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Objectives: This study aimed to investigate the impact of having a companion during vaginal birth on postpartum depression and birth satisfaction. Methods: This prospective cohort study included 220 postpartum women aged 18–45 who delivered vaginally at Ankara Etlik City Hospital between August 2023 and February 2024. During labor, each woman had the option to be accompanied by a companion person (such as a mother, partner or spouse, sibling, or friend) of her choice; those who opted not to have a relative present received the standard support provided by the hospital's routine birth protocol. Participants were divided into three groups based on the type of support received during childbirth: spousal support, support from others (non-spousal support), and no support. Data were collected within six weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and the Birth Satisfaction Scale-Revised (BSS-R). Results: Women supported by their spouses during childbirth had significantly higher BSS-QC (Quality of care provision), BSS-SL (Stress experienced during labor), and BSS-R total scores compared to those without support. BSS-SL scores were particularly higher for those with spousal support versus support from others or no support. Non-spousal support also resulted in higher BSS-QC scores than no support at all. BSS-WA (Women's personal attributes) scores and EPDS scores were similar between the groups. Additionally, no significant differences in BSS-QC, BSS-SL, BSS-WA, and BSS-R total scores were observed between women with high (≥13) and low (<13) EPDS scores, but a negative correlation between EPDS and BSS-R total scores was noted (r=-0.203, p = 0.003). Conclusion: Women receiving spousal support during childbirth reported significantly higher birth satisfaction, particularly in care quality (BSS-QC) and stress management (BSS-SL). The presence of a companion, whether spousal or non-spousal, positively influenced birth satisfaction, though it did not significantly affect postpartum EPDS scores. [ABSTRACT FROM AUTHOR]

In Japan, women continue to suffer from mental health and other postpartum issues despite good clinical outcomes of maternity care. As key care providers, midwives potentially affect women's overall birth experience. Most women in Japan give birth in hospitals or obstetric clinics where different midwives and nurses provide one woman with fragmented care. Women's lived experiences of the woman–midwife in these birth facilities are not well known in Japan. To understand women's birth experience and relationship with midwives in the mainstream maternity care system in Japan to improve maternity care and women's birth experience. Face-to-face individual interviews with 14 mothers were conducted. The data were analysed using van Manen's hermeneutic phenomenological approach, which reveals the meaning of human experience in the everyday world. Four themes were derived from the hermeneutic phenomenological analysis; 1) Closed hearts and bodies in insecure relationships, 2) Alienation, 3) Hopelessness and helplessness, and 4) Women's vulnerability and desire for positive relationships. In institutionalised and fragmented maternity care settings, it is difficult for women and midwives to develop a relationship. In such a care environment, women's birth experience with midwives is negative or even traumatic; yet, women still need and seek the midwife relationship. Respectful care—necessary for women's positive birth experience—requires positive relationship between women and midwives. Women's negative birth experience may affect their mental health and parenting. Maternity and midwifery care in Japan needs to develop relationship-based care to improve women's birth experience. [ABSTRACT FROM AUTHOR]

Most hospital birth environments remain clinical in appearance and are not attuned to the neurohormonal processes that orchestrate labour and birth. Hospital environments are therefore not aligned with the innate needs of a woman to feel safe and secure in the place where she gives birth. Research has suggested that audio-visual effects such as nature images and sounds may help promote physiological labour in women at low risk of complications. This study aimed to explore the experiences of women labouring in a hospital birth environment enhanced with audio-visual technology, regardless of pregnancy complexity and use of interventions. Experiences of midwives providing one-to-one midwifery care in this environment were also explored. Transcripts of semi-structured interviews conducted with thirty-two women and six midwives were analysed thematically. Universally, women reported that access to audio-visual imagery and soundtracks in the birth environment positively influenced their experience of labour. Nature images and sounds during labour helped create serenity and calmness within the woman and her surroundings, allowing her to relax and focus inwards. Midwives used this technology to create a calm and psychologically safe environment for women giving birth in the hospital. Projecting nature images and sounds became a medium for midwives to create ambience and instil calmness in the clinical environment. Midwives also reported observing positive impacts on the behaviours of other clinicians entering the room. Audio-visual enhancement of the hospital birth environment was found to enhance women's birth experiences and support midwives providing woman-centred care. [ABSTRACT FROM AUTHOR]

A woman's home birth and postpartum experience can have a major impact on her baby's, partner's and family's well being. It is a life-altering event that can help improve or worsen women's self-esteem and self-confidence. The aim of this study was to describe and understand the experiences, perceptions and attitudes of parents who planned a home birth in Spain. A qualitative study was conducted based on Gadamer's hermeneutic phenomenology. Two main methods were used for data collection; narratives and individual in-depth interviews with 14 mothers and 8 fathers who had planned a home birth in the last year. Inductive analysis was used to find themes based on the data obtained. Six main themes emerged from the data analysis: (1) in search of a natural and personalised birth, (2) breaking with social pressures, (3) experience of home birth for the mother, (4) role of the father in home birth, (5) how does the father experience home birth?, (6) home birth is not available to all mothers and fathers. For the mothers and fathers in this study the home birth experience fulfilled their previous expectations of an intimate and natural moment, making it a highly satisfying experience for both. However, parents expressed experiencing negative feelings such as fear and worry about complications and labor pain. According to our research society in general and public health professionals in particular issue numerous criticisms and value judgments towards mothers and fathers who opt for a home birth in our country. In addition, the study shows the economic and cultural inequalities in access to home birth in Spain. [ABSTRACT FROM AUTHOR]

Birth satisfaction is an important health outcome that is related to postpartum mood, infant caretaking, and future pregnancy intention. The COVID-19 pandemic profoundly affected antenatal care and intrapartum practices that may reduce birth satisfaction. To investigate the extent to which pandemic-related factors predicted lower birth satisfaction. 2341 women who were recruited prenatally in April–May 2020 and reported a live birth between April–October 2020 were included in the current analysis. Hierarchical linear regression to predict birth satisfaction from well-established predictors of birth satisfaction (step 1) and from pandemic-related factors (step 2) was conducted. Additionally, the indirect associations of pandemic-related stress with birth satisfaction were investigated. The first step of the regression explained 35% of variance in birth satisfaction. In the second step, pandemic-related factors explained an additional 3% of variance in birth satisfaction. Maternal stress about feeling unprepared for birth due to the pandemic and restrictions on companions during birth independently predicted lower birth satisfaction beyond the non-pandemic variables. Pandemic-related unpreparedness stress was associated with more medicalized birth and greater incongruence with birth preference, thus also indirectly influencing birth satisfaction through a mediation process. Well-established contributors to birth satisfaction remained potent during the pandemic. In addition, maternal stress and restriction on accompaniment to birth were associated with a small but significant reduction in birth satisfaction. Study findings suggest that helping women set flexible and reasonable expectations for birth and allowing at least one intrapartum support person can improve birth satisfaction. [ABSTRACT FROM AUTHOR]

• The passive second stage is an unknown phase to nulliparous women. • The women experienced uncertainty, loss of control and frustration. • Women with prolonged passive second stage require skilful midwifery support. • Shared decision-making is recommended. • The passive second stage should be included in antenatal preparations. Prolonged progress can occur in the first and second stages of labour and may contribute to a negative birth experience. However, previous studies have mainly focused on quantitative aspects or overall birth experience, and little is known about women's experiences of a prolonged passive second stage. To describe the lived experiences of a prolonged passive second stage of labour in nulliparous women. A qualitative study was conducted with 15 nulliparous women with a passive second stage lasting three hours or more. Data were analysed using thematic analysis based on descriptive phenomenology. The analysis resulted in four themes: "An unknown phase" that entailed remaining in a phase that the women lacked an awareness of. "Trust and mistrust in the body's ability" represents the mindset for vaginal birth as well as feelings of powerlessness and self-guilt. The theme "Loss of control" included experiences of frustration, fatigue, and having to deny bodily instincts. "Support through presence and involvement" signifies support through the midwife's presence in the birthing room, although there were also descriptions of emotional or physical absence. The findings contribute to the understanding of prolonged labour based on women's lived experiences and add to the body of knowledge about the prolonged passive second stage. This study highlights that women need support through information, presence, and encouragement to remain in control. It can be beneficial during birth preparation to include knowledge about the passive second stage together with unexpected or complicated situations during birth, such as prolonged labour. [ABSTRACT FROM AUTHOR]

Postpartum haemorrhage [PPH] remains a major cause of maternal morbidity and mortality. Whilst low-resource settings bear the greatest burden of deaths, women live with associated morbidities in all healthcare settings. Limited data exists regarding the experience for women, their partners, or healthcare professionals [HCPs], affected by PPH. To qualitatively investigate the experience of PPH, for women (n = 9), birth partners (n = 4), and HCPs (n = 9) in an inner-city tertiary referral centre. To provide multi-faceted insight into PPH and improve understanding and future care practices. Participants were interviewed about their experiences within two weeks of a PPH. Data were analysed using thematic analysis. Four distinct, but related, themes were identified: 'Knowledge specific to PPH'; 'Effective and appropriate responses to PPH'; 'Communication of risk factors'; and 'Quantifying blood loss'; which collected around a central organising concept of 'Explaining the indescribable'. PPH was viewed as a 'crisis-style emergency', generating respectful fear in HCPs, whilst women and partners had little-to-no prior knowledge. Specific PPH knowledge dictated HCPs' response and risk communication. PPH risks were typically linked to quantification of blood loss, assessment of which varied with acknowledged questionable accuracy. Women's and partners' confidence in HCPs' ability to deal with PPH was unquestionable. Non-verbal communication was highlighted, with HCP body language betraying professional confidence. Information about blood loss during childbirth must be imparted in a sensitive, timely manner. Whilst training for HCPs results in effective PPH management, consideration should be given to their non-verbal cues and the impact of dealing with this stressful, 'everyday emergency'. [ABSTRACT FROM AUTHOR]

Evidence relating maternal birth experience to a range of maternal and neonatal outcomes is increasingly compelling. Consequently valid and reliable self-report of birth experience from the mothers perspective is critical. The current study sought to translate and validate a Hungarian-language version of the Birth Satisfaction Scale-Revised (BSS-R). Following forward and backwards translation into Hungarian, the Hungarian BSS-R (HU-BSS-R) was administered to women in a major Transylvanian hospital maternity unit within 72 h postpartum. Key psychometric characteristics were then examined in relation to factor structure, divergent and convergent validity, internal consistency, and known-groups discriminant validity. Two-hundred and thirty-two women completed the HU-BSS-R. Confirmatory factor analysis revealed the HU-BSS-R to offer an excellent fit to data for the established tri-dimensional measurement model. The HU-BSS-R was also found to offer excellent convergent and divergent validity and known-groups discriminant validity. No significant differences were observed between internal consistency observations between the current study and the original UK validation study. The HU-BSS-R is a valid and reliable translation of the original BSS-R, it has proved itself to have excellent psychometric properties and is suitable for use in the Hungarian maternity context. [ABSTRACT FROM AUTHOR]

Continuity models of care are rare in Sweden, despite the evidence of their benefit to women and babies. Previous studies have shown certain factors are associated with a positive birth experience, including continuity of midwifery care. The aim was to investigate women's childbirth experiences in relation to background data, birth outcome and continuity with a known midwife, in a rural area of Sweden. An experimental cohort study. Participating women were offered continuity of midwifery care in pregnancy and birth, during selected time periods. Data were collected in mid-pregnancy and two months after birth. The Childbirth Experience Questionnaire was used to determine women's birth experiences. A total of 226 women responded to the follow-up questionnaire. Not living with a partner, fear of giving birth, and a birth preference other than vaginal were associated with a less positive birth experience. Having had a vaginal birth with no epidural, no augmentation and no birth complication all yield a better birth experience. Women who had had a known midwife were more likely to have had a positive birth experience overall, predominantly in the domain Professional support. The results of this study showed that women who received care from a known midwife in labour were more likely to have a positive birth experience. The results also pointed out the benefits of a less medicalized birth as important for a good birth experience, and that some women may need extra support to avoid a less positive birth experience. [ABSTRACT FROM AUTHOR]

Knowledge about mothers' perceptions of the quality of Finnish maternity services is limited. The aim of this cross-sectional study was to describe mothers' perceptions of the quality of Finnish maternity services, and to identify background factors associated with them. The data were collected from 1,760 mothers in autumn 2016. Descriptive statistics were used. This study is reported in accordance with STROBE. Most mothers (84%) considered the quality of the maternity services good. The mean response values for the quality of patient education (3.9), staff knowledge and skills (4.3), and hospital environment (4.3) were good. Parity and mode of childbirth were associated with perceptions of the quality of maternity services. Based on the results, development of midwifery and nursing practices should focus on sufficient pain relief, adequate duration of skin-to-skin contact, breastfeeding counselling and opportunities for mothers to reflect on their birth experience afterwards. Moreover, the study results can be used for education. Challenges for future research are presented. [ABSTRACT FROM AUTHOR]

The experience of labour and birth is complex, multidimensional and subjective and has the potential to affect the women and their families physically and emotionally. However, there is a lack of research around maternal satisfaction in Italy. To evaluate mothers' satisfaction with their childbirth experience in relation to socio-demographic characteristics, obstetric history and intrapartum care variables. A cross-sectional study involving 277 women who had given birth in a low risk maternity unit in Northern Italy was undertaken. Satisfaction with birth was measured using the Italian version of the Birth Satisfaction Scale-Revised (I-BSS-R). The scale comprises three Sub-Scales: quality of care provided, personal attributes of women and stress experienced during childbirth. No socio-demographic variables were related to maternal satisfaction. Multiparous women had a higher satisfaction score (p = 0.020; CI:0.23;2.75). Antenatal class attendance was negatively associated with maternal satisfaction (p = 0.038; CI:−2.58; −0.07). Intrapartum variables that significantly reduced maternal satisfaction were: epidural usage (p = 0.000; CI:−4.66; −2.07), active phase >12 h (p = 0.000; CI:−6.01; −2.63), oxytocin administration (p = 0.000; CI:−5.08; −2.29) and vacuum assisted birth (p = 0.001; CI:−6.50; −1.58). Women with an intact perineum were more likely to be satisfied (p = 0.008; CI:−4.60; −0.69). In accordance with other research, we showed that intrapartum interventions are negatively associated with maternal outcomes and therefore also with maternal satisfaction with birth. The sub-scale that measured Quality of Care provided scored higher than the other two Sub-Scales. Further studies on maternal satisfaction in Italy should be conducted, using the I-BSS-R with the aim to compare outcomes and understand what matters to women during childbirth. [ABSTRACT FROM AUTHOR]

Background and aims: A considerable research-literature focuses on pain during labor and associations with postpartum persistent pain and depression, with findings pointing in various directions. The aim of this study was to examine the role of labor pain and overall birth experience in the development of pain and depression 8 weeks after delivery. Methods: The study sample was drawn from the Akershus Birth Cohort. Data from multiple sources were used, including the hospital's birth record (n = 4,391), questionnaire data from gestational week 17 of pregnancy (n = 3,752), 8 weeks postpartum (n = 2,217), and two questions about pain and birth experience asked within 48 h after delivery (n = 1,221). The Edinburgh Postnatal Depression Scale was used to measure postpartum depression, a single question was used to measure persistent pain 8 weeks postpartum, while pain and birth experience were measured by numeric rating scales. A history of pre-pregnant depression and chronic pain were measured through self-report questions in gestational week 17. A total of 645 women had complete data from all sources. We applied multiple imputation techniques to handle missing responses on the two questions about pain and birth experience. Results: The results showed that neither labor pain nor birth experience were associated with persistent pain 8 weeks postpartum, whereas pain before pregnancy (OR 3.70; 95% CI 2.71–5.04) and a history of depression (OR 2.31; 95% CI 1.85–2.88) were statistically significant predictors of persistent pain. A negative birth experience was significantly (OR 1.16; 95% CI 1.04–1.29) associated with postpartum depression, whereas labor pain intensity was not. A history of depression (OR 3.95; 95% CI 2.92–5.34) and pre-pregnancy pain (OR 2.03; 95% CI 1.37–3.01) were important predictors of postpartum depression 8 weeks after delivery. Conclusions and implications: Whilst the relationship between labor pain intensity and postpartum pain and depression remain unclear, our results do imply the need to screen for previous depression and chronic pain conditions in pregnant women, as well as consider preventive measures in those who screen positive. [ABSTRACT FROM AUTHOR]

Evidence shows that women feel valued and satisfied after discussing their birth experiences. However, uncertainties persist surrounding the concept of postnatal debriefing practice. To explore the opinions and expectations of women relating to postnatal debriefing and their experiences when the postnatal debriefing is not presented. A descriptive qualitative study of 20 postnatal women was conducted using in-depth semi-structured interviews from April–May 2023. Thematic analysis was applied to the data collected in interviews. Analysis of interview data generated three main themes and nine sub-themes. Women wanted to make sense of their birth experience They expressed their opinions on the components of postnatal debriefing They advocated for all women to be offered this practice by known healthcare professionals who interact with them They do not want to only talk about their birth experience but also meet their needs Women agree that expectations related to birth determine the need for the practice. They hoped for psychological adaptation by relieving their distress and gaining a sense of closure. The discussion process was expected to prevent reflection of trauma to the future and provide transition to the postnatal period. The present study explored women perceptions and expectations of postnatal debriefing. Healthcare professionals should behave sensitively to women's expectations and needs in relation to their birth experience. Further research is warranted to clarify the components and effects of postnatal debriefing practice to develop consolidated guidance. • Uncertainties surround the concept of postnatal debriefing. • It is common worldwide for women to feel traumatic emotions that can be caused by traumatic birth events. • Stress experienced after a traumatic birth event causes many significant adverse effects. • Women may feel valued and satisfied after discussing their birth experiences. • Women want to be offered postnatal debriefing to make sense of their birth experience. • Many women felt the practice would be beneficial for their health and well-being. • Researchers should prioritise clarification of the optimal components and effects of postnatal debriefing practice in order to develop consolidated guidance. • Healthcare professionals should consider women's expectations and needs in relation to their birth experience. [ABSTRACT FROM AUTHOR]

Although primarily stemming from research conducted in high-income countries, culturally sensitive knowledge of women's experiences with and needs during childbirth, as well as how such experiences affect their psychological health and wellbeing, is important to add to the big picture of women's experiences with childbirth worldwide. The aim of the study was to clarify how primiparous women in Turkey experience childbirth and intrapartum care. Grounded theory guided depth-interviews with 12 women, whose data were analysed according to the constant comparative method. Participants reported wanting vaginal birth without interventions (i.e. normal birth), which required their empowerment as well as support from others. Although they recognised their readiness for the birth process as a decisive factor in coping with childbirth, they prioritised quality of care from healthcare professionals during birth, which most participants found unsatisfactory. They also highlighted the importance of giving birth in a health-promoting environment offering privacy, silence and comfort. To support normal birth, the World Health Organization's intrapartum care model prioritises continuity of care, respectful labour and childbirth care, effective communication from healthcare personnel and emotional support from a companion of choice. Salutogenesis can also guide clinical birth practices to promote normal birth and positive birth experiences. All women strove to experience normal birth, which required antenatal education and emotional support from a partner or family and from healthcare professionals. Normal birth and positive childbirth experiences also required quality intrapartum care and a health-promoting environment. [ABSTRACT FROM AUTHOR]

• Women's experiences of quality of care and feelings during labour and birth, are related to the length of latent phase. • For both primiparous and multiparous women, a prolonged latent phase of labour >18 h prior admittance to labour ward, was related negatively to birth experience, perceived quality of care and feelings. • Women with a prolonged latent phase of labour, could be considered as a risk group in terms of having a negative birth experience and the length of latent phase needs considerations. To describe primiparous and multiparous women's labour experiences and their perception of quality of intrapartum care, in relation to background characteristics and length of latent phase of labour prior to admittance to labour ward. A cross-sectional study. A middle-sized hospital in a rural county in western part of Sweden. Primiparous and multiparous women, both low-risk and risk, with a spontaneous onset of labour after gestational week 37+0 were included. In total, n = 1193 women were invited, and n = 757 responded the questionnaire, n = 342 primiparous and n = 415 multiparous women. The Intrapartal-specific Quality from Patient Perspective (QPP-I), with responses on perceived reality and subjective importance, was used for data collection. QPP-I covers ten factors of quality of care. Background characteristics, length of latent phase of labour, global items about labour experience and items regarding feelings during labour and birth were included. Data were analysed with descriptive and analytic statistics. All factors in QPP-I were rated higher for subjective importance than perceived reality, except for information about selfcare, for both primi- and multiparous women. Labour experience, perceived reality of quality of care, and feelings were related to length of the latent phase of labour. Primiparous women with a prolonged latent phase (>18 h) had significantly lower scores regarding six out of ten QPP-I factors (PR); Information procedures, Information self-care, Commitment (midwives), Commitment (enrolled nurses), Midwives present, and Partner/ significant others. They scored lower on Experience birth as normal and Safe during labour and birth. The felt less proud and felt more ignored by professionals. Multiparous women with a prolonged latent phase of labour scored significantly lower on one QPP-I factor, Commitment (midwives). They also scored lower on Control over the situation and felt less safe during labour and birth. Women's perception of quality of intrapartum care, the birth experience and feelings are related to length of the latent phase of labour. Women perceive quality of intrapartum care as being lower than its subjective importance. A prolonged latent phase of labour can be regarded as a risk factor for a more negative birthing experience. [ABSTRACT FROM AUTHOR]

• Fear of birth is associated with a negative birth experience. • Fearful women do not usually receive care from a known midwife during labour and birth. • Women having a known midwife during birth reported a more positive birth experience. • Information, decision making and control was higher when having a known midwife. There is evidence that continuity of midwifery care is beneficial to women. Women with fear of childbirth in Sweden are offered counselling, but receiving care from a known midwife during labour is unusual, despite its effects in reducing interventions and increasing birth satisfaction. The aim of this study was to describe and compare birth outcome and experience of intrapartum care among women with fear of childbirth who received intrapartum care from a known midwife, versus those who did not. An experimental study of 70 women referred to counselling due to fear of birth during pregnancy wherein the counselling midwife, when possible, also assisted during labour and birth. Having a known midwife during labour and birth had a positive impact on fearful women's birth experience and their perception of pain, but there was no difference in onset of labour or mode of birth. Women who received care from a known midwife experienced better care with regards to information, participation in decision making and perception of control. This study indicates that having access to a known midwife might have an impact on women's birth experience. This study was limited by its small sample size and further research would need to randomise fearful women to counselling or continuity of care to determine the contribution of each to reducing fear. [ABSTRACT FROM AUTHOR]

Parents' birth experiences affect bonding with their infant, which in turn may influence the child's future health. Parents' satisfaction with childbirth is multi-dimensional and dependent on both expectations and experiences. Increasing involvement of partners in intrapartum care may lead to an assumption that the birthing couple shares attitudes and expectations of intrapartum care. There is a limited knowledge regarding the uniformity of couples' experiences of labour and birth. To describe and compare uniformity in couples' birth experiences of the quality of intrapartum midwifery care. A quantitative cross-sectional study nested within a randomised controlled trial. In total 209 healthy primiparous mothers and their partners were recruited. A quality of care index was generated from an on-line questionnaire administered as a follow-up to the randomised controlled trial. Uniformity and differences were identified regarding the coupleś experiences of birth and their preferences for intrapartum care A high level of uniformity between the mothers and their partners was revealed. Birth was a positive experience for 79% of partners and 73% of mothers whom were more likely to have experienced a spontaneous vaginal birth. Partners and mothers with a less positive birth experienced deficiencies regarding: being in control , receiving information about labour progress and midwife's presence in labour room. Midwives can enhance couples' feeling of being in control during labour and birth by being attentive, present and continuously providing adequate information and emotional support. [ABSTRACT FROM AUTHOR]

Increasing evidence on disrespect and abuse during childbirth has led to growing concern about the quality of care childbearing women are experiencing. To provide quantitative evidence of disrespect and abuse during childbirth services in Germany a validated measurement tool is needed. The aim of this research project was the development and psychometric validation of a survey tool in the German language that measures disrespect and abuse of women during childbirth. A survey tool was created including the following measures: German adaptations of the short and long form of the "Mothers on Respect" (MOR) index (MOR-7 and MOR-G); the "Mothers' Autonomy in Decision Making" (MADM) scale; a mistreatment-index (MIST-I) comprising indicators of mistreatment during childbirth; and a set of items that measure experiences of discrimination during maternity care. Internal consistency reliability and construct validity of the scales were assessed using Cronbach's alpha, unweighted least squares factor analysis and non-parametric correlation analysis with a scale that measures a related construct, the Posttraumatic Symptom Scale – Self Report (PSS-SR) scale. We distributed the survey online, recruiting through snowball sampling via social media. A selection bias towards women who had experienced disrespect and abuse during their birth was intended and expedient for tool validation. The final sample of participants (n = 2045) had given birth in Germany between 2009 and 2018. More than 77% of the study participants reported at least one form of mistreatment with non-consented care being the most commonly reported type of mistreatment, followed by physical violence, violation of physical privacy, verbal abuse and neglect. All included scales showed good psychometric properties with high Cronbach's alphas (0.95 for both MOR versions and 0.96 for MADM). Factor analysis generated one factor scales with high factor loadings (0.75 to 0.92 for MOR-7; 0.37 to 0.90 for MOR-G and 0.83 to 0.92 for MADM). MOR-7, MOR-G, MADM and MIST-I scores were significantly (p <0.001) correlated with PSS-SR scores (Spearman's rho -0.70, -0.61 and 0.68 for MOR-G, MADM and the MIST-I, respectively). This study presents a valid and reliable instrument for the quantitative assessment of disrespect and abuse during childbirth in Germany. Childbearing women's experiences of disrespect and abuse are a relevant phenomenon in German hospital based maternity care. Disrespect and abuse during childbirth appear to contribute to post-traumatic symptoms and may be associated with severe mental health problems postpartum. [ABSTRACT FROM AUTHOR]

Highlights • Postpartum depression (PPD) in women can be seen in all societies commonly. • A negative experience of birth can increase a woman's PPD risk. • It has been found that the risk of PPD is high in women. • PPD risks of the mothers who are not trained about birth methods, who have vajinal delivery and who are intervened during birth have been found high. • As a result of the study, pregnant women should be trained to prepare for the birth and be avoided medical interventions during birth as far as. Abstract Aim This definitive and cross-sectional study was conducted to determine the relation between mothers' types of labor, birth interventions, birth experiences and postpartum depression. Methods A total of 1010 mothers who gave birth in four different provinces of Turkey were chosen to participate in the study via purposive sampling method Results: The Edinburgh Postpartum Depression Scale score was determined to be 13 and over in 36.4% of the women. In this study, it was determined that the Edinburgh Postpartum Depression Scale scores for women in the 18–24 age group who had a vaginal birth, did not have health insurance, experienced health problems during pregnancy and were not trained about type of labor during pregnancy were statistically higher. There was no significant correlation between the birth experiences and postpartum depression. The linear regression model showed that there was a statistically significant correlation between enema and amniotomy interventions practised during the birth and the Edinburgh Postpartum Depression Scale scores. Conclusion In conclusion, it is thought that preparing the mothers for birth with birth preparation training in the antenatal period and imposing the necessary regulations in the delivery room for the mothers to have a positive birth experience are important in reducing postpartum depression risk. [ABSTRACT FROM AUTHOR]

Highlights • The medicalisation concept has evolved according to its related research fields. • The medicalisation of childbirth can't be reduced to the medical dominance concept. • A positive or negative experience can be associated with birth medicalisation. • Research needs to explore the hierarchy between childbirth satisfaction factors. Abstract First described at the beginning of the 1970s, the concept of birth medicalisation has experienced a theoretical and ideological evolution influenced by the lines of research that have been associated with it. This evolution has given rise to different schools of thought concerning medicalisation, but also various methodologies used in different scientific fields. It seems relevant to propose a global synthesis of the various lines of thought related to birth medicalisation. To do this, the authors conducted a systematic literature review based on the PRISMA method. With a total of 38 occurrences in French and English, the authors scrutinised 17 databases with a publication period between 1995 and 2018. A total of 112 documents (107 articles, 3 book chapters, 2 books) has been identified, grouped and categorised into five main themes in the results section (1) the theoretical evolution of the concept of medicalisation, (2) factors related to the birth medicalisation, (3) the impact of the birth medicalisation, (4) the humanisation of birth and (5) experiences related to childbirth. A reasoned synthesis of the literature is therefore carried out in each part and then discussed according to the selected lines of research that require development in order to guarantee the best possible accompaniment to women who give birth. [ABSTRACT FROM AUTHOR]

Background Irish maternity services are predominantly medicalised and consultant led, therefore women who choose midwifery led care (MLC) do so in the context of limited birth choices. Transfers to consultant led unit (CLU) for consultant led care (CLC) can be unpredictable and can affect women's birth experiences. This study provides an in-depth exploration of women's experiences of transfer fromMLC to CLC during late pregnancy or labour. Methods Transfer experiences are explored through qualitative explorative in-depth interviews using interpretative phenomenological analysis (IPA). Sample Mothers who had experienced transfer from MLC to CLC during late pregnancy or labour were invited to participate. A purposive sample of eleven women following birth (five to 16 months post partum) provided their views. Findings Women described choosing MLC as a means of avoiding interventions and hoping for a fulfilling natural birth experience. However, participants describe feelings of ambivalence about their experiences, leading to conflicting emotions of joy with their new baby offset with disappointment about needing to transfer to CLC. Conclusions Choosing MLC in a risk averse culture can affect how women experience the transfer process. The impact of the transfer can involve a multilayered psychological and emotional adjustment to a different birth experience for women. The findings provide important insights into issues of policy, preparation, and communication prior to and after transfer to CLC, which should be useful for policy makers, health care professionals and educators. [ABSTRACT FROM AUTHOR]

Objective to evaluate women's satisfaction with care at the birthplace in Austria and to provide reference data for cross-country comparisons within the international Babies Born Better project. Design a cross-sectional design was applied. The data were extracted from the Babies Born Better survey as a national sub-dataset that included all participants with Austria as the indicated country of residence. Setting an online survey targeting women who had given birth within the last five years and distributed primarily via social media. In addition to sociodemographic and closed-ended questions regarding pregnancy and the childbirth environment, the women's childbirth experiences and satisfaction with the birthplace were obtained with three open-ended questions regarding (i) best experience of care, (ii) required changes in care and (iii) honest description of the experienced care. Participants five hundred thirty-nine women who had given birth in Austria within the last five years. Measurements and findings based on the concepts of public health, salutogenesis and self-efficacy, a deductive coding framework was developed and applied to analyse the qualitative data of the Babies Born Better survey. Regarding honest descriptions of the experienced care at the birthplace, 82% were positive, indicating that most of the respondents were mostly satisfied with the care experienced. More than 95% of the survey participants’ positive experiences and more than 87% of their negative experiences with care could be assigned to the categories of the deductive coding framework. Whereas positive experiences mainly addressed care experienced at the individual level, negative experiences more frequently related to issues of the existing infrastructure, breastfeeding counselling or topics not covered by the coding framework. Evaluation of these unassigned responses revealed an emphasis on antenatal and puerperal care as well as insufficient reimbursements of expenses by health insurance funds and the desire for more midwifery-led care. Key conclusions although the participating women were mostly satisfied with perinatal care in Austria, it appears that shortcomings particularly exist in antenatal and puerperal care and counselling. Implications for research the established coding framework that covered the vast majority of the women's responses to the open-ended questions might serve as a basis for cross-country comparisons within the international Babies Born Better project. [ABSTRACT FROM AUTHOR]

Upright positions in the second stage of labour are recommended by many international organizations. However, they have not been widely used worldwide, especially in China. One of the important factors is the absence of a practice programme based on the best available evidence. We thus developed a Practice Programme for Upright Positions in the Second Stage of Labour following the UK Medical Research Council framework. Under the guidance of the programme, whether the use of upright positions can improve the maternal birth experience is a question of great concern. This study aimed to explore the birth experience of Chinese women who adopted upright positions in the second stage of labour. This qualitative descriptive study was conducted as part of an implementation study that developed an evidence-based intervention and used strategies to integrate the evidence-based intervention into routine obstetric clinical practice. The maternity department of a tertiary comprehensive hospital in Hebei Province, China. Semi-structured interviews with twelve eligible women who adopted upright positions in the second stage of labour were conducted between March and April 2022. Qualitative data were analyzed by using conventional content analysis. The average age of included women was 26.5 ± 3.5 years, and ten of them were primiparous women. Eight women adopted epidural analgesia during labour to relieve labour pain. All women gave birth in at least one type of upright position in the passive second stage of labour and adopted the semi-recumbent position in the active second stage of labour. Through conventional content analysis, we found that the use of upright positions in the second stage of labour could possibly promote an overall positive birth experience. Women giving birth in upright positions generally perceived they were more involved in their birthing process, and had greater physical and mental capacity to cope with childbirth. Women have a positive birth experience when using upright positions in the second stage of labour. This study suggests upright positions could improve women's birth experience and have the potential to be widely applied in clinical practice. [ABSTRACT FROM AUTHOR]

• Obstetric interventions, severe fear, and pain during labour were the contributors to the perception of traumatic birth. • The factors that contribute to the perception of traumatic birth was included negative childbirth environment, and a lack of privacy. • Women were not supported sufficiently by health personnel during childbirth. • Social support was important in coping with traumatic childbirth and its effects. Childbirth experience and perception of birth are personal. It is important to understand how the traumatic childbirth experiences affected women and for the nursing care that would be given to them. The aim of the research was to determine the childbirth experiences perceived by women as traumatic, how they were affected by these experiences, and how they coped. The study was a descriptive phenomenological approach study. The data were obtained through semi-structured, in-depth individual interviews. Content analysis was used in the analysis of the data. The mothers were contacted by using the social media platforms. Sixteen women were included in the research who expressed that they had traumatic childbirth experiences. It was determined that women experienced severe fear and pain during childbirth, that they were in unsuitable maternity hospital environments, and that care was not taken for their privacy. At the same time, it was determined that they experienced disorders in the postpartum period connected to their traumatic birth experiences, that they postponed their pregnancy plans due to their fear of childbirth that developed connected to traumatic childbirth or that they did not want to become pregnant, and that they did not receive sufficient support from health personnel. It is necessary to provide privacy during childbirth, to take into consideration the decisions of women, and to provide for their continuous support by midwives. [ABSTRACT FROM AUTHOR]

• Previous negative experiences of hospital care as a reason for freebirth. • Receiving support for the decision of freebirth was crucial. • Longing for individual midwife-assisted home-birthing support. • Women had powerful and positive experiences of freebirth. • Easily available and respectful midwifery support should be offered to all women. To explore women's experience of freebirth, as giving birth without the presence of a skilled healthcare professional such as a midwife. Online semi-structured interviews with nine multiparous women in Sweden. A qualitative experiential approach, as described by Burnard, was followed for data analysis. The five main categories explored were: (i) previous negative experiences of hospital care as a reason for freebirth; (ii) receiving support for the decision of freebirth was crucial; (iii) longing for individual midwifery-assisted home-birthing support; (iv) to give birth in peace and in self-control, in the safe home environment; and (v) helpful support during labor and birth was appreciated. The women in the study had a powerful and positive experience of freebirth, but individual midwifery birthing support was also requested. Easily available and respectful midwifery support should be offered to all childbearing women. [ABSTRACT FROM AUTHOR]

Optimizing women's childbirth experience is essential for development of quality mother infant relationships. The Birth Satisfaction Scale-Revised (BSS-R) can be used to measure birth satisfaction. The current investigation sought to translate and validate a Swedish version of the BSS-R. Following translation, a comprehensive psychometric validation of the Swedish - BSS-R (SW-BSS-R) was carried out using a multi-model, cross-sectional, between- and within-subjects design. A total of 619 Swedish-speaking women participated, from which 591 completed SW-BSS-R and were eligible for analysis. Discriminant, convergent, divergent and predictive validity, internal consistency, test-retest reliability, and factor structure were evaluated. The SW-BSS-R was found to have excellent psychometric properties and hence is a valid translation of the original UK(English)-BSS-R. Important insights into relationships between mode of birth, post-traumatic stress disorder (PTSD), and postnatal depression (PND) were observed. The SW-BSS-R is a psychometrically valid translation of the original BSS-R and is suitable for use in a Swedish-speaking population of women. The study has also highlighted important dynamics between birth satisfaction and areas of significant clinical concern (i.e., mode of birth, PTSD and PND) in Sweden. [ABSTRACT FROM AUTHOR]

Background Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care. Objective The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia. Design Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark’s approach to thematic analysis. Findings Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care. Conclusion The study provides an understanding of Sub-Saharan African women’s experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women’s health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women. [ABSTRACT FROM AUTHOR]

Background women´s experience of emergency caesarean section is often described as less positive compared to a vaginal birth or a planned caesarean section. Midwifery care for women where deviations from a normal birth process are present is a challenge. The aim of study was to compare self-reported birth outcomes for women undergoing birth through spontaneous onset of labour between those who actually had a vaginal birth and those who eventually had an emergency caesarean section. Design and setting the study was part of a prospective longitudinal cohort study of parents' experiences, attitudes, and beliefs related to childbirth. Method and findings questionnaires were answered by 870 women in midpregnancy, two months postpartum and one year after birth. 766 women (88%) had a vaginal birth, and 104 (12%) had an emergency caesarean section. The most common indications of emergency caesarean section were dystocia, foetal distress, and malpresentation. Women in the emergency caesarean group were more likely to be primiparous (59.6%) and have a body mass index > 30 (10.7%). Childbirth fear was twice as common among these women, and they were more likely to have preferred a caesarean delivery when asked about birth preference in the middle of pregnancy (OR 3.7, Cl 1.8–7.5). Induction of labour (OR 2.5, Cl 1.6–4.0), the use of oxytocin for augmentation (OR 1.9, Cl 1.3–2.9), and the use of epidural as pain relief during labour (OR 5.6, Cl 3.6–8.7) were more common among women having an emergency caesarean section. Transport of the new-born to a neonatal intensive care unit was three times as common. More than a third (37%) of the women in the caesarean group preferred a caesarean section in case of another birth. Childbirth fear was more common one year after birth with 32% of these women describing their fear as moderate or strong (OR 3.6, CI 2.1–6.0). Key conclusions women undergoing emergency caesarean section are more likely to experience fear and to have a negative birth experience. It is essential for the midwife to promote a sense of control, involve the woman in the procedure, and create security in a threatening situation. This is made possible in relationship characterized by mutuality, trust, on-going dialogue, shared responsibility, and enduring presence. [ABSTRACT FROM AUTHOR]

Background Hypertension complicates 10% of pregnancies and involves specialised care of the woman and her baby, a longer stay in hospital, and an increased risk of physical and mental morbidity. There is limited research reporting the woman's perspective on her experience, how she coped with it psychologically, and whether the care she received influenced her experience. Aim To gain insight into women's experience of hypertension in pregnancy and to report on what mediating factors may help improve their experience. Methods A qualitative descriptive study was undertaken. Data were collected through a semi-structured, face to face interview at 10–12 months postpartum. In total, 20 women who had experienced hypertension in their pregnancy were interviewed. Thematic analysis was used to analyse the data. Findings Four main themes were identified. These were: Reacting to the diagnosis, Challenges of being a mother, Processing and accepting the situation, and Moving on from the experience. The mediating factors that improved the experience were Feeling safe and trusting the care providers, Having continuity of care and carer, and Valuing social support from partner, family and friends. Conclusion The diagnosis of hypertension in pregnancy has a significant impact on women. This affects their pregnancy and birth experience and their pathway to motherhood. The implications of the findings for midwifery practice include having access to multidisciplinary continuity models of care and facilitating the support for these women. [ABSTRACT FROM AUTHOR]

Background: maternal postnatal depression confers strong risk for impaired child development. Little is known about the association between women's postnatal birth experience and postnatal depression. Purpose: to systematically identify and review studies examining the association between the birth experience and postnatal depression. Methods: a systematic search strategy was employed using the Matrix Method (Garrard, 2014) and guided by the PRISMA reporting process. Criteria included broad search terms, English language, and publication years 2000-2015. The search revealed 1536 abstracts narrowed to full-text review of 112 studies. Findings: eleven of the 15 studies meeting search criteria demonstrated a significant association between women's postnatal birth experience and postnatal depression. Results show heterogeneity in birth experience instruments. Strength of evidence and potential for bias are discussed. Key conclusions: in spite of methodological limitations, the weight of evidence suggests that a negative birth experience may contribute to postnatal depression. Further research is warranted. Implications for practice: to promote a positive birth experience healthcare providers should provide supportive, nurturing care that promotes women's confidence, trust, respect, privacy, shared decision making, and feeling of safety. Healthcare policy that promotes quality caregiving may reduce risk of postnatal depression. [ABSTRACT FROM AUTHOR]

Aim: this study aimed to explore and understand the perceptions and experiences of women regarding quality of care received during childbirth in public health facilities. Design: qualitative in-depth interviews were conducted and analysed using the Grounded Theory approach. Participants: thirteen women who had given vaginal birth to a healthy newborn infant. Setting: participants were interviewed in their homes in one district of Chhattisgarh, India. Data collection: the interview followed a pre-tested guide comprising one key question: How did the women experience and perceive the care provided during labour and childbirth? Findings: 'cashless childbirth but at a cost: subordination during childbirth' was identified as the core category. Women chose a public health facility due to their socio-economic limitations, and to have a cashless and safe childbirth. Participants expressed a sense of trust in public health facilities, and verbalised that free food and ambulance services provided by the government were appreciated. Care during normal birth was medicalised, and women lacked control over the process of their labour. Often, the women experienced verbal and physical abuse, which led to passive acceptance of all the services provided to avoid confrontation with the providers. Conclusions: increasingly higher numbers of women give birth in public health facilities in Chhattisgarh, India, and women who have no alternative place to have a safe and normal birth are the main beneficiaries. The labour rooms are functional, but there is a need for improvement of interpersonal processes, information-sharing, and sensitive treatment of women seeking childbirth services in public health facilities. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study is to gain a deeper understanding of the experience of first-time mothers regarding how the midwife may promote a normal birth and a positive birth experience. Methods A qualitative approach was chosen for data collection, and the data presented are based on in-depth interviews. Twelve healthy, first-time Norwegian mothers, aged 22–34, who had experienced a normal and positive childbirth were interviewed five to six weeks after giving birth. The transcribed interviews were analysed with the help of systematic text condensation. Results The findings included two main themes: “To be seen as an individual” and “Health-promoting perspective”. The experience of being cared for by a midwife who provides presence is vital for the woman to be seen as an individual. When the midwife has a health-promoting perspective, she can more easily assist the woman in developing inner strength and coping strategies. Conclusion Midwives have a pivotal role in helping to promote a normal birth and positive birth experience. The women consider the midwife's attitude and behaviour as essential for their ability to feel safe and cared for. The midwife's individualized and motivating approach promotes the women's inner strength and belief in their own capability to handle the birth. Based on this salutogenic view, the midwife must focus on the woman's resources in order to promote good health during the childbearing process. [ABSTRACT FROM AUTHOR]

• The principles of informed consent regarding the decision to augment women's labour were not routinely respected. • Women described augmentation of labour as atypically painful and causative of negative childbirth experiences. • Incorporating women's views and experiences of augmentation of labour in evidence-based practice and clinical guidelines is essential. To explore and synthesise women's views and experiences of augmentation of labour with synthetic oxytocin infusion. A qualitative evidence synthesis was conducted. The SPIDER acronym was used to develop the search terms and determine the inclusion criteria. Six bibliographic databases: MEDLINE, CINAHL, EMBASE, PsycINFO, Maternity and Infant Care and Web of Science Core Collection were searched in October 2021. Grey literature sources, EThOS, DART-Europe, and the World Health Organization's Clinical Trials Registry were searched, and reference lists of included studies were reviewed. Methodological quality of included studies was assessed using the Evidence for Policy and Practice Information and Co-ordinating (EPPI) Centre assessment tool. Data were synthesised thematically. The confidence of each review finding was assessed using the Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Research ethical approval was not required. Women of any age, parity, and cultural background who underwent augmentation of labour with synthetic oxytocin infusion were included. A total of 9306 citations were retrieved. Twenty-five studies conducted across 14 countries met the inclusion criteria and contributed data. Three principal analytical themes emerged: feeling stuck; past and present shaping the future; and cause and effect of augmentation of labour. The decision to augment women's labour was often performed without their informed consent. Women's views and experiences of augmentation of labour were shaped according to their knowledge, beliefs and support received during labour. Irrespective of the context, women consistently associated augmentation of labour with pain. Clinical guidelines on augmentation of labour need to be informed by research that includes women's views and experiences as a main outcome. Future research exploring the experience of augmentation of labour rather than the experience of labour dystocia would be beneficial. Increasing women's awareness and knowledge of augmentation of labour may help to ensure that their informed consent is obtained. Healthcare providers should discuss the effects, side effects and implications of augmentation of labour with women, ideally before labour. [ABSTRACT FROM AUTHOR]

Objective To explore fathers' experiences of a birth by vacuum extraction (VE). Method A qualitative interview study with 10 fathers analysed with qualitative content analysis. Findings The theme ‘affected but helpless’ refers to the father's role changing when childbirth terminates with a VE. From initially being involved in the delivery, his role switches to being merely an observer at the mercy of the professionals' knowledge and guidance. The VE procedure evoked concerns over the mother's and the child's safety and wellbeing, even if the fathers wanted the birth process to be over. The fathers considered the choice of conducting a VE as an adequate alternative, but they expressed concerns about consequences on future decisions. The theme encompasses all the main categories: wish to be involved, anxious observer, turbulent feelings and thoughts about consequences. Conclusions VE delivery has a strong emotional impact on fathers and the procedure is often experienced as a dramatic way to end a birth and an ultimate way to terminate a long birth process. The results indicate that a lack of support and of a genuine opportunity to participate, as well as the mother's pain impair their experience, not the VE delivery, per se. [ABSTRACT FROM AUTHOR]

Objective: the aim of this study is to gain a deeper understanding of a woman's internal factors and factors in her environment that are important for a normal birth and a positive birth experience. Design/setting: a qualitative approach was selected for data collection, and the data presented are derived from in-depth interviews. Twelve healthy first time Norwegian mothers, aged 22-34, with a normal childbirth and a positive birth experience were interviewed five to six weeks after giving birth. All participants had given birth at a maternity unit, where 4000 births take place per year. The transcribed interviews were analysed through systematic text condensation. Findings: the findings included two main themes: safe environment and emotional strength. Stability in everyday life and close relationships provided the women with the safe environment they needed. The women had a positive attitude to childbirth and they had all previously developed coping strategies. They highlighted that these acquired coping strategies contributed to higher emotional strength and a positive birth experience. Conclusions: the women experienced that a safe environment and network contributed to a sense of trust and emotional strength, which were positive factors promoting a normal birth and a positive birth experience. The women had a positive attitude towards the birth and used acquired coping strategies to deal with it, which in turn led to a positive birth experience. The natural vision the women had in connection with childbirth was part of their antenatal preparation, which also contributed to a positive experience of childbirth. [ABSTRACT FROM AUTHOR]

Background A range of alternatives in pain management during childbirth are available in the western countries. Women's preferences for and use of pain relief methods during labour is not fully investigated. The aim of this study was to describe what pain relief methods pregnant women preferred when asked in late pregnancy and to identify factors associated with preferred and received pain relief methods. Methods A prospective longitudinal study in a northern region of Sweden (n = 936). Data were collected by three questionnaires. Odds ratios with a 95% confidence interval were calculated between preferred and received pain relief methods for several explanatory variables. Findings The most preferred pain relief methods were also the most common received pain relief methods; nitrous oxide, bathing, breathing techniques, epidural analgesia and massage. The strongest factors for using different pain relief methods were primiparity and preferences. Women who used epidural analgesia, regardless of preference, were two to four times more likely to have a less positive birth experience. Conclusions Women's preferences for a certain pain relief method were largely met. Greater differences were seen between background factors and preferences than the received pain relief methods. Preferences and primiparity were the most important factors for actually using pain relief. Epidural analgesia was associated with a less positive birth experience. [ABSTRACT FROM AUTHOR]

To evaluate women and partners' experience of birth in a "birth environment room" compared to a standard birth room. A single centre parallel randomised controlled trial. Women and partners were enrolled during a 3-year period (May 2015 to March 2018). The Department of Obstetrics and Gynaecology at Herning Hospital, Denmark. A total of 680 Danish speaking nulliparous women, more than 18 years old, with a singleton pregnancy in cephalic presentation, and a spontaneous onset of labour, and their partners were randomly assigned to give birth in a "birth environment room" (n = 340) or in a standard birth room (n = 340) on arrival at the birth unit. Outcomes were the overall birth experience and overall satisfaction with care, measured on a Likert scale, obtained in the postpartum questionnaire sent to the women 6 weeks after birth and to their partners 1/2 weeks after birth. Other outcomes were "staff support for partner", "undisturbed contact with new-born", "feeling of being listened to", "level of information", "attention to psychological needs", "suggestions for pain-relief", "participation in decision-making", "midwife present when wanted", "support from midwife", "birth wishes were met", "loss of internal control" (only women), "loss of external control", "support from partner" (partners: "being supportive for partner"), "importance of physical environment for birth" and "importance of physical environment for staff´s ability to involve the women" (only women). All outcomes were prespecified. We applied Mann Whitney U test for comparing the two groups. Data were collected from 326 women and 236 partners in the intervention group and from 315 women and 209 partners in the control group. The intention-to-treat analysis revealed no difference in the overall experience of birth for women or partners (p 0.81 and p 0.17, respectively). Partners in the intervention group reported more overall satisfaction with care compared to partners in the control group (p 0.048). In the intervention group, fewer women and partners responded they had not had the opportunity for undisturbed contact with their new-born in the first hours after birth (RR 0.19 (95% CI 0.04-0.87) and OR 0.00 CI (0.00–0.83), respectively). Otherwise, there were no differences between groups. The thematic analysis revealed that many women and partners felt they were not able to benefit from the features in "the birth environment room" in the most intense hours of birth. "The birth environment room" did not improve the overall experience of birth for women and partners. Partners in the intervention group were overall more satisfied with care. These findings are of importance in the developing of physical birth environments that support the mental/emotional process of labour. [ABSTRACT FROM AUTHOR]

The principal goal of this study was to examine risk factors for postpartum posttraumatic stress disorder (PTSD), such as mode of birth, obstetric violence and medical interventions during labor, in Russia. This study is also the first attempt to investigate the association between the support during labor and postpartum PTSD in a Russian sample. 611 Russian-speaking mothers aged 18 to 45 years (M = 31.2 + 4.5) filled in the online form, which included Edinburgh Postnatal Depression Scale, the City Birth Trauma Scale and survey on demographic characteristics and childbirth experience within one year after birth. Among the participants 45.7% had clinically significant depressive symptoms and 15% fulfilled all the diagnostic criteria for PTSD. Postpartum PTSD symptoms were higher among women who had a cesarean vs vaginal birth (p = 0.009), women with medical interventions (p = 0.043) and women who experienced obstetric violence (p < 0.001) during childbirth. The more interventions they had and the more instances of obstetric violence they experienced, the higher were the PTSD symptoms (B = 1.03, 95% CI 0.23; 1.84, p = 0.012 and B = 5.08, 95% CI 3.80; 6.37, p < 0.001, respectively). The presence of a partner or a personal midwife/doula at birth was associated with lower rates of cesarean birth, fewer medical interventions and less obstetric violence (p < 0.017 for all). Postpartum PTSD is widespread in Russia, and the problem of obstetric violence and overuse of medical interventions has a systematic nature. Increased availability of individual continuous support during labor and the development of professional midwife and doula communities might be a potential avenue to address these problems. Our findings emphasize the importance of ethics in patient-doctor communication in the maternal healthcare system and the role of support during labor, which is still not widely available in Russia. [ABSTRACT FROM AUTHOR]

• Continuity models of care is 'best evidence' although not implemented to a large extent in Sweden. • There might be a gap between women's birth expectations and experiences. Hence, it is important to investigate and follow up the fulfilment of birth expectations. • Pregnant women's expectations about continuity and postnatal home visits are largely unmet. The fulfilment of birth expectations is important to women and strongly related to birth satisfaction. The aim of this study was to investigate women's expectations and experiences of birth and the postnatal period and associated factors. An additional aim was to explore if women's expectations were fulfilled. A longitudinal cohort study of 280 women where 226 were followed up two months after birth. Data were collected using questionnaires. Odds ratios with a 95% confidence interval were calculated between the explanatory background variables and expectations/experiences. The majority (79%) rated continuity as important, but few (32%) actually had a known midwife assisting during birth. Positive birth expectations were found in 37% and a positive birth experience in 66%. Many women (56%) preferred a short postnatal stay, and 63% went home within 24 h. Thirty-six percent preferred postnatal home visits, but only eight women (3.5%) received this. Breastfeeding expectations were high with 86% rating it as important but after birth 63% reported exclusively breastfeeding. Only a few background factors were associated with women's expectations and experiences. Most likely to be fulfilled were women's expectations for a vaginal birth (83%), a positive birth experience (71%) and short length of postnatal stay (67%). Postnatal home visits (96%) and continuity of care (73%) were not fulfilled. Pregnant women's expectations about continuity are fulfilled only to a minor degree. The fulfilment of postnatal expectations varied and the preference for a short postnatal stay was fulfilled whereas home visits were not. [ABSTRACT FROM AUTHOR]

Objective: validated questionnaire assessment of fathers' experiences during childbirth is lacking in routine clinical practice. Salmon's Item List is a short, validated method used for the assessment of birth experience in mothers in both English- and German-speaking communities. With little to no validated data available for fathers, this pilot study aimed to assess the applicability of the German version of Salmon's Item List, including a multidimensional birth experience concept, in fathers. Design: longitudinal study. Data were collected by questionnaires. Setting: University hospital in Germany. Participants: the birth experiences of 102 fathers were assessed four to six weeks post partum using the German version of Salmon's Item List. Measurements: construct validity testing with exploratory factor analysis using principal component analysis with varimax rotation was performed to identify the dimensions of childbirth experiences. Internal consistency was also analysed. Findings: factor analysis yielded a four-factor solution comprising 17 items that accounted for 54.5% of the variance. The main domain was 'fulfilment', and the secondary domains were 'emotional distress', 'physical discomfort' and 'emotional adaption'. For fulfilment, Cronbach's a met conventional reliability standards (0.87). Key conclusions: Salmon's Item List is an appropriate instrument to assess birth experience in fathers in terms of fulfilment. Larger samples need to be examined in order to prove the stability of the factor structure before this can be extended to routine clinical assessment. Implications for practice: a reduced version of Salmon's Item List may be useful as a screening tool for general assessment. [ABSTRACT FROM AUTHOR]

to explore first-time Italian parents' expectations of labour and birth. qualitative Husserlian phenomenological approach, using face-to-face focus groups for parents during the late third trimester of pregnancy. Data analysis, using Colaizzi's phenomenological method, included the processes of reading and re-reading the text to extract relevant statements in order to identify themes and finally member checking was performed to validate participants' expressions consultant-led maternity unit in Northern Italy, with approximately 2500 births per annum. purposive sample of eight first-time parents-to-be, with a straightforward singleton pregnancy, who participated in two focus groups during pregnancy, one for women and one for their partners, to explore their expectations of birth. uncertainties, doubts and fears were reported by all women. Although they expected to have a normal birth, they remained open-minded due to the awareness of the unpredictable nature of childbirth. One of the strongest emotions expressed by women was that of fear, especially of labour. They found different strategies to cope with those fears and to anticipate their potential disappointment and frustration regarding a childbirth experience that potentially could differ from their expectations. Women wanted their partner with them to share the birth experience and they valued their presence as essential. The midwife was expected to be a supportive guide. Fathers-to-be, although happy about the idea to be present at birth, were also concerned about their reaction to an unknown experience, about the woman's labour pain and were worried about not being helpful to her. to our knowledge this is the first such study to be conducted in Italy. In order to support families as a whole, the importance of the father in a supportive role and as an essential parent himself should be addressed, considering his wishes. Midwives should strive to provide family centre-care, to be supportive and sensitive. Antenatal education classes should be conducted with both parents in order to understand their expectations, give information about duration and stages of labour and birth, prepare for parenthood, addressing fears and enhancing a positive experience of birth. [ABSTRACT FROM AUTHOR]

Objective: the aim of the present study was to gain a deeper understanding of how relational continuity in the childbearing process may influence the woman's birth experience. Research design/setting: a Q-methodological approach was chosen, as it allows the researcher to systematically assess subjectivity. 23 women were invited to sort a sample of 48 statements regarding their subjective view of birth experience after having participated in a pilot project in Norway, where six midwifery students provided continuity of care to 58 women throughout the childbearing process. The sorting patterns were subsequently factor-analysed, using the statistical software 'PQ' which reveals one strong and one weaker factor. The consensus statements and the defining statements for the two factors were later interpreted. Findings: both factors seemed to represent experiences of psychological trust and a feeling of team work along with the midwifery student. Both factors indicated the importance of quality in the relation. Factor one represented experiences of presence and emotional support in the relationship. It also represented a feeling of personal growth for the women. Factor two was defined by experiences of predictability in the relation and process, as well as the feeling of interdependency in the relation. According to quality in the relation, women defining factor two experienced that the content, not only the continuity in the relation, was important for the birth experience. Key conclusions: relational continuity is a key concept in the context of a positive birth experience. Quality in the relation gives the woman a possibility to experience positivity during the childbearing process. Continuity in care and personal growth related to birth promote empowerment for both the woman and her partner. Relational continuity gives an opportunity for midwives to provide care in a more holistic manner. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To explore fear of childbirth (FOC) during pregnancy and one year after birth and its association to birth experience and mode of delivery. Design: A longitudinal population-based study. Population: Pregnant women who were listed for a routine ultrasound at three hospitals in the middle-north part of Sweden. Method: Differences between women who reported FOC and who did not were calculated using risk ratios with a 95% confidence interval. In order to explain which factors were most strongly associated to suffer from FOC during pregnancy and one year after childbirth, multivariate logistic regression analyses were used. Results: FOC during pregnancy in multiparous women was associated with a previous negative birth experience (RR 5.1, CI 2.5–10.4) and a previous emergency caesarean section (RR 2.5, CI 1.2–5.4). Associated factors for FOC one year after childbirth were: a negative birth experience (RR 10.3, CI 5.1–20.7), fear of childbirth during pregnancy (RR 7.1, CI 4.4–11.7), emergency caesarean section (RR 2.4, CI 1.2–4.5) and primiparity (RR 1.9, CI 1.2–3.1). Conclusion: FOC was associated with negative birth experiences. Women still perceived the birth experience as negative a year after the event. Women''s perception of the overall birth experience as negative seems to be more important for explaining subsequent FOC than mode of delivery. Maternity care should focus on women''s experiences of childbirth. Staff at antenatal clinics should ask multiparous women about their previous experience of childbirth. So that FOC is minimized, research on factors that create a positive birth experience for women is required. [Copyright &y& Elsevier]

Abstract: Objective: the aim of this study was to gain knowledge and a deeper understanding of the value attached by parents to relational continuity provided by midwifery students to the woman and her partner during the childbearing process. The focus of the study was on the childbirth and the postnatal home visit. Design/setting: in this pilot project by researchers at Sør-Trøndelag University College, Norway, six midwifery students provided continuity of care to 58 women throughout their pregnancy, birth and the postnatal period. One group interview of eight women and two group interviews of five men, based on the focus group technique, were conducted at the end of the project. Qualitative data were analysed through systematic text condensation. Findings: the findings included two main themes: ‘trusting relationship’ and ‘being empowered’. The sub-themes of a ‘trusting relationship’ were ‘relational continuity’ and ‘presence’. For the women, relational continuity was important throughout the childbearing process, but the men valued the continuous presence during birth most highly. ‘Being empowered’ had two sub-themes: ‘individual care’ and ‘coping’. For the women, individual care and coping with birth were important factors for being empowered. The fathers highlighted the individual care as necessary to feel empowered for early parenting. The home visit of the student was highly appreciated. The relationship with the midwifery student could be concluded, and they had the opportunity to review the progression of the birth with the student who had been present during the birth. During the home visit, the focus was more on the experiences of pregnancy and birth than on what lay ahead. Key conclusions: when midwifery students provided continuous care during pregnancy, birth and the postnatal period, both women and men experienced a trusting relationship. Relational continuity was important for women in the entire process, but for the men this was mostly important during childbirth. Individual care and coping with birth and early parenting enhanced empowerment. The limited sample size in this study means that it cannot be generalised without caution, and further research is needed. [Copyright &y& Elsevier]

Abstract: Background: While attending birth mostly has a positive impact on becoming a father, it has also been described as including feelings of discomfort and is more demanding than expected. Objective: The objective was to explore Swedish fathers’ birth experiences, and factors associated with a less-positive birth experience. Methods: Mixed methods including quantitative and qualitative data were used. Two months after birth 827 fathers answered a questionnaire and 111 (13%) of these commented on the birth experience. Data were analysed with descriptive statistics, chi-square test for independence, risk ratios with a 95% confidence interval, logistic regression and content analysis. Results: In total, 604 (74%) of the fathers had a positive or very positive birth experience. Used method identified a less-positive birth experience associated with emergency caesarean section (RR 7.5; 4.1–13.6), instrumental vaginal birth (RR 4.2; 2.3–8.0), and dissatisfaction with the partner’s medical care (RR 4.6; 2.7–7.8). Healthcare professionals’ competence and approach to the fathers were also related to the birth experience. Conclusions: As the fathers’ birth experiences were associated with mode of birth and experiences of the intrapartum medical care fathers should be respectfully and empathically treated during labour and birth. It is essential to better engage fathers during the intrapartum period through involvement and support to improve the likelihood of a positive birth experience. [Copyright &y& Elsevier]

Abstract: Background: Parental stress has been recognized as a problem despite governmental support of parent education programs aiming to prepare parents for parenthood. Aim: to compare parents who underwent a mental training program during pregnancy with a control group to measure feelings and experiences during pregnancy and birth and perceived parental stress. Methods: A comparative pilot study of 46 self-selected parents who underwent a mental training program during pregnancy, and 1408 parents living in the same catchment area (control group). Data was collected in mid-pregnancy, 2months and 1year after birth. The main outcome was parental stress. Results: Parents in the mental training group were more often expecting their first baby and had a higher level of education compared to parents in the control group. Parents participating in the mental training program had less positive feelings about expecting a baby (OR 14.0; 6.7–29.3), the upcoming birth (OR 2.0; 1.1–3.8) and the newborn baby (OR 3.1; 1.6–6.2). Parents who attended the mental training program attended an antenatal parent education to a higher degree (OR 2.0; 1.6–2.4) and were more likely to stay in contact with other participants in the antenatal education (OR 4.1; 1.9–8.6). Mothers in the mental training program used psycho prophylaxis to a higher extent (OR 3.0; 1.2–7.1) There was no difference in the birth experience or the perceived parental stress. Conclusion: Participating in a mental training program for birth and parenthood was not associated with the birth experience or the assessment of parental stress 1year after birth. [Copyright &y& Elsevier]

For the First Nation peoples of Canada, birthing a baby was always part of sacred cultural practices and religious traditions. The birth of a baby was a spiritual experience that required certain ceremonies welcoming the child and protecting the life of the mother and child. The prenatal experience was grounded in the teachings that new mothers received from their mothers, grandmothers, and aunts. What they ate, what they were allowed to do while pregnant, and what ceremonies were needed as preparation for the birthing experience were taught to Aboriginal women by their mothers and elders. [ABSTRACT FROM AUTHOR]

Abstract: Objective: More than 10% of all planned home births in high-income countries are completed in the hospital. The aim of this study was to compare the birth experiences among women who planned to give birth at home and completed the birth at home and women who were transferred to hospital during or immediately after the birth. Methods: All women in Sweden who had a planned home birth between 1998 and 2005 (n =671) were invited to participate in the study. The women who agreed to participate received one questionnaire for each planned home birth. Mixed methods were used for the analysis. Results: Women who had been transferred during or immediately after the planned home birth had a more negative birth experience in general. In comparison with women who completed the birth at home, the odds ratio for being less satisfied was 13.5, CI 8.1–22.3. Reasons for being dissatisfied related to organizational factors, the way the women were treated or personal ability. Conclusion: Being transferred during a planned home birth negatively affects the birth experience. Treatments as well as organizational factors are considered to be obstacles for a positive birth experience when transfer is needed. Established links between the home birth setting and the hospital might enhance the opportunity for a positive birth experience irrespective of where the birth is completed. [Copyright &y& Elsevier]