Pregnancy and childbirth are important life experiences in a woman’s psychosocial and psychological development. For many women, vaginal birth is still considered an integral part of being a woman and becoming a mother. Furthermore, it is thought to promote maternal well-being through helping women to match their expectations to experiences. For these women, a failed natural birth can be a psychological, psychosocial, and existential challenge that can result in significant and far-reaching consequences for their psychological wellbeing. Research, especially recent research, on the experiences of women who most wanted to, but were unable to deliver their babies naturally is relatively rare. This is surprising given the potential implications of these experiences on a mother’s emotional well-being, as well as for her feelings towards her new baby. Nevertheless, literature on the topic presents a coherent perspective on the problem and indicates that these women experience difficulties in adapting to not being able to fulfill their dream of delivering their baby naturally. There is no existing research on the subjective experiences of South African women who delivered their babies by unplanned Caesarean section. This study therefore aimed to contribute to knowledge that may fill this gap to some extent. Through purposeful sampling, ten mothers who had wanted to deliver their babies naturally, but had not been able to for whatever reason, were selected as the study sample. Various aspects of their birth experiences were explored in indepth phenomenological interviews. This allowed the researcher to probe certain aspects offered by participants in order to understand and explore their contributions in as much depth as possible. A semi-structured, open-ended approach allowed for the exploration of relevant opinions, perceptions, feelings, and comments in relation to the women’s unplanned Caesarean experiences. The transcribed data was synthesized within a framework of phenomenological theory, where women’s experiences were analyzed and explored in an attempt to understand how participants made sense of their experiences. The different aspects of women’s experiences were explored in three substudies. The results are reported in three manuscripts/articles. Research suggests that post-partum adjustment difficulties are influenced by the potentially virulent stress reactions generated in response to a perceived birth trauma. The objective of the first article was to explore women’s labour and birthing accounts with specific regard to the subsequent stress responses experienced. The stress responses experienced by the women in this study both prior to, and during the Caesarean section were predominantly anxiety-based. This was distinguished from the post-partum period, where women described having experienced more depressive symptoms. Post-traumatic stress responses are associated with negative perceptions of the birth, self and infant. The experience of adverse emotional consequences during the post-partum period can undermine a woman’s ability to successfully adapt to her role as a mother, meet the needs of her infant, and cope with post-partum challenges. The second article highlighted the possible impact of women’s unexpected and potentially traumatic childbirth experiences on initial mother-infant bonding. The unplanned Caesarean sections left mothers feeling detached from the birthing process and disconnected from their infants. Passivity, initial separation, and delayed physical contact further compromised mother-infant interaction. Postpartum physical complications and emotional disturbances have important implications for a woman’s perceptions of herself as a mother and her ability to provide for her infant, her self-esteem, and feelings of relatedness with her baby. Adverse responses to a traumatic birth experience could therefore influence the establishment of a maternal role identity, the formation of balanced maternal attachment representations, the caregiving system, and ultimately initial motherinfant bonding. In the third article, women’s experiences were contextualized in relevant coping resources and strategies. The processes occurring during a traumatic birth experience, such as during an unplanned Caesarean section, could be influenced by perceived strengths when coping with the stress related to the incident. The mothers in this study described several factors and coping strategies that they perceived to have been effective in reducing the impact of their traumatic birth experiences. These included active coping strategies, problem-focused coping strategies, and emotion-focused coping strategies. Coping strategies could result in reassessment of the birth process, and be associated with a more positive, acceptable and memorable experience. This study contributes to nursing, midwifery and psychological literature, by adding to the professional understanding of the emotional consequences of surgical delivery on South African childbearing women. This exploration therefore has important implications for preventative measures, therapeutic intervention, and professional guidance. However, the restricted sample may limit the generalizability of results. Further investigation of the experiences of a larger, more biographically and culturally diverse population could be instrumental in the development of knowledge and understanding in this field of study. / Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013

Pregnancy and childbirth are important life experiences in a woman’s psychosocial and psychological development. For many women, vaginal birth is still considered an integral part of being a woman and becoming a mother. Furthermore, it is thought to promote maternal well-being through helping women to match their expectations to experiences. For these women, a failed natural birth can be a psychological, psychosocial, and existential challenge that can result in significant and far-reaching consequences for their psychological wellbeing. Research, especially recent research, on the experiences of women who most wanted to, but were unable to deliver their babies naturally is relatively rare. This is surprising given the potential implications of these experiences on a mother’s emotional well-being, as well as for her feelings towards her new baby. Nevertheless, literature on the topic presents a coherent perspective on the problem and indicates that these women experience difficulties in adapting to not being able to fulfill their dream of delivering their baby naturally. There is no existing research on the subjective experiences of South African women who delivered their babies by unplanned Caesarean section. This study therefore aimed to contribute to knowledge that may fill this gap to some extent. Through purposeful sampling, ten mothers who had wanted to deliver their babies naturally, but had not been able to for whatever reason, were selected as the study sample. Various aspects of their birth experiences were explored in indepth phenomenological interviews. This allowed the researcher to probe certain aspects offered by participants in order to understand and explore their contributions in as much depth as possible. A semi-structured, open-ended approach allowed for the exploration of relevant opinions, perceptions, feelings, and comments in relation to the women’s unplanned Caesarean experiences. The transcribed data was synthesized within a framework of phenomenological theory, where women’s experiences were analyzed and explored in an attempt to understand how participants made sense of their experiences. The different aspects of women’s experiences were explored in three substudies. The results are reported in three manuscripts/articles. Research suggests that post-partum adjustment difficulties are influenced by the potentially virulent stress reactions generated in response to a perceived birth trauma. The objective of the first article was to explore women’s labour and birthing accounts with specific regard to the subsequent stress responses experienced. The stress responses experienced by the women in this study both prior to, and during the Caesarean section were predominantly anxiety-based. This was distinguished from the post-partum period, where women described having experienced more depressive symptoms. Post-traumatic stress responses are associated with negative perceptions of the birth, self and infant. The experience of adverse emotional consequences during the post-partum period can undermine a woman’s ability to successfully adapt to her role as a mother, meet the needs of her infant, and cope with post-partum challenges. The second article highlighted the possible impact of women’s unexpected and potentially traumatic childbirth experiences on initial mother-infant bonding. The unplanned Caesarean sections left mothers feeling detached from the birthing process and disconnected from their infants. Passivity, initial separation, and delayed physical contact further compromised mother-infant interaction. Postpartum physical complications and emotional disturbances have important implications for a woman’s perceptions of herself as a mother and her ability to provide for her infant, her self-esteem, and feelings of relatedness with her baby. Adverse responses to a traumatic birth experience could therefore influence the establishment of a maternal role identity, the formation of balanced maternal attachment representations, the caregiving system, and ultimately initial motherinfant bonding. In the third article, women’s experiences were contextualized in relevant coping resources and strategies. The processes occurring during a traumatic birth experience, such as during an unplanned Caesarean section, could be influenced by perceived strengths when coping with the stress related to the incident. The mothers in this study described several factors and coping strategies that they perceived to have been effective in reducing the impact of their traumatic birth experiences. These included active coping strategies, problem-focused coping strategies, and emotion-focused coping strategies. Coping strategies could result in reassessment of the birth process, and be associated with a more positive, acceptable and memorable experience. This study contributes to nursing, midwifery and psychological literature, by adding to the professional understanding of the emotional consequences of surgical delivery on South African childbearing women. This exploration therefore has important implications for preventative measures, therapeutic intervention, and professional guidance. However, the restricted sample may limit the generalizability of results. Further investigation of the experiences of a larger, more biographically and culturally diverse population could be instrumental in the development of knowledge and understanding in this field of study. / Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013

Thesis (M.S.)--University of Michigan, 1987. / "A research report submitted in partial fulfillment of the requirents for the degree ..."

Thesis (M.S.)--University of Michigan, 1987. / "A research report submitted in partial fulfillment of the requirents for the degree ..."

Thesis (M.S.)--University of Michigan, 1992.

Thesis (Ph. D.)--University of California, Santa Cruz, 1987. / Typescript. Includes bibliographical references (leaves 266-300).

Thesis (M.S.)--University of Michigan, 1992.

Este trabalho tem como objetivo compreender os símbolos atribuídos às tecnologias utilizadas na atenção obstétrica, como também conhecer as práticas femininas na busca por cuidados médicos na assistência ao parto. Para tanto, analisamos os relatos de 16 gestantes atendidas pelo setor privado e os de 13 gestantes assistidas pelo setor público. O estudo combinou duas técnicas qualitativas: a observação etnográfica e entrevistas semi-estruturadas. A pesquisa encontrou, entre outros, os seguintes resultados: 1-a maioria das mulheres observadas expressou a preferência pelo parto normal. 2- o nascimento, independente do tipo de parto desejado, está associado a categorias de medo, tensão e risco. 3- o discurso médico, segundo as gestantes atendidas pela rede privada, reforça a ansiedade e medo feminino e de sua família na medida em que associa o parto normal à dor e ao risco de morte. A cesariana, por outro lado, é descrita como um parto seguro. 4- na maternidade pública, as mulheres e seus acompanhantes vivenciaram o parto normal de maneira sofrida e passiva. 5- práticas profissionais compatíveis com a humanização do parto e as orientadas pelo modelo médico hegemônico, isto é, centrado na tecnologia na atenção ao nascimento, coexistem na rede pública. Contudo, a abordagem normativa ainda está presente em ambas as práticas. 6- a participação das parturientes nas decisões sobre o parto é escassa na rede pública. Em suma, concluímos que mulheres e médicos compartilham a visão de parto normal enquanto categoria de risco e a cesariana como prática segura. / This work aims to understand the symbols associated to technologies adopted in obstetric practice, and also women practices in searching for medical cares during childbirth. This study was carried out from June 2011 to October 2011 in 16 pregnant women attending the private hospitals and 13 pregnants attending public sector. I combined two qualitative techniques: Ethnographic observation and Semi-structured interview. I identified some ethnographic findings, such as: 1- most of women request for vaginal birth. 2. birth experience, regardless of delivery type desire, is associated with three categories: fear, tension and risk of death. 3-medical discourse, according to pregnant women attending private hospitals, reinforces womens and their families fear of pain and the risks of vaginal births. Cesarean birth, on the other hand, is described as a safe childbirth. 4- at the public maternity, I observed that women and their partners have experienced a painful and passive vaginal birth. 5- professional practices of humanized birth and medical intervention based on technologies in birth assistance, co-exist in public hospitals. However, normative approach is still on both practices. 6- the womens participation on childbirth decision is rare at the public health institution examined. In sum, our data suggest that both women and obstetricians share perception of the risks inherit in natural process of birth. Cesarean section, on the other hand, is being considered a fitting and safe form of childbirth.

Becoming a mother is a transition that leads the woman from a known to an unknown existence, both social and professional support can facilitate this revolutionary event. In order to offer a good support, more knowledge about women's thoughts on the birth of their first child is needed. Aim:To describe pregnant women's thoughts before the birth of their first child. Method: Qualitative content analysis with inductive approach. Qualitative questionnaires were answered by 18 informants. Findings: Four main categoriesreveal; thoughts about their own ability and experience, thoughts about the childbirth environment, thoughts about the partnerand thoughts about the unborn child. The theme that reveals is that pregnant women's thoughts about the birth of their first child commute between trust and doubt.Conclusion: Women have confidence in their own ability but at the same time concern about the unknown. Thoughts that the delivery may affect the experience, therefore it is important that the midwife helps the woman to handle her thoughts so that she gains realistic expectations. Women have ambivalent thoughts about the support she will be offered. Professional and social support is important for achieving a positive childbirth experience and therefore continuous support should be offered during childbirth. / Att vänta barn och att bli mamma är en transition som leder kvinnan från en känd till en okänd tillvaro och både socialt och professionellt stöd kan underlätta vid denna omvälvande händelse. För att bättre kunna erbjuda kvinnorna ett gott stöd behövs mer kunskap om kvinnornas tankar inför deras första barns födelse, då detta område är relativt outforskat. Syfte: Att belysa gravida kvinnors tankar inför sitt första barns födelse. Metod: Kvalitativ innehållsanalys med induktiv ansats.Kvalitativa frågeformulär besvarades av 18 informanter. Resultat: Det framkommer fyra huvudkategorier; tankar om den egna förmågan och upplevelsen, tankar om förlossningsmiljön, tankar kring partnern och tankar om det ofödda barnet.Temat som genomsyrar resultatet är att gravida kvinnors tankar kring sitt första barns födelse pendlar mellan tillit och tvivel.Konklusion: Kvinnorna har tilltro till den egna förmågan men samtidigt en oro inför det okända.Tankar inför förlossningen kan påverka upplevelsen, därför är det viktigt att barnmorskan hjälper kvinnan att hantera sina tankar så att hon får realistiska förväntningar. Kvinnorna har ambivalenta tankar om det stöd hon kommer att erbjudas. Professionellt och socialt stöd är viktigt för att uppnå en positiv förlossningsupplevelse och därför bör kontinuerligt stöd erbjudas till alla födande kvinnor.

Pesquisa descritiva com abordagem qualitativa, que teve como objeto as estratégias de luta das enfermeiras obstétricas para preservar o espaço institucional da CPDCF como lócus no desenvolvimento do cuidado humanizado. Selecionou como objetivos: descrever o habitus profissional das enfermeiras que atuam na CPDCF; analisar a posição das enfermeiras obstétricas na CPDCF e no campo hospitalar e discutir as estratégias utilizadas pelas enfermeiras obstétricas para manterem o modelo humanizado. Utilizou para apoiar a análise os conceitos de campo, habitus, capital, violência simbólica e poder simbólico sob a ótica de Pierre Bourdieu. A pesquisa foi realizada com quatorze enfermeiras que trabalham na CPDCF. Os dados foram coletados através de entrevista semi estruturada e analisados pelo método de análise de conteúdo de Bardin. Foram evidenciadas duas categorias: 1) O habitus profissional das enfermeiras obstétrica s que atuam na CPDCF profissional cujas subcategorias expressaram os motivos da inserção na enfermagem e enfermagem obstétrica, as disposições incorporadas pela enfermeira obstétrica da CPDCF em sua formação profissional e a Renovação do habitus; 2) A posição e estratégias utilizadas pelas enfermeiras obstétricas para manterem o modelo da CPDCF, cujas subcategorias evidenciaram a posição e estratégias utilizadas pelas enfermeiras na CPDCF e a posição e estratégias utilizadas pelas enfermeiras da CPDC no hospital de referência. Os resultados evidenciaram que as enfermeiras obstétricas da CPDCF utilizam estratégias eficientes para a manutenção do modelo humanizado na casa e ocupam posição de prestígio porque o campo favorece o desenvolvimento de suas habilidades de acordo com o seu habitus desmedicalizado. / Descriptive research with qualitative approach, that had as object the strategies of the obstetric nurses' fight to preserve the institutional space of CPDCF as locus in the development of the humanized care. It was selected as objectives: to describe the nurses' professional habitus that act in CPDCF; to analyze the obstetric nurses' position in CPDCF and in the hospital field and to discuss the strategies used by obstetric nurses for us to maintain the humanized model. It was used to support the analysis field concepts, habitus, capital, symbolic violence and to symbolic power under Pierre Bourdieu optics. The research was accomplished with fourteen nurses that work in CPDCF. The data were collected through semi-structured interview and analyzed by the method of contents analysis of Bardin. Two categories were evidenced: 1)The professional habitus of obstetric nurses that act in professional CPDCF whose subcategories expressed the reasons of the insert in nursing and obstetric nursing, the incorporated dispositions for obstetric nurse of CPDCF in your professional formation and the Renewal of habitus; 2) The position and strategies used by obstetric nurses to maintain the model of CPDCF, which subcategories evidenced the position and strategies used by the nurses in CPDCF and the position and strategies used by nurses of CPDC in the referenced hospital. The results evidenced that obstetric nurses of CPDCF use efficient strategies for the maintenance of humanized model at the house and they occupy prestige position because the field favors the development of your abilities in agreement with their desmedicalized habitus.