Elsevier

Midwifery

Volume 21, Issue 4, December 2005, Pages 346-354
Midwifery

Swedish women's experience of childbirth 2 years after birth

https://doi.org/10.1016/j.midw.2005.01.001Get rights and content

Summary

Objective

to describe women's experiences of childbirth 2 years after the birth.

Design

qualitative study using a phenomenological approach. Data were collected via tape-recorded interviews.

Setting

interviews in the women's homes between 1999 and 2000, 2 years after the birth.

Participants

10 women, five primiparous and five multiparous, who had received care at the ABC centre, Sahlgrenska University Hospital, Göteborg, Sweden, between 1996 and 1997.

Key findings

the essential structure was described as ‘an unavoidable situation, which was demanding for both control and loss of control; as going with the flow and at the same time taking command of oneself.’ To be in this unavoidable situation may have caused feelings of helplessness if the women were experiencing that the process of childbirth was not progressing. Support and help from the midwife were central to women's ability to handle the situation. To have been in an unavoidable situation changed the women and was also empowering. However, the women's approach to childbirth, to go with the flow and at the same time take command of themselves, is not congruent with the common view of childbirth in Swedish society today. This describes childbirth as something entirely negative that should be handed over to professionals. Five constituents can further describe the essential structure: to be in a situation without return, to receive help, to be changed, to have a different experience and the experience is not in agreement with expectations.

Implications for practice

the basis for maternity care should be influenced by women's long-term experiences of childbirth. This could be done by supporting women's own participation, the midwives’ opportunity to take a central role, and factors that help women to receive an empowering and strength-giving experience of childbirth.

Introduction

The experience of childbirth is an important life experience for women, and their long-term memories are generally accurate compared with statements shortly after birth (Simkin, 1991, Simkin, 1992). However, according to Waldenström (2004), more negative aspects may take longer to integrate. Women′s overall experiences are an important outcome of labour (Waldenström, 2003). The quality of these experiences affects the future well-being of the woman, the baby, and the relationship between mother and child (Lagerkrantz, 1979; Oakley, 1983; Green et al., 1990; Morris-Thompson, 1992); it also affects the relationship between the woman and her partner (Brudal, 1985). Features, such as pregnancy-related factors, complications, expectations, pain, the form of organisational care, and support, all influence women's experience of childbirth (Lundgren, 2002). All in all, the most pivotal factor for a positive childbirth experience is support (Hodnett, 1999; Lavender et al., 1999; Waldenström, 1999). Thereby, the dimension of caring (Kennedy, 2000) and ‘being with women’ (e.g. the provision of emotional, physical, spiritual and psychological presence) should be central concepts for midwifery (Hunter, 2002). A form of organisation that emphasises support from midwives is alternative birth centre (ABC) care, which provides continuity of care, restriction of medical technology, parental responsibility and self-care (Waldenström, 1993; Waldenström, 1998). Two such centres have been established in Sweden since the late 1980s. Antenatal care was not provided in the ABC centre in Göteborg; instead, a preparatory visit before the delivery was integrated into the service. However, as a research project, women were given the opportunity to receive antenatal care at the unit between 1996 and 1997.

To summarise, several studies have described women's experiences of childbirth shortly after the birth. However, in-depth knowledge about women's long-term experiences is limited. The aim of the study reported here was to describe women's experiences of childbirth 2 years after the birth.

Section snippets

Methods

To be able to describe women's long-term experiences of childbirth, the research must enter deeply into this experience. This is possible using a phenomenological method, based on a life-world approach (Dahlberg et al., 2001). Emphasis is placed on the phenomenal field (Merleau-Ponty, 1995). The purpose of phenomenological research is to describe phenomena as they are lived and experienced by individuals. The phenomenological analysis seeks to uncover the meaning of humanly experienced

Sample

The sample consisted of 10 women who had received antenatal care at the ABC centre, Sahlgrenska Hospital, between 1996 and 1997. Five of the women were primiparous, two had had their second baby, two their third and one her fourth. Seven of the women gave birth at the ABC centre, and three at the standard delivery ward. Two primiparous women were transferred to the standard delivery ward during delivery because of prolonged labour. One of the multiparous women did not give birth at the ABC

Discussion

This study was undertaken with a small group of women who had received care at one ABC centre in Sweden. We cannot claim that the women in this study are representative of all women using birth centre care, let alone all women giving birth in Sweden. However, there are some lessons that can be learned from these findings.

The main finding from this study was that the women described childbirth as an unavoidable situation, which demands control and loss of control. To give birth involves

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