Bakground : A new kind of birthing center, providing a new concept of maternal care is about to open in a city located in the eastern part of India. Being part of a new concept in maternal care and having the opportunity to work at a new advanced multispecialty hospital as well as being a newly graduated nurse can create a lot of expectations in which we aim to explore. Aim : The aim was to explore newly graduated nurse's expectations before the opening of a natural birthing center in the eastern part of India. Method : Qualitative interviews were chosen as a data collecting method. The participants were five newly graduated nurses. A qualitative content analysis with an inductive approach and a manifest content was selected for analyzing the collected data. Findings: Four categories with sub-categories were found. They were Unknown future, In relation with patients and relatives, Opportunities to develop as a nurse and to become a good nurse. Conclusion : In this study it was seen that the nurses felt unsure in their role and about their future. To be able to care for patients and relatives as a newly graduated nurse in a professional manner (and make them feel safe), it is important to have the confidence to feel safe in the nursing role. It is also of importance that the organization allows the nurse to develop by creating attuned climates for this, all to become a good nurse.

Pregnancy and childbirth are critical life events and women and their families require physical as well as emotional support and care. The concepts continuity of care, choice and a sense of control are prominent in the literature on women’s satisfaction with as well as outcomes of care. Midwives have globally been identified as important role players in women-centred care for low risk pregnant women. To be able to offer their women safe, supportive care they need not only a certain degree of autonomy, but also the support of other health care professionals such as obstetricians to whom they can refer women with risk factors or complications. Maternity care has become “medicalised” and the overuse of interventions such as caesarean section is prevalent in many countries. South African women make use of either the public or private health sector for care during pregnancy and birth. The public sector is overburdened and women do not have a high level of continuity of care. The private sector is mainly obstetrician-led and intervention-driven, even for low risk women. The estimated caesarean section rate is higher than 70%. Private midwife-led care is available in South Africa, but is concentrated in the major cities. Private midwives practise at hospitals, birth centres, “active birth units” and women’s homes. No evidence could be found on the outcomes of private midwife-led care in South Africa. The objectives of this study were to explore and describe the outcomes of births attended by private midwives in Gauteng over a two year period and to compare these outcomes with the latest Cochrane review on midwife-led care. A retrospective cohort design was chosen to audit the birth registers of private midwives in Gauteng and conduct quantitative analyses. Gauteng midwives’ patients, when compared with the Cochrane review that juxtaposes midwife-led care with other models of care, had a significantly lower percentage of interventions such as induction of labour (9.6% versus 18.6%) but caesarean sections were performed significantly more frequently (19.3% for the women in Gauteng versus 12.5% for the women in the review). Women in Gauteng also made significantly less use of medications in labour. Maternal and neonatal outcomes were reassuring. Significantly more Gauteng women had intact perineums (53.4% versus 31.4%). A higher percentage of postpartum haemorrhage was found in the Gauteng sample (7.9% versus 6.2%). The difference is significant, although, only three women were admitted to high care units as a result of postpartum haemorrhage. Overall foetal loss (4.3% versus 6.7%) and neonatal ICU admissions (0.3% versus 2.9%) occurred significantly less frequently in the Gauteng sample. The study findings indicate that private midwife-led care in Gauteng compared well with that in the rest of the world in terms of intervention rates and outcomes. / MCur, North-West University, Potchefstroom Campus, 2015

Pregnancy and childbirth are critical life events and women and their families require physical as well as emotional support and care. The concepts continuity of care, choice and a sense of control are prominent in the literature on women’s satisfaction with as well as outcomes of care. Midwives have globally been identified as important role players in women-centred care for low risk pregnant women. To be able to offer their women safe, supportive care they need not only a certain degree of autonomy, but also the support of other health care professionals such as obstetricians to whom they can refer women with risk factors or complications. Maternity care has become “medicalised” and the overuse of interventions such as caesarean section is prevalent in many countries. South African women make use of either the public or private health sector for care during pregnancy and birth. The public sector is overburdened and women do not have a high level of continuity of care. The private sector is mainly obstetrician-led and intervention-driven, even for low risk women. The estimated caesarean section rate is higher than 70%. Private midwife-led care is available in South Africa, but is concentrated in the major cities. Private midwives practise at hospitals, birth centres, “active birth units” and women’s homes. No evidence could be found on the outcomes of private midwife-led care in South Africa. The objectives of this study were to explore and describe the outcomes of births attended by private midwives in Gauteng over a two year period and to compare these outcomes with the latest Cochrane review on midwife-led care. A retrospective cohort design was chosen to audit the birth registers of private midwives in Gauteng and conduct quantitative analyses. Gauteng midwives’ patients, when compared with the Cochrane review that juxtaposes midwife-led care with other models of care, had a significantly lower percentage of interventions such as induction of labour (9.6% versus 18.6%) but caesarean sections were performed significantly more frequently (19.3% for the women in Gauteng versus 12.5% for the women in the review). Women in Gauteng also made significantly less use of medications in labour. Maternal and neonatal outcomes were reassuring. Significantly more Gauteng women had intact perineums (53.4% versus 31.4%). A higher percentage of postpartum haemorrhage was found in the Gauteng sample (7.9% versus 6.2%). The difference is significant, although, only three women were admitted to high care units as a result of postpartum haemorrhage. Overall foetal loss (4.3% versus 6.7%) and neonatal ICU admissions (0.3% versus 2.9%) occurred significantly less frequently in the Gauteng sample. The study findings indicate that private midwife-led care in Gauteng compared well with that in the rest of the world in terms of intervention rates and outcomes. / MCur, North-West University, Potchefstroom Campus, 2015

Every year roughly 350,000 women die during childbirth, primarily from preventable causes. The developing world accounts for the majority of this number, and in many regions maternal mortality rates are currently increasing despite the advancements our world has seen in the past decades. Maternal mortality has become a global issue, with international initiatives being launched around the globe. However, this problem hits closer to home than many Americans may know. The United States has the highest GDP in the world, yet it has only the 48th lowest maternal mortality rate. In addition, the past decade has seen our national maternal mortality rate increase rather than decrease. Throughout my study I explore why the United States is not a safer nation for women to give birth in considering our status as a wealthy, developed nation. In doing so I expose the problems inherent in the American medical system and the roots of those problems in larger cultural and social issues. Beneath this is an examination of the history of midwifery in the United States and an argument for increased use of midwives by American mothers and increased collaboration between midwives and the American medical system.

For many American women, insurance restrictions and lack of access restrict women’s options when choosing birth experiences. This research uses a biocultural approach and cognitive anthropological methods to explore the ways and the degree to which alternative birthing practices, such as home-, clinic-, and hospital-based natural births, and midwifery services, physically and emotionally affect the women and infants who experience them. This research explores the reasons women pursue natural or alternative births. These topics are explored through interviews with women who have had natural births, who have used midwifery services, and who have had highly medicalized, OBGYN-attended births. Findings indicate that while there is not an overarching cultural model of how women want to experience birth, there is a shared cultural model concerning the nature of birth among Mississippi women. Results show that women benefit more, emotionally and physically, from natural birth and midwifery care than from highly medicalized birth.

This diploma thesis deals with home births and how they were referred to in the media regarding the medial cause with a midwife Ivana Königsmarková. The goal of this work is to describe approaches that can be traced on this cause, what is the gender dimension of these approaches like and how does the aspect of power manifest itself on them. To achieve that I've chosen a method of discourse analysis which is the best one to point out the relation between language, power and ideology. Analysed material is represented by the articles from Czech media that are associated with the given cause and on basis of which the most frequently occurring topics can be traced along with their tendencies throughout time. Last but not least I'm closely analysing two chosen articles which represent two dominant ways of thinking - the medical approach of labour and natural or alternative approach.

Aims: The main aim of this thesis was to study a perspective of women`s expressed wishes for mode of delivery and how they actually give birth. Additional aims were to examine the notion of risk applied to childbirth, to examine what characterizes women who want to give birth as naturally as possible without painkillers or intervention and the characteristics of women who would, if possible, choose to have a cesarean section. Material and methods: The notion of risk was examined in an essay. Self-rating instruments were completed by 55,858 MoBa participants during week 30 of their pregnancy and available from The Norwegian Mother and Child Cohort Study (MoBa) by April, 2007. Individually reported information on socioeconomic factors, lifestyle factors, feelings related to childbirth, factors concerning psychosocial health, physical, psychological and sexual harassment and information on satisfaction with antenatal care health services were collected from a MoBa questionnaire. Data on the mother’s age, parity, physical health before and during the pregnancy, previous cesarean sections and actual mode of delivery were collected through a linkage to the The Medical Birth Registry of Norway. Findings: General perspectives on risk differ depending on both the person and the profession. More and more childbearing women are in danger of being considered deficient and in the danger zone. Figures on risk are not objective values, and the association between risk and security is socially and culturally determined. Personal symbols can be basic assumptions about the life one leads, and the childbearing woman has preferences of her own. Interest in natural childbirth was expressed by 72 percent and a wish for caesarean section was expressed by ten percent of the women. Positive experience from previous childbirths, first birth or third or later birth, no dread of giving birth, and reporting positive intra-psychic phenomena are significantly associated with the wish for natural birth. Negative experiences from previous childbirths and fear of giving birth are two of the strongest factors associated with a wish for a caesarean section.Overall, 47 percent of the women who wanted ”as natural a birth as possible” had their preference fulfilled. The figures differed largely for primiparas and multiparas; the risk of acute caesarean sections was high among primiparas and the effects of the predictors of natural birth were stronger for primiparas than for multiparas. Conclusions:The factors that influence the chance of having a natural birth are different for primiparas and multiparas. The high rate of non-natural births among first time mothers who actually want to have a vaginal birth without interventions should call attention to the increasing incidence of cesarean section in Norway. The chance of actually having a natural birth for women with a preference for a natural birth is much larger for multiparas. Negative experiences from previous childbirths and cesarean section are, however, important factors associated with non-natural birth and should be taken into consideration in public health / Mål: Det overordna målet for denne avhandlingen var å studere perspektiv omkring hvordan kvinner uttrykker at de ønsker å føde og hvordan de faktisk føder. I tillegg var målet å undersøke risikobegrepet anvendt innen fødselsomsorg, undersøke hva som karakteriserer kvinner som ønsker å føde så naturlig som mulig uten smertestillende eller intervensjon og undersøke hva som karakteriserer kvinner som ville valgt å ta keisersnitt dersom det var mulig. Materiell og metode: Avhandlingen inkludere fire artikler. Risikobegrepet drøftes i første artikkel som er et essay. De 3 andre inkluderer data fra Den norske mor og barn-undersøkelsen. Data fra 55,858 MoBa informanter var ferdigregistrert april 2007 og omfatter individuell informasjon om sosioøkonomiske faktorer, livsstilsfaktorer, følelser/opplevelser relatert til fødsel, faktorer som omhandler psykososial helse, fysiske, psykiske og seksuelle overgrep og informasjon om tilfredshet med offentlig svangerskapsomsorg. Tidligere keisersnitt og hvordan kvinnene faktisk fødte i dette svangerskapet ble hentet fra en link til Medisinsk Fødselsregister. Funn: Generelt perspektiv på risiko er forskjellig, avhengig av både person og profesjon. Stadig flere gravid/fødekvinner står i fare for å bli betraktet som utsatte/mangelfulle og i faresonen. Kalkulasjoner av risiko er ikke objektive verdier og assosiasjonen mellom risiko og sikkerhet er sosialt og kulturelt bestemt. Subjektive symbol kan være grunnleggende antagelser/forståelser i forhold til det livet en lever og blivende mødre har sine egne preferanser. Syttito prosent av kvinnene uttrykte ønske om å føde så naturlig som mulig og ti prosent av kvinnene ønsket å ta keisersnitt. Positive erfaringer fra tidligere fødsler, det å være førstegangsfødende eller ha født mer en ett barn tidligere, ikke være redd for å føde, samt å rapportere positivt i forhold til intrapsykiske fenomen, er signifikant assosiert med ønske om å føde så naturlig som mulig. Negative erfaringer fra tidligere fødsler og redsel for å føde er de to faktorene som er sterkest assosiert med ønske om keisersnitt. Samlet sett fikk 47 prosent av de kvinnene som ønsket så naturlig fødsel som mulig, oppfylt ønskene sine. Resultatet var svært ulikt mellom førstegangsfødende og fleregangsfødende; risikoen for akutt keisersnitt var høg blant førstegangsfødende og effekten av prediktorene for naturlig fødsel var sterkere i forhold til førstegangsfødende enn for fleregangsfødende. Konklusjon: Faktorene som influerer sjansen til å føde så naturlig som mulig er ulike for førstegangsfødende og for fleregangsfødende. Den høge tallet på fødsler med intervensjon hos førstegangsfødende som egentlig ønsker å føde vaginalt uten intervensjon burde fått større oppmerksomhet. Dette bør også sees i sammenheng med en stadig økende innsidens for keisersnitt i Norge. Muligheten for å få en så naturlig fødsel som mulig er mye større for fleregangsfødende. Negative erfaringer fra tidligere fødsler og tidligere keisersnitt er, likevel, viktige faktorer assosiert med ikke-naturlig fødsel og bør reflekteres over/tas i betraktning i et folkehelseperspektiv.

From the assumptions found in Madeleine Leininger’s Transcultural Nursing Theory, the current work analized the cultural dimensions that influenced on women’s search of natural humanized birth, in Maceió – AL, considering the potential of cultural studies to support culturally congruent practices. This is a qualitative and descriptive study, made between december 2015 and april of 2016 in Maceió - AL. 14 (fourteen) women, who sought or not a natural humanized birth in said context, are our informants of this research. For information gathering a semistructured interview form was used based on the theoretical referential, that propitiated the survey of cultural meanings analyzed in its universality and diversity, in order to meet this research objective. From the results analysis, it was possible to identify whether or not the search for a natural humanized birth permeates the meaning of parturition to the informants taking into account their realities and health contexts. The cultural dimensions involved that guided their choices: 1) Their ideologies and beliefs, directing a way of life that guides them according to their desires to enjoy full autonomy of their bodies and that, even when they delegate their health processes to other people, they do it according to positively valued experiences and care; 2) Class issues, access to information, technology and public health policies, whose differences are mitigated by the social differences from a capitalist society; 3) Meanings and experiences of your support networks, which are present in all other dimensions. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A partir dos pressupostos da Teoria do Cuidado Transcultural de Madeleine Leininger, o presente trabalho analisou as dimensões culturais que influenciaram na busca de mulheres pelo parto natural humanizado, no município de Maceió-AL, considerando o potencial dos estudos culturais para subsidiar práticas culturalmente congruentes. Trata-se de um estudo qualitativo e descritivo, realizado entre dezembro de 2015 e abril de 2016 em Maceió/AL. São informantes desta pesquisa 14 mulheres que buscaram ou não um parto natural humanizado no referido contexto. Para coleta de informações, utilizou-se um formulário de entrevista semi-estruturado baseado no referencial teórico, que propiciou o levantamento designificados culturais analisados em sua universalidade e diversidade, de modo a atender os objetivos da pesquisa. A partir da análise dos resultados, foi possível identificar que a busca ou não busca de mulheres por um parto natural humanizado perpassa o significado da parturição para as informantes, segundo suas realidades e contextos de saúde. As dimensões culturais envolvidas que direcionam suas escolhas abarcam: 1) Suas ideologias e crenças, direcionando um modo de vida que as orienta de acordo com suas vontades de gozarem plena autonomia de seus corpos e que, mesmo quando delegam seus processos de saúde a outras pessoas, fazem-no de acordo com experiências e cuidados valorados positivamente; 2) Questões de classe, acesso à informação, tecnologia e políticas públicas de saúde, cujas diferenças são atenuadas pelos desníveis sociais da sociedade capitalista; 3) Significados e experiências de suas redes de apoio, que estão presentes em todas as outras dimensões.

Objective The present study aimed to explore women's perceptions and experiences of childbirth by unplanned Caesarean section. Background New motherhood is characterised as a profound change, and research suggests that the psychological effects of childbirth can be significant and far–reaching for some women. The processes occurring during a traumatic birth experience could affect a woman's emotional and psychological state, and she may experience considerable adjustment difficulties in adapting to unfulfilled expectations of delivering her baby naturally. Methods In–depth interviews explored 10 women's lived experiences of childbirth, after which thematic content analysis was used to synthesise data. The elements of phenomenological theory served as a broad framework for the structuring, organizing and categorizing of data, with interpretation aimed at gaining a greater understanding of women's internalised childbirth accounts. Findings Women described their contact with medical personnel, as well as the physical, environmental, and emotional aspects of their unplanned Caesarean sections, as distressing and traumatic. A sense of loss of control was the most significant contributor to women's negative childbirth experiences. Feelings of failure and disappointment were primarily related to unmet expectations and a lack of preparedness. Negative experiences were mediated by attentive caregiving, inclusion in decision–making, and support from loved ones. / Thesis (M.Sc. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.

Objective The present study aimed to explore women's perceptions and experiences of childbirth by unplanned Caesarean section. Background New motherhood is characterised as a profound change, and research suggests that the psychological effects of childbirth can be significant and far–reaching for some women. The processes occurring during a traumatic birth experience could affect a woman's emotional and psychological state, and she may experience considerable adjustment difficulties in adapting to unfulfilled expectations of delivering her baby naturally. Methods In–depth interviews explored 10 women's lived experiences of childbirth, after which thematic content analysis was used to synthesise data. The elements of phenomenological theory served as a broad framework for the structuring, organizing and categorizing of data, with interpretation aimed at gaining a greater understanding of women's internalised childbirth accounts. Findings Women described their contact with medical personnel, as well as the physical, environmental, and emotional aspects of their unplanned Caesarean sections, as distressing and traumatic. A sense of loss of control was the most significant contributor to women's negative childbirth experiences. Feelings of failure and disappointment were primarily related to unmet expectations and a lack of preparedness. Negative experiences were mediated by attentive caregiving, inclusion in decision–making, and support from loved ones. / Thesis (M.Sc. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.