and proces sof giving birth in czech environment remains very limited and domestic deliveries are subject of controversy among professional medical community and state institutions on the one hand and midwives, civil movements and comitted mothers on the other hand. Theme divides laical and expert public. It's established through discourses, reflect the views and opinions of the two quarreled groups - supporters of medically controlled childbirth and supporters of natural birth. In the context of media reporting can be identified two main streams of discursive formations, scattering of concepts, thematic choices, objels and modalities of coming to the statement - medical discourse and natural discourse. The controversy both discourses in the Czech media escalated with court case with midwife Ivana Königsmarková, who in 2009 assisted at home birth that ended tragically - serious damage and subsequent death of a child. Just on the case of Ivana Königsmarková and its...

This thesis deals with the issue of biopsychosocial factors in childbirth. It aims to map factors and their possible relationships that contribute to a positive birth experience. The study used a mixed methods research design. A questionnaire was used for the quantitative part of the research. Respondents completed a set of online questionnaires about pregnancy and childbirth, followed by a questionnaire on childbirth experience, stress management strategies (SVF-78), and the Psychosocial Climate of the Maternity Hospital (KLI-P). For the qualitative part, semi-structured interviews were used. The research sample for the quantitative part consisted of 81 first-time mothers, from which five respondents who scored above average on the birth experience questionnaire were subsequently interviewed. The results showed that the absence of obstetric complications, perceived low pain intensity, delivering without pain relief medication, a pleasant psychosocial climate of the maternity hospital and stress avoidance coping strategies significantly contributed to a positive birth experience. The qualitative analysis results showed that a close person, especially a partner, who assists with their passive presence or practical help, also plays an important role. Women with positive birth experiences in the...

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In an attempt to strengthen marriages during the transition to parenthood, the Marriage Moments program was developed from Blaine Fowers' virtues based model of marital quality. Marriage Moments is a non-intrusive, mostly self-guided approach to marriage education, which is easily incorporated into childbirth education classes. The Marriage Moments curriculum stresses building marriage on a strong foundation of friendship and partnership. In this model, marital friendship is strengthened through a shared vision of life and important life goals; partnership is nurtured by the virtues of generosity, fairness and loyalty. This program was tested on 155 married couples that were expecting their first child. Couples were randomly assigned to one control or two treatment groups. The control group participated in a childbirth education class, but did not receive the Marriage Moments program. The instructor-encouraged treatment group viewed the Marriage Moments video in their childbirth education classes and were encouraged to do workbook activities by their class instructor; the self-guided treatment group couples were given the video and workbook to use at home. The Marriage Moments video is comprised of five, eight-minute segments introducing the marital virtues of friendship, generosity, fairness and loyalty. The workbook provides couples with additional information about the transition to parenthood and the possible applications of the virtues principles, including individual and couple activities. All couples were assessed using a battery of self- and spouse-report measures immediately before and after their child-birth classes and then at three and nine months after the birth of their babies. This longitudinal study examined the effect of the Marriage Moments program on marital virtues, marital quality, and intentionality. Relationship outcome measures included in this study were the Marital Virtues Profile, Revised-Dyadic Adjustment Scale, RELATE Satisfaction subscale and Transition Adjustment Scale. Treatment group couples reported high involvement in and enjoyment of the program. When asked to rate the program, couples evaluated the program as 'important' and 'worthwhile.' However, despite positive program evaluation, statistical tests revealed no consistent difference between the control and treatment groups over four times. Subgroup analysis also failed to reveal group differences when controlling for education, number of years married, and early marital distress. Suggestions for future study include contrasts of skills and virtues based curriculums, as well as high and low dosage interventions. In addition, this program should be studied in both clinical and educational settings.

Syfte: att belysa barnmorskors upplevelser och erfarenheter av vårdmötet med förlossningsrädda kvinnor under aktiv förlossning. Design: kvalitativa intervjuer som analyserades med innehållsanalys. Lokalisation: studien utfördes på en mellanstor förlossningsklinik i Norra Sverige.  Deltagare: sex barnmorskor anställda och i aktiv tjänst på förlossningsavdelningen.  Resultat: tre beskrivande kategorier framkom; Att uppfatta och respektfullt bemöta rädsla; Att skapa en tillitsfull relation och Att utvecklas i professionen. Slutsats: Resultatet visade att barnmorskorna betraktade förlossningsrädsla som något normalt och uttryckte att de flesta kvinnor bar på någon form av oro och rädsla. Tillit och närvaro uttrycktes som viktiga grundförutsättningar för ett bra vårdmöte med en förlossningsrädd kvinna, och barnmorskorna efterfrågade forum i verksamheten som kunde främja deras professionella utveckling.  Praktiska implikationer: Resultatet tyder på att barnmorskor saknar regelbunden reflektion och handledning som en möjlighet att utvecklas och stärkas i vårdmötet med den förlossningsrädda kvinnan. / Objective: to highlight midwife's experience of care meeting with women with fear of childbirth. Design: qualitative interviews analyzed using content analysis.  Settings: the study was conducted on a medium sized childbirth clinic in Northern Sweden.  Participants: six midwives employees in active service at the delivery ward. Findings:Three descriptive categories emerged; To perceive and respectful response to fear; To create a trusting relationship and To develop in the profession.  Key conclusion: The results showed that midwives regarded the fear of childbirth as something normal and expressed that most women wore some form of fear. Presence and dialogue emerged as key prerequisites for a trusting relationship with the childbirth scared woman and midwives demanded forums in the business who could promote their professional development. Implications for practice:The results suggest that midwives have no regular reflection and tutoring as an opportunity to develop and strengthen the health care encounter with the woman with fear of childbirth

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Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Mental health is still the step-child of Health Services, although many studies show the serious negative impact it has on the mother, baby and the family. Knowledge about Postnatal Depression (PND) and associated risk factors which influence the development of PND is vital for early detection and intervention. Worldwide PND affects on average 10-15% of women after giving birth regardless of socio-economic status, race or education. Studies also reveal that the prevalence of PND is as high as 40-60% amongst women after giving birth. The goal of the study was to investigate the prevalence and factors influencing PND in a rural setting, in the Witzenberg Sub-district. The objectives included determining the prevalence of PND and identifying the contributing risk factors associated with PND. A descriptive explorative research design with a quantitative approach was applied. The target population was (N=1605) mothers, 18 years and older who gave birth in this Sub-district in one year, a convenience sampling method was used to select the study sample of (n=159/10%) participants who met the criteria and who gave voluntary permission to take part in the study. Validity and reliability was supported through the use of validated questionnaires EPDS and BDI including a questionnaire based on demographical, psychosocial and obstetrical data. In addition experts in statistics, nursing and psychiatry were consulted including language experts who validated the correctness of the Afrikaans and Xhosa translated questionnaires. A pilot study was conducted to test the feasibility of the study and all data was collected personally by the researcher with the support of two trained field workers. Ethics approval was obtained from Stellenbosch University and permission from the Department of Health, Provincial Government of the Western Cape, including informed written consent from each participant. The data was analysed with the assistance of a statistician and are presented with histograms and frequency tables. The relationship between continuous response variables and nominal input variables was analysed using analysis of variance (ANOVA). Various statistical tests were applied to determine statistical associations between variables such as the chi-square tests using a 95% confidence interval. Non-parametric tests such as the Mann-Whitney U–test or Kruskal-Wallis test were used for randomised design. Levene’s test was used for Homogeneity of Variance and the Bonferonni test of probability. The study revealed that 50.3% of the mothers, who participated in the study, had PND. Various risk factors were determined in this study that influences the development of PND. Results include statistical associations between PND and the following: - unplanned babies and unwelcome babies (p=<0,01) - life events (p=0.01) - partner relationship (p=<0.01) - family and social support (p=<0.1) Furthermore, the majority of the participants (53.8%) with PND (n=80) had a history of a psychiatric illness which was shown with significance (p=<0.01), the majority of the participants (63.5%) were unmarried and 23.8% were teenagers who suffered from PND. Recommendations include promoting healthy lifestyles, empowerment of women, prevention of teenage pregnancies, early and holistic assessment for symptoms of PND and approriate referral. In conclusion the prevention and promotive measures, early detection of PND and appropriate referrals and treatment are critical in managing maternal, child and family well being. / AFRIKAANSE OPSOMMING: Geestesgesondheid blyk die stiefkind van gesondheidsdienste te wees, ten spyte daarvan dat navorsing die negatiewe impak wat dit op moeder, baba en die gesin het bevestig. Kennis van postnatale depressie (PDN) en verwante risiko faktore wat die ontwikkeling van PND beïnvloed is van uiterste belang vir die vroeë opsporing en ingryping daarvan. PND affekteer gemiddeld 10%-15% van vroue wêreldwyd wat dit ervaar nadat hulle geboorte geskenk het, ongeag sosio-ekonomiese status, ras of opleiding. Navorsing dui daarop dat die voorkoms van PND so hoog is soos 40%-60% onder vrouens nadat hulle geboorte geskenk het. Die doel van hierdie studie was om die prevalensie van PND en die faktore wat PND beïnvloed in ’n landelike nedersetting in die Witzenberg Subdistrik te ondersoek. Die doelwitte sluit die bepaling van die prevalensie van PND in en die identifisering van die risiko faktore wat daartoe aanleiding gegee het. ’n Beskrywende verkennende navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep was (N=1605) moeders, 18 jaar en ouer wat geboorte geskenk het in hierdie subdistrik binne een jaar. ’n Gerieflikheidssteekproef metode is gebruik om die deelnemers (n=159/10%) te selekteer wat aan die kriteria voldoen het en vrywillig toestemming gegee het om aan die studie deel te neem. Geldigheid en betroubaarheid is gerugsteun deur die gebruik van geldige vraelyste, naamlik EPDS en BDI wat ’n vraelys insluit wat gebaseer is op demografiese, psigososiale en verloskundige data. Hierbenewens is deskundiges in statistiek, verpleegkunde en psigiatrie geraadpleeg, asook taalkundiges wat die taalkorrektheid van Afrikaans en Xhosa vertaalde vraelyste nagegaan het. ’n Loodsondersoek is uitgevoer om die haalbaarheid van die navorsing te toets en alle data is persoonlik deur die navorser met die hulp van ’n opgeleide veldwerker ingesamel. Etiese goedkeuring is verkry van die Universiteit van Stellenbosch en toestemming van die Departement Gesondheid, die Provinsiale Regering van die Wes-Kaap, asook skriftelike toestemming van elke deelnemer. Die data is ontleed met die bystand van ’n statistikus en is deur frekwensie tabelle aangebied. Die verhouding tussen volgehoue/aaneenlopende respons veranderlikes en nominale inset/invoer veranderlikes is ontleed deur gebruik te maak van die analise van variansie (ANOVA). Verskeie statistiese toetse is toegepas om die statistiese assosiasies tussen veranderlikes vas te stel soos die chi-kwadraat toetse deur ’n 95% betroubaarheidsinterval te gebruik. Nie-parametriese toetse soos die Mann-Whitney U-toets of Kriskal-Wallis toets is gebruik vir ewekansige ontwerp. Levene se toets is gebruik vir homogeniteit van variansie en die Bonferonni toets vir waarskynlikheid. Die toets het bewys dat 50.3% van die moeders wat aan die studie deelgeneem het, het PND. Verskeie risiko faktore is in hierdie studie vasgestel wat die ontwikkeling van PND beïnvloed. Resultate sluit statistiese assosiasie tussen PND en die volgende in: - onbeplande babas en onwelkome babas (p=<0,01) - lewensgebeure (p=0.01) - lewensmaat verhoudings (p=<0.01) - familie en maatskaplike ondersteuning (p=<0.1) Vervolgens het die meeste van die deelnemers (53.8%) met PND (n=80) ’n geskiedenis van ’n psigiatriese siekte met ’n beduidenis (p=<0.01), die meeste van die deelnemers (63.5%) is ongetroud en 23.8% is tieners wat aan PND ly. Aanbevelings sluit die bevordering van gesonde leefstyle, die bemagtiging van vrouens, voorkoming van tienerswangerskappe, vroeë en holistiese assessering van simptome van PND in en die aangewese verwysing. Daar kan tot die slotsom gekom word dat voorkoming- en bevorderingsmaatstawwe, vroeë opsporing van PND en aangewese verwysings en behandeling, krities is in die hantering van moeder-, kind- en gesinswelstand.

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: This research was an attempt to investigate the role of the doula during labour and the promotion of natural childbirth as well as the assessment of the effect of the presence of the doula during natural childbirth. There has been a shift from home-based deliveries to hospital-based deliveries, which does not sufficiently provide for optimal care and emotional support to the women during labour. The registered midwives in the maternity units in Port Elizabeth in the Eastern Cape region in both private and public hospitals displayed some reluctance in using the doulas during labour. The design for this study utilised a quantitative approach which is non-experimental, explorative, descriptive and contextual in nature. The data -collection method used was only the statistical data from the registered midwives’ questionnaire designed as per the format from the University of Stellenbosch. Research ethics implemented were confidentiality, informed consent, privacy, protection, information and debriefing. Validity and reliability had to be observed on this study as it was observed that the content of the study had to be closely related to what was measured, as well as consistency of the data –gathering instrument in obtaining the same results in similar situations The study took place at the Port Elizabeth Maternity Units in the Eastern Cape with registered midwives (40 in the Public Sector and 45 in the Private Sector),and 45 in the private sector of the maternity units of the selected hospitals. The results of this study and the interpretation thereof assisted the researcher to confirm that there was indeed a great need for the doulas during natural childbirth in the maternity units in the public sector, where there is a shortage of registered midwives and care workers to attend to the basic needs of the patients. The value of the contributions of the doula to support and provide comfort measures to women during labour should not be underestimated; and registered midwives should be informed about the important role of the doula and how the doula can complement the obstetrical care rendered by the midwife. / AFRIKAANSE OPSOMMING: Hierdie navorsingstudie is uitgevoer om die rol van die doula of kindergeboorte-begeleidster gedurende baring in die bevordering van natuurlike kindergeboorte asook die effek van die teenwoordigheid van laasgenoemde te ondersoek. Die klem het verskuif van tuisbevallings na hospitaal- bevallings. Hierdie tendens het veroorsaak dat daar nie genoeg voorsiening gemaak word vir versorging en emosionele ondesteuning nie. Die geregistreede vroedvroue in die verlossings-eenhede in Port Elizabeth in die Oos-Kaapse streek, in beide openbare en private hospitale toon ‘n mate van onwilligheid om doulas tydens baring te benut, Die studie ontwerp is non-eksperimenteel, eksploratief, beskrywend en kontekstueel van aard, met ‘n kwantitatiewe benadering. In kwantitatiewe studies help die ontwerp, die navorser deur middel van prosedures om akkurate en interpreteerbare data te ontwikkel. Die studie is onderneem by die Port Elizabeth se Verloskunde-eenhede in die Oos-Kaap. In hierdie hospitale is daar 40 geregistreerde vroedvroue in die Openbare- en 45 in die Privaatsektor. Die resultate van hierdie studie en die interpretasie daarvan het die navorser gehelp om te bevestig dat daar inderdaad ‘n groot behoefte bestaan vir die bydraes van kindergeboortbegeleidsterss en veral in die openbare sektor waar daar groot tekorte aan geregistreerde vroedvroue voorkom en nie genoeg personeel is om in die basiese behoeftes van die pasiënte te voorsien nie. Die waarde van die bydraes van doulas om ondersteuning en bemoedigingsmaatreëls vir die vrou tydens baring te voorsien moet nie onderskat word nie; en geregistreerde vroedvroue behoort bewus gemaak te word van die belangrike rol van die doula en hoe die doula die obstetriese sorglewering van die pasient kan komplementeer.

Bakgrund: Statistik visar på ökat antal elektiva kejsarsnitt internationellt och nationellt. Ett kejsarsnitt kan rädda liv på mor och barn om komplikationer uppstår, elektivt kejsarsnitt är även liksom andra stora operationer förenat med risker för komplikationer. Antalet elektiva kejsarsnitt på humanitär indikation har ökat i Sverige och cirka 17 % av alla förlossningar sker via kejsarsnitt. Att vårda och stödja kvinnor före, under och efter en förlossning med kejsarsnitt hör till barnmorskans arbete. Syftet med studien var att beskriva barnmorskors uppfattning om indikationer och effekter av förlossning med elektiva kejsarsnitt på humanitär indikation belyst utifrån arbetslivserfarenheter. Metod: kvalitativ metod: semistrukturella intervjuer med nio barnmorskor. Materialet analyserades via fenomenografisk analys i sju steg. Resultat: Fyra beskrivningskategorier framkom, Elektivt kejsarsnitt på humanitär indikation är ett etiskt dilemma, Elektivt kejsarsnitt på humanitär indikation är en stor operation, Elektivt kejsarsnitt på humanitär indikation påverkar organisation och barnmorskans arbetsmiljö och Elektivt kejsarsnitt på humanitär indikation påverkar kvinnans förlossningsupplevelse. Vidare framkom nio kategorier som beskriver barnmorskors uppfattningar. Slutsats Barnmorskor uppfattar elektiva kejsarsnitt som något komplext, att de med sina yrkeskunskaper värnar det naturliga vid kejsarsnitt på humanitär indikation och att de har brist på mandat att stödja och stärka kvinnors informerade val om elektivt kejsarsnitt på humanitär indikation. Klinisk tillämpbarhet: Resultatet kan användas vid undervisning kring barnmorskans stödjande och vårdande arbete i samband med förlossning via kejsarsnitt. Vidare kan resultatet vara underlag till diskussioner inom mödrahälsovård och förlossning i syfte att ge barnmorskor stärkt mandat till sina stödjande och informativa uppgifter. / Background: Statistics show an increased number of elective caesarean section internationally and nationally. A caesarean section can save the life of mother and child if complications arise, elective caesarean section in common with other major surgeries involve risk of complications. The number of elective caesarean sections on humanitarian indication has increased in Sweden and about 17% of all deliveries via caesarean section. To care and support women before, during and after a cesarean is an essential part of midwifery work. Objective: The aim of the study is to describe midwives' perception of indications and effects of childbirth by elective caesarean section on humanitarian indication illuminated on the basis of work experience. Method: A qualitative approach: semi structural interviews with nine midwives, phenomenographic analysis in seven steps was used for analysis of data. Results: Four descriptive categories emerged, elective Caesarean section on humanitarian indication is an ethical dilemma, elective Caesarean section on humanitarian indication is major surgery, elective Caesarean section on humanitarian indication affect the organization and midwives working environment and elective Caesarean section on humanitarian indication affect the woman's birth experience. Further nine categories that describe midwive´s perceptions emerged. Conclusion: Midwives perceived elective ceaserean section as something complex, that with their professional skills they support the natural part in caesarean sections on humanitarian indication and they lacked mandate to support and strengthen women's informed choice regarding elective Caesarean section on humanitarian indication. Clinical applicability: The result can be used in education regarding midwives supportive and caring role in deliveries with caesarean section. In addition the result can be used in discussions at delivery wards and antenatal care units regarding improving midwives mandate for their supportive and informative tasks.