This study was designed to elicit Indo-Canadian women immigrants' experience of childbearing. Health care professionals do not know enough about the childbearing experiences of this cultural group. This may lead to conflicts and discrepancies of viewpoints between clients and professionals which may result in nurses providing care that is not perceived as relevant by the individual. This study was directed by the following questions: What are Indo-Canadian women's beliefs about childbearing? What are their perceptions of their traditional practices, in their ethnic community, surrounding childbearing? What are the western health care resources utilized by the women during childbearing? How are these western health care resources perceived by the women? Phenomenology, a qualitative research methodology, was used in this study. Data were collected through a series of indepth interviews with eight women. The initial audiotaped interviews were guided by the research questions and addressed the women's perceptions of their childbearing experiences. The data were comprised of the accounts given by the women in these interviews. Data collection and analysis occurred simultaneously throughout the study. Analytic material was thus used to focus and clarify the ongoing construction of accounts. The women described very different childbearing experiences. Dissimilarities in the phenomena under investigation were more evident than similarities and were attributed to the concept of acculturation. Two themes emerged from the data: the subjects' relationships with their families and the subjects' relationships with health care professionals. Each theme affected and was affected by the concept of acculturation. Influencing factors within the two themes were respect, authority, lack of knowledge and, in the case of the family, shyness. Perceived discrimination was an influencing factor in the subjects' relationships with post-partum hospital nurses. This study concluded that dissimilarities in the childbearing experiences of Indo-Canadian immigrant women are attributable to the process of acculturation; and that the women's childbearing experiences are located within a broader context of meanings associated with the reproductive cycle. The subjects' relationships with their families and with health care professionals are significant aspects of their childbearing experiences and are influenced by authority, respect, lack of knowledge and shyness. Discrimination is perceived by the women in relation to the post-partum hospital nurses. These conclusions have implications for nursing practice, research and education. / Applied Science, Faculty of / Nursing, School of / Graduate

Using the framework of the reformulated learned helplessness (RLH) model of depression, this study examined the nonachievement of self-expectations of primigravidas desiring natural childbirth in terms of their attributional style and the possible resulting depression. The RLH model predicts that individuals who have a depressive attributional style experience a sense of helplessness when faced with situations which seem difficult or out of their control and are more apt to fail and become depressed. Natural childbirth is an experience which has the potential of appearing out of control to women involved in the birth process. Using a before and after design, the study was based on a sample of forty-one married primiparas who had an uncomplicated pregnancy, attended Lamaze childbirth classes, and anticipated an uncomplicated, unmedicated vaginal delivery. Sixteen subjects stated they did not meet their self-expectations during childbirth and twenty-five stated they did meet their self-expectations. The hypothesis were tested using two matched groups of sixteen each. Data from all subjects were used for post hoc analysis of the hospital data.

This thesis deals with disagreement between midwives and doctors about the fact where and in which conditions mothers should give birth to a child. While the doctors support the present way when most children are born in hospitals under doctor's control, midwives argue for so called natural childbirth when women deliver the child surrounded by familiar environment and with midwife's assistance. The description of both groups behaviour is based on the theory of Peirre Bourdieu. Midwives are focused on the change of their status in the process of childbirth while doctors want to preserve the present situation. Both groups use different discourses while creating their professional position providing different services. Doctors' way is more technological and clinical, while midwives create their professional position in more psychological way. There is a competitive fight in which both group use strategy of their own professionalization and disprofessionalization of the rival group and different interpretation of the same data. Because of disadvantageous position of midwives in the process of childbirth, they create their own strategies against doctors.

Förlossningsrädsla kan beskrivas som specifik rädsla kopplat till förlossning som i någon grad påverkar det dagliga livet på ett negativt sätt. Rädslor kan innefatta att kvinnan själv eller barnet ska skadas under förlossningen, tappa kontrollen, vara beroende av andra eller ha en koppling till fobier som rör sjukhusmiljön. Förlossningsrädsla ökar risken att få en negativ förlossningsupplevelse. Tidigare forskning visar också att den enskilt viktigaste riskfaktorn för svår förlossningsrädsla hos flerföderskor är en tidigare traumatisk förlossningsupplevelse. Prevalensen för förlossningsrädsla varierar mellan länder från 14 till 23 procent, få studier på förlossningsrädsla är gjorda i utvecklingsländer. Förlossningsrädsla kan drabba alla kvinnor men riskfaktorer är depression och ångest, bristande socialt stöd, låg smärttröskel, tidigare psykiskt förlossningstrauma, tidigare våld eller sexuella övergrepp samt annan kulturell bakgrund. Barnmorskan är central för att identifiera och stödja kvinnor med förlossningsrädsla. Hjälpen som kvinnorna får för sin rädsla varierar internationellt. Behandlingen kan bestå av stödsamtal, olika former av terapi, planlagd förlossning eller kejsarsnitt samt barnmorskeledda kontinuitetsmodeller. Konsekvenser av förlossningsrädsla är utdragna förlossningar med fler interventioner inklusive akuta kejsarsnitt, sänkt smärttröskel, psykiska svårigheter i efterförloppet som PTSD, fördröjning till nästa graviditet samt undvikande att skaffa fler barn. Förlossningsrädda kvinnor önskar sig i högre utsträckning kejsarsnitt vilket kan innebära fler risker än vaginal förlossning när det inte finns en medicinsk indikation. Syftet med denna litteraturöversikt var att belysa förlossningsrädda kvinnors upplevelser av föregående födsel som orsakat förlossningsrädsla. Metoden för arbetet var en allmän litteraturöversikt med kvalitativ ansats. Artiklar som granskats och använts i resultatet har baserats på intervjuer och skriftliga kommentarer från kvinnor med förvärvad förlossningsrädsla. Data har analyserats med kvalitativ innehållsanalys. I resultatet identifierades tre kategorier: ”Vikten av stöd”, ”Att tappa kontrollen över sin förlossning” och ”Att gå vidare”.  Vidare kunde flera underkategorier urskiljas under varje kategori. ”Vikten av stöd” innefattade både bristfälligt bemötande och bristande fysisk närvaro av personal vilket skapade oro och en känsla av att vara betydelselös. ”Vikten av stöd” innefattade även upplevelser när vårdpersonal varit betydande för att ta sig igenom en traumatisk förlossning. ”Att tappa kontrollen över förlossningen” kunde innebära att bli exkluderad genom bristfällig kommunikation, dåliga attityder eller att medicinska ingrepp skedde utan samtycke. Detta kunde leda till att kvinnorna började tvivla på vårdpersonalens kompetens, kände sig felbehandlade, emotionellt frånvarande eller fråntagna sin förlossning. ”Att gå vidare” berörde hur kvinnorna hade hanterat sina traumatiska upplevelser, hur de förhållit sig till en ny graviditet och vilka rädslor som var kopplade till en eventuellt kommande förlossning. Slutsatsen är att vårdpersonalens stöd innan, under och efter förlossningen är av största vikt för att förlossningsrädda kvinnor ska kunna gå igenom en förlossning och äga sin upplevelse genom bevarad kontroll, samt för att kunna gå vidare efter en tidigare traumatisk förlossning. / Fear of childbirth can be described as specific fear linked to childbirth that to some extent affects daily life in a negative way. Fears may involve the woman herself or the child being injured during childbirth, losing control, being dependent on others or phobias concerning the hospital environment. Fear of childbirth increases the risk of having a negative experience of childbirth. Previous research also shows that the single most important risk factor for severe fear of childbirth is a previous traumatic birth experience. The prevalence of fear of childbirth varies between countries from 14 to 23 percent, few studies on fear of childbirth have been done in developing countries. Fear of childbirth can affect all women, but risk factors are depression and anxiety, lack of social support, low pain threshold, previous psychological birth trauma, previous violence or sexual abuse and different, cultural backgrounds. The midwife is central to identifying and supporting women with fear of childbirth. The help that women receive varies internationally. The treatment can consist of counseling, various forms of therapy, induced delivery or caesarean section as well as midwife-led continuity models. Consequences of fear of childbirth are delayed births with more interventions including emergency caesarean section, lowered pain threshold, mental difficulties in the aftermath such as PTSD, delay to the next pregnancy and avoidance of having more children. Women who are afraid of childbirth want a caesarean section to a greater extent, which entails more risks than vaginal birth when there is no medical indication. The purpose of this literature review was to shed light on women's birth experiences that´s caused a fear of childbirth. The method of this study a general literature review with a qualitative approach. Articles reviewed and used in the results have been based on interviews and written comments from women with a fear of childbirth. Data have been analysed with qualitative content analysis. The results identified three main categories: "Support", "Losing control of childbirth" and "Moving on". Furthermore, several subcategories could be identified under each main category. The category “support” included both inadequate treatment and lack of physical presence of staff, which lead to anxiety and a feeling of being insignificant. “Support” also included experiences of the staff being important in getting through a traumatic birth. “Losing control of childbirth” meaning being excluded because of the staff´s poor communication, bad attitudes or medical interventions without the woman´s consent. This could make the women doubt the staff´s competence, feeling mistreated, emotionally absent or deprived of their birth. “Moving on” concerned how women handled their traumatic experiences, how they related to a new pregnancy and fears linked to a possible future birth. The conclusion is that the care staff's support before, during and after the birth is of the utmost importance for women who are afraid of giving birth to be able to go through a birth with preserved control and to be able to move on after a previous traumatic birth.

Barnafödande är ett komplicerat och mångfacetterat ämne. Att föda är både en högst privat, intim upplevelse och en kulturell och politiskt kodad händelse. Hur ett samhälle behandlar sin födande befolkning beror på politik, normer och ideal som sträcker sig längre än den födande individen. En förlossningsberättelse är unik då den existerar i tvärsnittet mellan det privata och det publika, vilket gör den ett intressant ämne för litterära studier. Denna masteruppsats är en undersökning av förlossningsskildringar i samtida svensk skönlitteratur. Materialet för uppsatsen är tre svenska romaner som alla publicerades år 2021 – Bära Frukt av Emilia Millares, Vård, skola och omsorg av Linn Spross och Den stora kyrkan av Tove Folkesson. Analysen utgår från tre centrala teman; hur kroppen och det kroppsliga gestaltas under förlossningsscenerna, hur sjukhuspersonalen porträtteras och om, och hur, barnafödande sammankopplas med uppfattningar om kvinnlighet. För att utföra studien vänder jag mig till Tess Cossletts Women Writing Childbirth: Modern discourses of Womanhood (1994) som huvudteori. Jag tar även stöd i Yi–Lin Yus Mother, She Wrote (2005) och Emily Martins The Woman in The Body: a cultural analysis of reproduction (1987). Det teoretiska ramverket ger insikt i de framträdande diskurser som omger förlossningar och moderskap, samt hur dessa kan gestaltas inom skönlitteraturen.  Analysen är uppdelad i tre kapitel, där varje roman analyseras separat. Varje analysdel är i sin tur uppdelad i tre delar, där varje sektion motsvarar ett av de tre temana kroppen, kvinnlighet och gestaltningar av vårdpersonal. Analysens resultat kan summeras med att kroppen porträtteras som att vara både en källa till kraft för den födande kvinnan, och som en separat enhet som agerar självmant utan att hon kan kontrollera den. Kroppen och dess reproduktiva funktioner beskrivs ofta med naturbildspråk och paralleller dras till barnafödande som en primitiv kraft, inneboende i kvinnan.  Detta förhöjs ytterligare genom att rollfigurerna söker matrilinjära kontakter, framför allt genom att återknyta till sina mormödrar. Vårdpersonalen porträtteras både som änglar som hjälper och guidar den födande kvinnan med sin expertis, samt som ett osympatiskt, opersonligt ”dem” som behandlar kvinnan mer som en bebisproducerande maskin än en person. Ingen av romanerna kan sägas ansluta sig till en specifik bild av förlossningar, i stället reproducerar och kritiserar de samtliga dominerande diskurser som medföljer graviditeter och barnafödande. / Childbirth is a complicated and multifaceted phenomenon. Giving birth is a both highly private, intimate experience and a culturally and politically coded event. How a society treats its birthing population is dependent on politics, norms and ideals that stretches beyond the individual woman giving birth. A birth story is unique in that it exists in the cross section between private and public, which makes the literary depiction of childbirth an interesting focus for literary study. This master’s thesis is an examination of depictions of birth in contemporary Swedish fiction through analysis of three novels, all published in 2021 – Bära Frukt (Bear Fruit) by Emilia Millares, Vård, skola och omsorg (Care, education and nurturing) by Linn Spross and Den stora kyrkan (The grand church) by Tove Folkesson. The analysis focuses on three main themes; how the body is depicted throughout the birthing scenes, how hospital staff is portrayed and, if, and how, the experience of birth is linked to ideals surrounding womanhood. To conduct the study I turn to Tess Cosslett’s Women Writing Childbirth: Modern discourses of Womanhood (1994) as the main theoretical foundation, as well as Yi–Lin Yu’s Mother, She Wrote (2005) and Emily Martin’s The Woman in The Body: a cultural analysis of reproduction (1987). The theoretical framework provides insight into what the dominant discourses surrounding childbirth and motherhood are, and how these can manifest in literature. Within the study the novels are examined separately, with each analysis being sectioned into three parts, corresponding to the three main themes body, womanhood, and portrayal of hospital staff. In summary, the study concludes that the body is portrayed as both a source for control for the birthing woman, as well as acting on its own accord without her being able to regulate its actions. The body and its reproductive functions are often depicted using nature imagery and parallels are drawn to childbirth being a primitive, ancient force inherent to womankind. This is highlighted by the characters continuously seeking matrilinear connections, mainly by asserting their link to their grandmothers. The hospital staff is portrayed both as angels helping and guiding the birthing woman through labor, as well as an unsympathetic, impersonal “they” who treats the woman more as a baby-producing machine rather than a person. None of the novels can be seen as promoting one singular view of childbirth – instead, the novels can be seen as reproducing and critiquing the dominant discourses surrounding pregnancy and childbirth.

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Experimentation in field settings addressing socially sensitive topics are generally avoided by researchers. This avoidance is based on the restrictive nature of the required controls and the perceived inability to implement the required designs. In this study, the researcher has documented the necessary steps to meet design requirements for the conduct of a quasi-experimental study in two field settings. This quasi-experimental study addresses a case dealing with the attitudes of parents regarding their childbirth experiences. Programs for childbirth education traditionally emphasize the "natural" method of birth. Socially, cesarean births are currently being performed in 20 percent of the cases. Nursing education literature Suggests that prepared childbirth education programs contribute to negative parental attitudes for those experiencing cesarean birth. In the case for this study, attitudes of parents experiencing both vaginal and cesarean births and receiving three different levels of childbirth education were investigated. Documentation of the required research controls for the case was achieved through the maintenance of a log of events. The three levels of childbirth education included two types of Lamaze training and the non-prepared. Two hundred and sixteen (216) parents in each of the settings were included in the study representing 54 vaginal and 54 cesarean births. The measurements included hospital records/and response to a modified Likert scale. Analysis of variance was used to test the research hypothesis. Documentation of all research requirements for the study was successfully completed and case results obtained. Parents experiencing cesarean birth had more negative attitudes than those experiencing vaginal birth. In one of the two field settings, childbirth education was validated as contributing to more negative attitudes for cesarean birth, but was not replicated in the second setting. A significant (P<.05) first order interaction between type of birth and receipt of childbirth education was found in both settings. / Ed. D.

The Ministry of Health (MOH) and its partners are determined to prevent and manage preventable causes of morbidity and mortality in mothers, neonates and children. In the last decade, special emphasis has been given to increasing the number of health facilities that provide maternal and child health services (MNCH), huge production of skilled birth attendants (SBAs), and equipping the health facilities to improve the utilisation of quality services. This study investigated the community perspectives of health service utilisation and proposes a framework for improving the utilisation of the available SBA and postnatal care (PNC).The purpose of this study was to develop a framework for the utilisation of skilled care for delivery and postnatal care by women of childbearing age (15-45). The study used a Sequential explanatory Mixed Methods Approach to investigate the utilisation of SBA and PNC in a district in Ethiopia. The Delphi Technique helped to solicit input from maternal health care experts on the development of a Framework for utilisation of SBA and PNC. This study utilised the Anderson Health Utilisation Model. In the study, 79.8% and 248 (71.5%) of the women who delivered within 12 months prior to this study received ANC and skilled birth attendance respectively from SBA. Fifty five (15.8%) mothers and 131 (38%) babies received Postnatal care from SBA with in 45 days after delivery. The study further found that women who can read and write and were educated are more likely to utilise SBA and receive quality health care services. The study showed that certain factors such as disrespecting service users, abusing service users’ lack of trust on the SBA by service users, religion and superstition contribute negatively to the use of SBAs. None of the predisposing, enabling and need factors predicted the use of SBA for PNC by the mothers. Nevertheless, through the focus group discussions (FGDs) and individual interviews (IDI), it was revealed that there was a widespread knowledge and perception gaps in the community related to the importance of postnatal period and PNC. Religious sanctification also have imperative role in hampering PNC service use by the mothers. The Health care workers (HCWs) also lacked the keenness and orientation to provide the service. Babies born from families with monthly income equal to 500 or above USD were more likely to use PNC within 45 days. There was a widespread misconception in the community that Babies do not need PNC before 45 days of birth except for vaccination purpose. To examine their role in health service utilisation for SBA and PNC, researches can integrate social support and social network to the Andersen’s health- ervice utilisation model. A framework for utilisation of SBA and PNC is proposed. The researcher recommends developing an utilisation tool kit that specifies the detail operationalisation of the framework. / Health Studies / D. Litt. et Phil. (Health Studies)

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Attitudes of primiparous women toward childbirth were studied longitudinally as they varied with the intervention of childbirth education classes before delivery; and as they varied with the experience of labor and deli very and having a baby in the home after delivery. An anxiety scale was used measuring anxiety toward labor, delivery, the parenthood role, and stress on the marriage relationship. Measurement on the anxiety scale was taken prior to childbirth education when primiparous mothers ranged from 4 months to 7-l/2 months gestation. Measurement II on the anxiety scale was taken after childbirth education, one month prior to delivery. Measurement III on the anxiety scale was taken one month following delivery . The sample consisted of primiparous women selected from two Childbirth Education Classes at the Logan L. D. S. Hospital, Logan, Utah, in September and October of 1974. The following numbers of women responded on each of the three questionnaires: Measurement I - 77 Measurement II - 69 Measurement III - 66 Total Matched sample including all three measurements - 56. H was found that anxiety toward delivery increased significantly alter childbirth education and as time for delivery drew nearer, while anxiety toward labor decreased slightly but not significantly. One month following delivery, however, anxiety decreased toward both labor and delivery, as was expected, but anxiety toward delivery decreased to a lower level than did anxiety toward labor. It appears that these primiparous women experience more anxiety toward delivery prior to the experience, but after experiencing labor and delivery, some feel more anxious about labor than about delivery. No difference was found between any of the three measures on anxiety toward the role of parent. The participation of husbands in labor and delivery was viewed by over 90 percent of these primiparous mothers as a positive factor, on all these measurements. Earlier in pregnancy, prior to childbirth education on Measurement 1, a strong positive correlation was found between physical symptoms of pregnancy and overall anxiety level. However, this relationship seemed to disappear after childbirth education, one month prior to delivery on Measurement II. An analysis of variance showed significant variation in the anxiety or stress of the childbearing cycle on the marriage relationship with the highest stress being just prior to delivery.