Hensikt: Å belyse hvilke aspekter kvinner selv trekker fram når de beskriver sin fødselsopplevelse som negativ. Metode: Kvalitativ tematisk analyse er anvendt for å analysere fritekstkommentarer fra 103 kvinner som har vurdert sin fødselsopplevelse som negativ, i den norske kohorten av Bidens-studien. Hovedresultater: Tre hovedtemaer trer fram i resultatene: ”Komplikasjoner hos mor, barn eller begge”, ”Å ikke føle seg sett og hørt” og ”Opplevelse av smerte og tap av kontroll”. Funnene viser at majoritetenav kvinnene hadde opplevd uventede og dramatiske komplikasjoner. Mange hadde følt seg ignorert, dårlig behandlet og ikke inkludert i avgjørelser. Et mindretall opplevde at den negative fødselsopplevelsen hovedsaklig skyldtes smerte og/eller tap av kontroll. Konklusjon: Kvinnenes beskrivelser viser at de ikke forventet å oppleve det de gjorde i fødsel, det være seg komplikasjoner eller mangelfull ivaretakelse. Enkelte opplevde situasjoner som må betraktes som overgrep i form av forsømmelse, verbale overtrampog uhøflig opptredenfra omsorgsgivernes side. I denne studien kommer det fram at omsorgsgiveres holdninger og væremåte er vesentlig for en positiv fødselsopplevelse. Den informasjonen som komfram gjennom funnene kan brukes av jordmødre for på best mulig måte å forebygge negative fødselsopplevelser. / Aim: This study aimed to explore the aspects women describe as contributing to their negative experience of childbirth. Methods: We used qualitative thematic analysis to analyze 103 free-text comments in a questionnaire from the Norwegian cohort of the Bidens study. The comments were provided by women who had a negative childbirth experience. Main findings: The majority of respondents reported experiencing unexpected and dramatic complications during childbirth. We identified three major themes: “(i) complications in mother, baby or both”, “(ii) not being seen or heard”; and (iii) “experience of pain and loss of control”. Further, the majority of respondents had felt ignored, had not been treated with respect, and did not feel included in decisions about their childbirth. A minority described pain and loss of control as the main reason for their negative birth experience. Conclusions: The women’s comments show that they did not expect to experience negative things during childbirth. Further, they were unprepared for complications and improper care. Alarmingly, many respondents experienced what must be characterized as abuse in the health-care system (i.e. neglect, verbal abuse or rudeness). The present study shows that caregivers’ attitudes and presentation contribute importantly to a positive childbirth experience. Midwives can use the information gained from this study to prevent negative birth experiences. / <p>ISBN 978-91-86739-95-9</p>

Aim: The overall aim of this study is to describe experiences of, and the association between, fear of childbirth and birth experiences of women with fear ofchildbirth. Methods: In studies I, II, and IV, a reflective lifeworld approach based on phenomenological philosophy was used to describe women’s experiences of fear of childbirth (I), previous birth experiences (II), and fear of childbirth and of birth experience in a long-term perspective (IV). In study III, differences between women who reported fear of childbirth and those who did not were calculated using risk ratios with a 95 % confidence interval and multivariate logistic regression analysis. Data were collected from interviews with eight (I) and nine (II) pregnant women with intense fear of childbirth, and with six women who had sought care for intense fear of childbirth 7 to 11 years prior to the interview (IV), and via questionnaire from a sample of 763 women during pregnancy and again one year following birth (III). Findings: Fear of childbirth was described as “to lose oneself as a woman into loneliness” (I). Previous birth experience was described as “a sense of not being present in the delivery room and an incomplete childbirth experience” (II). Fear of childbirth was associated with a previous negative birth experience and a previous emergency caesarean section (III). From a long-term perspective, fear of childbirth and birth experience was described as “an effort to make all the pieces come together” (IV). Conclusions: This thesis generates evidence on the importance of previous birth experience for women with fear of childbirth, from both qualitative and quantitative perspectives. These perspectives illustrate the complexity where women´s experiences in the delivery room are central. To avoid creating fear of childbirth, it is important that maternity care services focus on women’s birth experiences and critically evaluate care in relation to childbirth.