Background: Due to the profound and life-changing aspects of giving birth and to each woman’s individualized birthing experience, it is important to understand the myriad of factors that contribute to a positive childbirth experience. The aims of this study were to: (1) identify factors related to a positive childbirth experience; (2) to examine relationships among women’s perceptions and personal evaluations of their childbirth experience, stress associated with labor pain, support from the nursing staff, initial contact with the baby following birth, support from partners, education, age, and obstetric history; and (3) to identify predictors of a positive childbirth experience. Method: A cross-sectional correlational study was conducted using a sample of 122 new mothers recruited over a 3-month period. Data were collected using self-report questionnaires. The three questionnaires used in this study consisted of: (a) the Questionnaire Measuring Attitude About Labor and Delivery Experience (QMAALD 29 items); (b) the Questionnaire Measuring Stress Associated with Labor Pain [SLPS (version 2)]; and (c) Personal Information Questionnaire (Demographic data). The Cronbach’s alpha coefficient for the 29 item QMAALD in this study was .82 and the Cronbach’s alpha coefficient of the SLPS (version 2) in this study was .89. The SPSS statistical software version 16.0 for Windows was used for data analysis. Results: Participants reported a low degree of stress associated with labor pain and a moderate amount of support received from the nursing staff. They reported holding and touching their baby immediately after birth. A positive childbirth experience was inversely related to stress associated with labor pain. The reduction of stress due to support received from the nursing staff was found to be positively related to a positive childbirth. Education was related to a positive childbirth experience; but not a significant predictor of a positive childbirth experience. Maternal age, initial contact with the baby following birth, number of labor and delivery experiences, duration of labor, interventions during labor, attendance at prenatal classes, and support from a partner did not relate to a positive childbirth experience. The regression analysis results indicated that the stress associated with labor pain, the reduction of stress due to the support received from the nursing staff, and attendance at prenatal classes were significant predictors of a positive childbirth experience. Conclusion: Stress associated with labor pain and the reduction of stress due to support received from the nursing staff were key factors contributing to a positive childbirth experience. Further research is needed to better understand the factors influencing women’s positive perceptions of the childbirth experience.

Introduktion: Ett av de viktigaste målen inom förlossningsvården är att kvinnor får en positiv förlossningsupplevelse. En positiv förlossningsupplevelse utvecklar en positiv inställning till moderskapet och hjälper till att underlätta övergången till att bli föräldrar. Trots att det framkommer i ett flertal studier att ett gott stöd, bemötande och trygghet främjar en positiv förlossningsupplevelse, förekommer det att avsaknad av dessa tre faktorer som orsakar negativa upplevelser för nyblivna föräldrar.Syfte: Syftet var att beskriva orsaker till att föräldrar inte är nöjda med stöd och bemötandet och/eller inte kände sig trygga i samband med vård under förlossningen, samt att beskriva vad som kan förbättras i stöd och bemötandet.Metod: En webbaserad enkät som besvarades av nyblivna föräldrar efter förlossningen under 2011 på ett sjukhus i västra Sverige. Web-enkäten innefattar föräldrarnas upplevelser under hela vårdkedjan, mödrahälsovård, förlossning samt BB. Denna magisteruppsats består av en analys baserad på tre slutna frågor samt efterföljande tre öppna frågor där en lägre grad av nöjdhet alternativt missnöjdhet (5%) gällande upplevelser av stöd, bemötande och trygghet i samband med barnafödande. Datamaterialet analyserades med en kvalitativ innehållsanalys. Resultat: De som var mindre nöjda/missnöjda med förlossningsvården uttryckte empatilöst och oprofessionellt behandlande av personal, att inte bli lyssnad till eller betrodd, att personalen inte läst journalen eller gav otillräckligt med information. Vidare sågs att föräldrarna saknade fysisk och mental närvaro av personal och de upplevde personalen som stressad. Detta kunde resultera i en otrygghet hos föräldrarna samt medförde det en oro, vilket kunde bidra till en negativ förlossningsupplevelse. Analysen av materialet resulterade i sju kategorier. Konklusion: De flesta föräldrarna är nöjda eller mycket nöjda med stöd, bemötande och trygghet i samband med barnafödande på förlossningsavdelningen. Andelen föräldrar som var mindre nöjda eller missnöjda beskrev framförallt ett missnöje med stöd, bemötandet och informationsflödet från vårdpersonalen. Detta visade sig resultera i en otrygghet samt en negativ förlossningsupplevelse. [Abstract:] Introduction: One of the most important aims within obstetric care is to give women a positive birth experience. A positive birth experience develops a positive attitude towards motherhood and helps to ease the transition to become parents. Although it’s found in several studies that good support during labor, a respectful and professional attitude from obstetric staff and the sense of security promote a positive birth experience, it occurs that absence of these three factors cause a negative perception of labor for parents.Objective: The aim was to describe the causes why parents were not satisfied with the support and treatment and / or did not feel safe in connection with care during labor, and to describe what can be improved when it comes to support and treatment.Method: A web-based questionnaire answered by parents after giving birth in 2011 at a hospital in western Sweden. Web survey includes parents' experiences throughout the continuum of care, maternity care, obstetric care and maternity ward. This master thesis consists of an analysis based on three closed questions and subsequent three open questions where a lower degree of satisfaction or dissatisfaction (5%), regarding perceptions of support, treatment and protection in connection with childbirth, describes in text. The data were analyzed using a qualitative content analysis. Results: Those who were less satisfied / dissatisfied with maternity care expressed a lack of empathy and unprofessional treatment by the staff, not to be listened to or mistrusted, that the staff did not read the journal or gave insufficient information. Furthermore the parents described a lack of physical and mental presence of staff and experienced staff as being stressed. This could result in parents feeling less secure which could led to anxiety which could contribute to a negative birth experience. The analysis of the data resulted in seven categories.Conclusion: The majority of parents are satisfied or very satisfied with the support, attitude and sense of security during childbirth. The proportion of parents who were less satisfied or dissatisfied described the particular dissatisfaction with support, attitude and information flow from the staff. This was found to result in a sense of feeling insecure and a negative birth experience. / Program: Barnmorskeutbildning

Bakgrund: Av alla gravida kvinnor räknas omkring 5 % lida av svår förlossningsrädsla. Kvinnor med förlossningsrädsla löper högre risk för komplikationer under och efter graviditeten. I Sverige läggs idag mycket resurser på Auroraverksamhet för att hjälpa kvinnor med förlossningsrädsla. Det saknas omfattande utvärdering av Auroraverksamheten. Syfte: Syftet med detta fördjupningsarbete var att undersöka upplevelse och effekt av Aurorasamtal inför förlossning samt upplevelse av den efterföljande förlossningen bland först- och omföderskor. Metod: Studien har en retrospektiv studiedesign där datainsamling skedde via en enkätundersökning. Datamaterialet sammanställdes därefter i SPSS. Resultat: Majoriteten av kvinnorna upplevde att samtalen hjälpte dem till en mer positiv förlossningsupplevelse. Fler förstföderskor än omföderskor önskade planerat kejsarsnitt när de kom till Auroramottagningen. De flesta kvinnor som önskade vaginal förlossning blev vaginalt förlösta. Över hälften av kvinnorna som deltog i studien var mindre rädda för förlossning 1 – 2 år efter förlossningen än de upplevde att de var innan Aurorasamtalet och förlossningen. Konklusion: Aurorasamtal förefaller ha störst betydelse för omföderskor och för de kvinnor som önskar vaginal förlossning. / Background: About 5 % of all pregnant women suffer from severe fear of childbirth. Women with fear of childbirth are at higher risk for complications during and after pregnancy. In Sweden a lot of resources are being spent on Aurora counselling to help women with fear of childbirth. There is no comprehensive evaluation of Aurora counselling though. Aim: The aim of this study was to examine the experience and impact of Aurora counselling for childbirth as well as the experience of the following birth among primipara and multipara women. Method: The study had a retrospective study design in which data was collected through a survey. The data was compiled in SPSS. Results: The majority of women felt that the Aurora counselling has helped them to experience a more positive birth experience. More primipara than multipara desired an elective caesarean section when they came to Aurora Clinic. Most of the women who desired to have a vaginal birth became vaginally delivered. More than half of the women who participated in the study were less afraid of childbirth 1 - 2 years after the birth than they estimated they were before the Aurora counselling and childbirth. Conclusion: Aurora counselling seems to have the greatest impact on multipara women as well as on women who desire vaginal birth.

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

Title: Psychosocial aspects of intrapartum and postpartum care Author: Mgr. Lea Takács Department: Department of Psychology Supervisor: PhDr. Simona Hoskovcová, Ph.D. Consultant: MUDr. PhDr. Pavel Čepický, CSc. Abstract Background: Satisfaction with perinatal care is largely a result of psychosocial aspects of the care provided. However, despite a considerable body of research, the concept of satisfaction with perinatal care is not sufficiently defined and understood, being often confused with other concepts, particularly with that of satisfaction with childbirth experience. The lack of knowledge concerns especially the psychosocial dimensions and determinants of the care, most importantly for different groups of women, and the level of importance of psychosocial factors for satisfaction compared to biomedical variables. Objective: The aim of the present dissertation is to contribute to the theory of satisfaction by investigating the psychosocial and biomedical factors that affect satisfaction with perinatal care and satisfaction with childbirth experience in different groups of women depending on the mode of delivery (vaginal delivery, emergency caesarean section or elective caesarean section). Method: Ordinal logistic regression was used to identify the key predictors of satisfaction. The data were...

Title: SOCIAL-PSYCHOLOGICAL ASPECTS OF CHILDBIRTH EXPERIENCE AND THEIR IMPACT ON EARLY PARENTAL SELF-EFFICACY OF FIRST-TIME MOTHERS Author: Eliška Kodyšová Department of Psychology, Faculty of Arts, Charles University in Prague Supervisor: PhDr. Simona Horáková Hoskovcová, PhD., Department of Psychology, Faculty of Arts, Charles University in Prague Abstract: Transition to parenthood is a significant transition period in a woman's psychological ontogenesis. An important predictor of parenting abilities and well-being is parental self-efficacy. Recent studies show that mothers' parental self-efficacy can be influenced by childbirth satisfaction, which, in turn, is predicted by social-psychological aspects of childbirth experience, especially support by caregivers. In a longitudinal 2-phase research, we have followed parental self-efficacy determinants working around 1st childbirth as well as childbirth experience determinants. Using multiple linear regression analysis we determined that although parental self-efficacy is mainly prenatally determined, caregivers' support and baby's soothability can impact it positively. We have also confirmed the decisive influence of caregivers' support on childbirth satisfaction in our sample, which is representative for Czech primiparas. ...

The thesis is aimed at perinatal factors affecting the emotional bond between a mother and a child (boding) during the first weeks postpartum. The literature review is divided into three chapters. The first chapter discusses the childbirth, the experience of childbirth and the factors affecting a subjective evaluation of the childbirth by a parturient. The second chapter follows up with an overview of findings concerning the initial afterbirth moments, and the interaction between a mother and a child during early contact. The third chapter introduces the concept of bonding. It describes its manifestations, possible measuring methods, and factors influencing its quality. The research part analyzes perinatal factors affecting bonding on a sample of 1108 mothers with the use of generalized linear regression. The independent variables are: mode of birth, the evaluation of childbirth experience by mother, and the process of early contact between a mother and a child. The results show that bonding during the first weeks postpartum was not affected by the mode of birth or by the parturient's evaluation of the childbirth experience. A significant effect was found in the occurrence of early contact between a mother and a child; mothers who had contact with the child during the first postpartum hour reported...

Bakgrund Vattenfödsel innebär att den födande befinner sig i vatten och att barnet föds fram under ytan. Det finns många fördelar med att föda i vatten och det är ovanligt med negativa utfall för mor eller barn. Vattenfödslar efterfrågas av födande kvinnor, men är inte tillgängligt på alla förlossningskliniker. Barnmorskor ska bistå den fysiologiska processen och stödja kvinnor valfrihet, varför det av vikt att få en djupare förståelse för kvinnors upplevelser av vattenfödslar. Syfte Att beskriva kvinnors upplevelser av att föda barn i vatten. Metod En kvalitativ litteraturöversikt med åtta inkluderade artiklar, publicerade åren 1998–2022, med sammanlagt 198 deltagare. Sex av artiklarna bedömdes ha obetydliga/mindre metodologiska brister och två måttliga metodologiska brister. Analysmetod var innehållsanalys med induktiv ansats. Resultat I resultatet framkom två övergripande teman. Positiva och stödjande upplevelser av att föda i vatten beskriver upplevelser kopplade till relationer, kroppsliga och mentala faktorer samt miljön. Negativa upplevelser av att föda i vatten beskriver oro och rädsla kring att tappa kontroll och att barnet ska ta skada av att födas i vatten. Slutsats Vattenfödsel upplevdes generellt som något mycket positivt av födande kvinnor. Det ökade avslappningsförmågan samt var smärtlindrande. Vidare upplevdes det stärkande och ökade känslan av att föda i en trygg hemlik miljö på egna villkor. Dessa faktorer hade förmågan att påverka kvinnans förlossningsupplevelse positivt, vilket har potential att influera hennes inställning till eventuella kommande födslar. Några få upplevde sig vara obekväma eller kände rädsla och oro under sin vattenfödsel. / Introduction Water birth implies that the woman is in water during birth and that the child is born under water. There are many benefits to water births and negative fetal or maternal outcomes are rare. Water births are desired by birthing women but aren’t available at all clinics. Midwives should support the physiological process and women’s right to choose. Therefore, it’s important to gain a deeper understanding of women’s experiences. Aim To describe women’s experiences of giving birth in water. Method A qualitative literature review with eight articles included, published between 1998-2022, with a total of 198 participants. Six of the articles was determined to have insignificant/lesser methodological flaws and two had moderate methodological flaws. Method of analysis was qualitative content analysis. Result Two overall themes were identified. Positive and supporting experiences of giving birth in water which describes feelings regarding relationships, physical and mental components, and the surrounding environment. Negative experiences of giving birth in water describes anxieties and fears regarding losing control or that the child would be harmed during water birth. Conclusion Water birth was generally a very positive experience for women. It enhanced the ability to relax and relieved pain. Being in the water was empowering, heightened the feeling of giving birth on her own terms and facilitated the creation of a safe home-like environment. These factors had the ability to positively influence the birthing experience and hence impact the women’s feelings towards potential future births. A few women experienced feelings of being uncomfortable, scared or anxious during water birth.

<p>The experience of pregnancy and childbirth is a central life event with special implications for women at high risk. This thesis describes the meaning of pregnancy, childbirth and midwifery care in four qualitative interview studies based on the lifeworld theory. Women were interviewed during pregnancy and within one week after childbirth. Midwives were interviewed concerning midwifery care for women at high risk. In an intervention study, childbirth experience as reported through a post partum questionnaire was compared between women receiving standard care and women who had formulated a birth plan preceded by a questionnaire on their expectations and feelings about childbirth. </p><p>The findings emphasise that childbearing women at high risk live in an extremely vulnerable situation. The vulnerability is obvious in the use of an individual birth plan, where negative feelings become more frequent in women at high risk than in those with normal pregnancy and childbirth. During pregnancy the women feel a moral commitment towards the child, including feelings of objectification and of exaggerated responsibility. During an obstetrically complicated childbirth the essential meaning is the women’s desire to be recognised and affirmed as individual persons. Like women with normal pregnancy and childbirth, they need an emotionally present midwife who sees, give trust and supports. </p><p>Good midwifery care of childbearing women at high risk is synthesised as "genuine caring in caring for the genuine". The ethos of caring constitutes the basis of caring. Women’s transition during pregnancy and childbirth is described as a genuinely natural process. Midwives have a special responsibility to encourage and preserve this process within women at high risk. The caring relationship is the core and the most essential tool in the care. Distinctive features in the midwifery care are embodied knowledge, physical as well as emotional presence, sensitivity, a mutual dialogue including shared control between midwife and woman, and confirmation and support of the genuine in each woman. The midwifery care is a struggle and a balance between natural and medical perspectives.</p>