The primary aim of the present study was to compare mothers' reactions to obstetrical interventions and procedures and obstetricians' perceptions of these. The sample population consisted of one hundred and forty seven white, married, English-speaking mothers and a group of fifty three obstetricians practising in trie Johannesburg area. Questionnaires, developed for both groups, were administered postally to obstetricians and in hospital within the first post-partum week to mothers. Perceptions of interventions occurring in the ante-natal period and during the three stages of labour were explored. Reactions to psycho-social and hospital procedures were also obtained. Median and modal ratings of these events were calculated for both samples. The data were analysed using the Median test to compare the groups and Fisher's exact probability test to determine significant differences. Using a significance level of one per cent, several significant findings emerged. Results suggested that, in general, obstetricians rated mothers' experiences more negatively than did the mothers themselves, These findings were discussed in the light of available research and literature in the area

No description available.

Giving birth to a child can have a major impact on a woman's feelings about herself and her newborn, influencing perceptions and interactions, and having both short and long term implications. In this study the effect of an experience of labour and delivery discrepant or not discrepant with expectations on mood and level of distress postpartum were investigated. / Thirty primaparas were pretested on a Labor and Delivery Expectation scale and posttested on an Experience scale two days postpartum. Two mood measures and a Distress scale were administered at this time. The influences of formal preparation for childbirth and of personality variables on the childbirth experience and postpartum mood were also investigated. / It was found that a positive mood and low distress postpartum were related to an experience of labour and delivery better than had been expected. An experience more negative than expected resulted in low mean scores for mood with high distress levels.

This study examines the psychological issues of personal responsibility and control in the childbirth process. It examines the implications of the woman's preparation process and the choices she makes during pregnancy and childbirth. It also explores the way in which the birthing environment and the woman's interpersonal relationships affect her experience of personal control within the context of the childbirth period. Use was made of the case study research design. This qualitative design involved indepth exploration, of cases in which the women had recently given birth to their first child in the local hospital of a small town. The data analysis involved the use of a "reading guide", established by the researcher to allow for the examination of the data specifically in terms of the themes in question. Within the study the importance and value of the woman's accurate and sufficient preparation for the birth was seen to facilitate a realistic sense of predictability, which led to an increased awareness and ability of the woman to remain in control. This, along with the active participation of the husband and supportive network in the hospital, allowed for a sharing of the responsibility within the labour situation. This taking and appropriately yielding of control and responsibility had positive effects on the woman's experience of the event and for initial mother-infant bonding

No description available.

The purpose of this study is to describe six-to twelve-year-old children's views of childbirth using words and drawings of children who were present when a baby was born in order to understand children's conceptualization of birth. As background to the study, the accessibility of childbirth to children through time and space was reviewed in the Human Relations Area Files. The information revealed cultural units both allowing and forbidding attendance of children at birth. Interviews and drawings were used to collect data from 14 informants. Audiotape-recordings of the interviews were transcribed, analyzed and organized into meaningful categories, which were validated by six key informants. The categories represented the knowledge used by children to interpret childbirth and included: people who do things at birth, steps in a baby being born, things people do at birth, best parts of being there, worst parts of being there, things that are gross at birth, things that are scary at birth, and things for kids to know about being there. The relationships of the categories were discussed in themes inferred from the data by the researcher. The themes identified were: I never seen it before; the first time you don't know; it might not be scary for you, but it was for me; the more often you see it, the less it bothers you; dads, kids and ladies help; I can't stand to miss it; it's kind of gross for the person who has to watch; and you learn by being there. The themes are discussed in relation to the research questions, health care and concepts that guided the study (childbirth as a sociocultural event, culture of childhood, child's-eye view, and cognitive development). Health professionals, especially nurses, have the opportunity to prepare parents and children for birth, to facilitate family-centered birthing practices and to minimize the strains related to life processes, such as birth and development. Childbirth through children's eyes communicates the birth event as a situational crisis as well as a developmental opportunity.

The transition to parenthood has been noted to be a significant milestone in an individual’s life that can have varying effects on the marital relationship. The marital relationship has further been noted to have implications on father involvement with children, where such involvement allows for better health and well being of the child. Sexual intimacy has been noted to be a significant aspect of a marital relationship that has an impact on marital satisfaction. As such the aim of this study was to explore father’s experience and understanding of fatherhood as well as their perceptions of the marital relationship post birth of the first child. The marital relationship was explored through understanding how the birth experience and presence of the baby influence fathers’ perceptions of their wife’s desirability’s, of marital intimacy and how sexual intimacy fits into the relationship post birth of the baby. The study consisted of a qualitative design and eight fathers were interviewed using a semi structured interview schedule. The data was then analysed using thematic content analysis. Findings suggested that whilst fathers reported a distinct decline in sexual intimacy there was no decline in marital satisfaction. Decline in marital satisfaction may have been buffered against, as fathers seemed to prepare for the birth of their child and held realistic expectations of the adjustments that would be required post birth of the baby. In addition, their view of intimacy had broadened to include sensuality where spending alone time with their wife and communication were seen as equally significant to sexual intimacy. The results from the study further indicated that fathers are becoming more involved in their parental role. In this regard fathers tended to create an individual space between them and their baby. This finding is in direct contrast to psychodynamic theories which discuss the father as involved in a triadic relationship with his child and hence relating only through the mother.

No description available.

M.Cur. / Obstacles to labour companionship at Bamalete Lutheran Hospital (BLH) in Botswana are discussed. There is an underutilization of labour companionship in the BLH maternity ward despite several efforts that have been made to introduce labour companionship. Labour companionship is a rare exception in the BLH labour ward. Why is labour companionship underutilized at Bamalete Lutheran Hospital and what could be done to promote labour companions? An explorative, descriptive, qualitative, contextual, multiple case study was conducted to explore and describe obstacles to, and the need for, the utilisation of labour companionship, and to develop and recommend strategies to overcome the identified obstacles to labour companionship at BLH. Five unaccompanied primigravidae were selected from mothers who had delivered at BLH. Their ideal labour companions and the attending midwives were also selected for the study. A semi-structured interview with open-ended questions and an audiotape were used to collect data from the primigravidae and their ideal companions. Naive sketches were used to collect data from the attending midwives. Morse and Field cognitive processes were used to analyse the data (1996: 103). This study identified four major obstacles to labour companionship as the lack of knowledge about the concept of labour companionship and the availability of the service by the primigravidae; the lack of knowledge on how labour companionship should be practised in a hospital setting by the ideal companions; the lack of privacy of the labour ward unit; and the reluctance of the midwives to implement labour companionship. The Botswana Sexual Reproductive Health information, education and communication (IEC) approach was utilized as a guide in developing the promotion strategies for labour companionship at BLH

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.