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The aim of this study was to explore women's preferences and experiences of degree of control in decision making when planning an induction of labor (IOL). This multi‐method study was conducted using semi‐structured individual interviews and the completion of two Control Preferences Scales by eight postnatal women from a metropolitan health service in Melbourne, Australia. Four themes were generated from the interview data: "shared decision making"; "changing expectations"; "IOL experience"; and "informed consent." Women's expectations of, and preferences for, an IOL changed during pregnancy and were influenced by their perception of risk to the fetus, indication for the procedure, and trust in clinicians. Information that was personalized to the woman to include practical aspects, risks, and alternative options was rarely provided. Overall, women reported that they did not experience the degree of control they preferred when planning an IOL. Clinician understanding of decision making preferences of women when planning an IOL can assist with care that is individualized and aligned to women's values, which is crucial to improving the quality of care provided. [ABSTRACT FROM AUTHOR]

Summary: This cross‐sectional study investigated the effect of maternal sleep quality in late pregnancy on prenatal, birth and early postnatal outcomes. The research was conducted in three parts with women at 28 or more weeks of gestation. In the first part, pregnant women admitted for delivery were evaluated in terms of eligibility criteria. Pregnant women in the latent phase of labour completed the Prenatal Questionnaire. In the second part, labour follow‐up was performed. The researchers completed the Birth Follow‐up Questionnaire based on observations and hospital birth records. In the third part, mothers were interviewed between the 12th and 24th hour of postnatal. Participants filled out the Postnatal Questionnaire, the Childbirth Experience Questionnaire, and the Pittsburgh Sleep Quality Index (n = 385). The data were analysed using the chi‐square independence test, Fisher test, independent samples t‐test, effect sizes, and binary logistic regression analysis. Participants had a mean maternal sleep quality score of 4.00 ± 1.38. They slept for 7.53 ± 0.92 hr on average. One‐third of the participants were poor sleepers (32.2%). Employed participants were 71.6% less likely to have poor maternal sleep quality than their non‐employed counterparts (odds ratio = 0.29, 95% confidence interval: 0.13–0.62; p = 0.002). The odds of poor maternal sleep quality increased by 13.7% when maternal weight gain during pregnancy increased by 1 kg (odds ratio = 1.14, 95% confidence interval: 1.03–1.26; p = 0.014). Increased maternal sleep quality positively affected the birth process (p < 0.05). Healthcare professionals should routinely screen the maternal sleep quality of pregnant women and increase their sleep hygiene. [ABSTRACT FROM AUTHOR]

This descriptive qualitative study aimed to understand the feelings and thoughts experienced by 4th year midwifery students during the first birth they attended during clinical practice. Focus group interviews were conducted with 22 final year midwifery students in Istanbul, Türkiye December 2020. The transcribed data were analyzed by the descriptive qualitative analysis method. The students experienced not only negative feelings such as fear, torment, anxiety but also positive feelings such as hope, excitement, and curiosity during the first birth practice. The situations that caused negative feelings and thoughts were not only the feelings of the students but also the conditions that negatively affected the care provided to the patient in the clinic. The clinical practice environment affects the feelings and thoughts of midwifery students about the birth process. For this reason, improving the clinical practice environment and supporting students throughout the education process may contribute to the development of positive feelings and thoughts when attending as a student for their first birth suite placement. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the risk factors for a negative birth experience using the Birth Satisfaction Scale‐Revised (BSS‐R) questionnaire. Methods: A cross‐sectional study including women who gave birth at a single tertiary hospital between February 2021 and January 1, 2022. Birth satisfaction was measured using the BSS‐R questionnaire. Maternal, pregnancy, and delivery characteristics were collected. Negative birth experience was defined as a BSS‐R score lower than the median. Multivariable regression analysis was used to examine the association between birth characteristics and negative birth experience. Results: A total of 1495 women answered the questionnaire and were included in the analysis; 779 women comprised the positive birth experience group and 716 women comprised the negative birth experience group. Prior deliveries, prior abortions, and smoking (adjusted odds ratio [aOR], 0.52 [95% confidence interval (CI), 0.41–0.66]; aOR, 0.78 [95% CI, 0.62–0.99]; aOR, 0.52 [95% CI, 0.27–0.99], respectively) were independently associated with lower risk of negative birth experience. Immigration, answering the questionnaires in person, and cesarean delivery were independently associated with increased negative birth experience risk (aOR, 1.39 [95% CI, 1.01–1.86]; aOR 1.37 [95% CI, 1.04–1.79]; aOR, 1.92 [95% CI, 1.52–2.41], respectively). Conclusion: Parity, prior abortions, and smoking were associated with a lower risk of negative birth experience, while immigration, answering questionnaires in person, and cesarean delivery were associated with a higher risk of negative birth experience. Synopsis: Risk factors for a negative birth experience using the Birth Satisfaction Scale‐Revised (BSS‐R) include parity, prior abortions, immigrant status, answering the questionnaire in person, and cesarean delivery. [ABSTRACT FROM AUTHOR]

In this paper we explore whether mental representations about birth (birth‐related mindsets) assessed during pregnancy can predict labour and birth in the sense that the perception of birth as a natural (rather than a medical) event increases the probability of a low‐intervention birth. Birth, in turn, might affect short‐term and long‐term psychological well‐being. These assumptions were tested in a longitudinal study (N = 311), spanning the first half of pregnancy and up to 6 months after birth. The results of a single indicator model displayed a sequential process: women who held a more natural mindset prenatally were more likely to have low‐intervention births, which resulted in a more positive evaluation of the birth experience, which in turn predicted well‐being in the first weeks after birth (measured with ecological momentary assessment), and subsequently postpartum depression and post‐traumatic stress symptoms 8 weeks after birth as well as mother‐infant bonding 6 months after birth. The study demonstrates the relevance of psychological factors for childbirth. The construct of a birth‐related mindset could contribute to a better understanding of childbirth and help to make women's birth experiences safer and more satisfying and to improve the transition to motherhood. [ABSTRACT FROM AUTHOR]

Aim: Critical to maternal outcome and development of a healthy and relationship between mother and baby, is the woman's perception of her birth experience. The Birth Satisfaction Scale‐Revised (BSS‐R) has been demonstrated to be psychometrically robust, easily administered, and scored self‐report measure of birth experience. Aim of the study was to translate the UK‐BSS‐R into Hindi, collect data, and psychometrically validate an Indian (Hindi)‐BSS‐R. Methods: Psychometric assessment of the Indian (Hindi)‐BSS‐R was undertaken following translation using a cross‐sectional design. Evaluation of known‐groups validity was undertaken using an embedded between‐subjects component. Data were collected from (n = 312) postnatal Hindi speaking women in India. Measurement characteristics were assessed using confirmatory factor analysis, divergent validity and internal consistency analysis. Results: The measurement properties of the Indian (Hindi)‐BSS‐R were observed to be equivocal, with the established tri‐dimensional measurement model not achieving best fit to data. Instead, an alternative two‐factor model offered an excellent fit to data. Significant differences were observed between Indian (Hindi)‐BSS‐R scores and family type and gestation term status, which highlights the relevance of these contextual aspects to the Indian birth experience. Internal consistency was observed to be low on some sub‐scales, indicating the potential need for future revision. Conclusions: The Indian (Hindi)‐BSS‐R is a measure of birth experience, which accepting some measurement caveats, is acceptable for use with Hindi speaking women in India. Further research is required to determine if modification of some of the items is required to improve internal consistency. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) and related maternal mood disorders affect anywhere from 7% to 19% of postpartum women. Although historically a neglected issue, there has been a strong impetus in the past few decades to implement routine, universal screening and to address PPD as a major public health concern. Still, there has been relatively little analysis of how the quality of the birth experience influences subsequent maternal mental health. We examine the relationship between perceived birth experience and two PPD screeners (Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale). Methods: Data came from waves I and II of the Listening to Mothers data set. This is the only national survey of US women's childbirth and postpartum experiences. In logistic and linear regression models, we used a 12‐item "feeling" index (perceived birth experience) to predict (a) overall PPD screener scores, and (b) likelihood of meeting the clinical cutoff for depression risk. We also controlled for other known socio‐demographic and obstetric risk factors. Results: Perceived birth experience strongly and consistently predicted both PPD screener measures, and in both forms—raw scores and clinical cutoffs. By contrast, other known risk factors had inconsistent results across the two screeners. Discussion: Perceived birth experience should be considered more central in assessing PPD. It may also be more robust than the PPD screeners used in practice, and therefore, could be a more reliable predictor of PPD. Providers should consider how the improved social‐psychological quality of women's birth experience can act as a buffer to PPD and other postpartum concerns. [ABSTRACT FROM AUTHOR]

Objectives: To compare in the early postpartum the perinatal experience during a COVID‐19 related lockdown ('lockdown' group) and a pandemic control group subject to looser restrictions. Design and setting: This national multicentre prospective cohort study took place in four French maternity units. Population: Women were recruited during the postpartum stay for the lockdown and pandemic control groups, according to their enrolment period. Both faced the same labour and delivery restrictions but only the pandemic control group could have a postpartum visitor. Main outcome measures: The primary outcome was the perinatal experience during childbirth, assessed by the Labour Agentry Scale (LAS) self‐administered questionnaire, completed before discharge. Results: The study included 596 women and analysed 571 of them: 260 in the lockdown group and 311 in the pandemic control group. The mean LAS score was lower in the lockdown group (161.1 ± 26.8, 95% confidence interval [CI] 157.8–164.3 versus 163.3 ± 24.0, 95% CI 160.6–166.0; P = 0.289). In multivariable analysis, the LAS score was lower in the lockdown group (−6.2 points, P = 0.009), in women with caesarean (−21.6 points, P < 0.001) versus spontaneous deliveries, and among women financially impacted by the lockdown (−6.4 points, P = 0.007) or who experienced restrictions during childbirth (−8.1 points, P < 0.001). The LAS score rose with the prenatal care quality score (P < 0.001). Conclusions: The perinatal experience was more negatively affected by lockdown restrictions than by the looser pandemic restrictions for controls, but mode of delivery remained the main factor influencing this experience. Perinatal experience, while most affected by caesarean, was worse in lockdown than later in the pandemic. [ABSTRACT FROM AUTHOR]

Aims: To explore and describe Myanmar student midwives' perceptions of professional learning using storytelling videos of women's childbirth experiences by conducting a qualitative study and to assess potential pedagogical uses of storytelling videos in midwifery education. Methods: This pilot study used a qualitative content analysis study design implemented as part of the Diversity and commonalities of birth from women's voice sharing project of the Toyota Foundation. Storytelling videos of the childbirth experiences of seven Asian women (three Myanmar, three Lao, and one Japanese women) were viewed by the students. Thereafter, a semistructured interview with focus group discussion was conducted to explore and assess the students' perceptions. Setting: Kyaing Tong township, Shan State, Myanmar. Participants: Five second‐year midwifery students from a single midwifery training school in Myanmar. Results: Data analysis of their perceptions yielded four major categories: (1) deep reverence for women/mothers;; (2) respectful attitude as a midwife to support mothers; (3) wish for a safe and secure birth environment; and (4) importance of learning from the mother's voice. Conclusions: The student midwives realized the importance of listening to the mothers' voices regardless of the nationalities or cultural background. The findings indicated that the storytelling videos broadened the students' perspectives of pregnancy and childbirth, and motivated them to provide better maternity care. Storytelling videos of childbirth experiences can be powerful educational materials for enhancing professional learning of student midwives. [ABSTRACT FROM AUTHOR]

Psychological research on childbirth is rare, even though research from other scientific fields such as obstetrics or midwifery highlights the importance of psychological factors in childbirth. In this article, the theoretical construct of a birth‐related mindset and direct and indirect measures for assessing the mindset are proposed. It is assumed that childbirth can be mentally presented as a rather natural (natural mindset) or a rather medicalized (medicalized mindset) event. In three online studies (Study 1: N = 117, Study 2: N = 206, Study 3: N = 192), we aimed to explore whether the proposed birth‐related mindset is related to the retrospectively reported process of labor and birth (operationalized, e.g., by performed interventions, duration of birth, place of birth). For this, the relation between the mothers' birth‐related decisions and outcomes of childbirth and the mothers' birth‐related mindsets were analyzed. Results indicated that (1) birth‐related criteria such as place of birth, epidural anesthesia, and C‐sections were associated with the birth‐related mindset, (2) these aspects of the delivery were related to the evaluation of the birth (birth experience), (3) the birth‐related mindset moderated the relationship between C‐section and birth experience, and (4) the indirect measures had little to no added explanatory value to the developed Mindset and Birth Questionnaire. Thus, the results indicate that the birth process experienced by the women and the mental representations of birth (birth‐related mindset) are closely related. Future studies need to investigate to what extend the experienced birth process influences the mindset of birth, or the mindset the experienced birth process, or both. [ABSTRACT FROM AUTHOR]

Labor and birth constitute a significant emotional event for a childbearing woman. The aim was to explore women's reflections on their experiences of labor and birth and how these were influenced by the midwifery care they received. A modified version of Noblit and Hare's meta‐ethnographic approach was used to develop an inductive and interpretive synthesis of nine qualitative articles. Relevant databases were searched and qualitative articles appraised by means of the Critical Appraisal Skills Program. Two metaphors were identified: The guide–Please share your knowledge and The motherly midwife as an anchor. The comprehensive understanding of the images evoked by the metaphors resulted in an overall metaphoric representation of the women's experiences: The midwife as a birth pilot, that is, a positive labor and birth experience is dependent on the relationship with the midwife. This finding confirms previous knowledge that a trusting relationship results in confidence, while feeling secure leads to a positive birth experience. The metaphors facilitate understanding of the significance of the midwife for women's labor and birth experiences. Knowledge of labor and birth experiences helps to broaden understanding of the necessity of midwives being willing to engage, act, be aware of errors that may affect women's birth experience, and employ tools to predict unexpected adverse events. [ABSTRACT FROM AUTHOR]

Introduction: Various biopsychosocial factors affect women's preferences with respect to mode of birth, but they are usually not examined simultaneously and prospectively. In the current study, we assessed the contribution of personal characteristics of first‐time mothers, their prior prenatal perceptions, events during birth, and subjective birth experiences, on their preference about mode of second birth. Methods: This was a secondary analysis of two prospective birth cohort studies. Participants included 832 primiparous women recruited mostly from women's health centers in Israel, and through natural birth communities and cesarean birth websites. Women completed questionnaires prenatally and were followed up at 6‐8 weeks postpartum to understand their preferences for a second birth. Results: Regression models indicated that after vaginal first birth, being less religious, believing that birth is a medical process, and having a negative experience increased the odds of preferring primary cesarean for the second birth. After cesarean birth, being more religious, having higher education, conceiving spontaneously, having a more negative birth experience, and perceiving better treatment from the staff during birth contributed to preferring vaginal birth for the second birth. Conclusions: Religiosity is central to women's preferences, probably because of its association with the desire to have many children. Modifiable factors, such as women's beliefs about the nature of birth, their overall birth experience, and their perceived treatment from the staff, could influence the uptake of having vaginal births. Intrapartum care that is empathic and encouraging, along with education about modes of birth, could help decrease cesarean birth rates. [ABSTRACT FROM AUTHOR]

Background: This study investigated the surrogates' birth experiences, their levels of emotional struggle at relinquishment, how often they thought about the surrogacy children, and the surrogate–parent relationship dynamics during pregnancy and post‐birth. Methods: Data were collected from 06/2016 to 02/2017 using an anonymous questionnaire. Participants were Canadian gestational surrogates who had completed the process with or without a successful live birth, and who were at various stages of an ongoing surrogacy. For this paper, only a subgroup of cases with a successful live birth was selected for analysis. Results: The data set included 131 births involving 90 surrogates who delivered 157 babies (105 singletons and 26 sets of twins). Their mean age at the time of surrogacy was 31.7 ± 5 years (range: 21‐47y). More than one‐third (37.4%) of the cases were for intended parents who were same‐sex male couples and single men. Surrogates assisting Canadian‐resident intended parents had an overall better birthing experience compared with those assisting nonresidents. There was none or very little struggle with the relinquishment of the baby in 96.9% of cases. Continued contact with parents after the births was reported in 93.0% of cases. Surrogates were significantly more likely to have frequent post‐birth contact with same‐sex and single fathers compared with heterosexual parents and single mothers (76.6% vs 54.3%). Conclusions: Same‐sex male couples and single men can develop a long‐lasting relationship with their surrogates even when no intended female partners are involved. The development of institutional practice guidelines in standardizing surrogacy birth practice is paramount in optimizing surrogates' care. [ABSTRACT FROM AUTHOR]

Introduction: About 8% of the pregnant women in Sweden receive counseling for fear of childbirth (FOC) during pregnancy. Little is known about the long-term reproductive and obstetric outcomes after counseling for FOC: Therefore, the objective of this historical cohort study was to compare the long-term reproductive and obstetric outcomes in women treated for FOC in their first pregnancy to women without FOC.Material and Methods: All nulliparas consecutively referred for treatment of severe FOC between 2001 and 2007 (n = 608) were compared with all other nulliparas giving birth on the same day (n = 431). Women who were not fluent in Swedish, missing a postal address, had moved out of the area, given birth at another hospital or had a late spontaneous abortion were excluded (n = 555). A total of 235 women agreed to participate in the study, 63 (39%) women in the index group and 172 (53%) in the reference group. The women were contacted by letter in 2015, ie 7-14 years after first childbirth, and asked to permit access to their medical charts from pregnancies and childbirths and to fill out a study specific questionnaire. Based on data from the medical charts and questionnaire, the mode of delivery, birth experience, obstetric complications, FOC, counseling for FOC and number of childbirths were compared in the two groups.Results: Women in the index group less often gave birth more than twice compared with the reference group (8.2% vs 22.0%, P = 0.012). We found no significant differences in complications during subsequent pregnancies and deliveries. Women in the index group more often gave birth by CS in their first (P = 0.002) and second childbirth (P = 0.001), more often had a less positive birth experience (index group NRS: median 6.0, interquartile range 6 vs reference group NRS: 7.0, interquartile range 5, P = 0.004) in their first delivery and more often received counseling for FOC (58.7% vs 12.5%, P < 0.001) in subsequent pregnancies. Women in the index group more often experienced FOC (18% vs 5.3%, P = 0.001) 7-14 years after first childbirth.Conclusions: FOC is not easily treated. Despite treatment and exposure to childbirth many women received treatment in their next pregnancy and still suffered from FOC 7-14 years after the first childbirth. [ABSTRACT FROM AUTHOR]

Abstract: Background: Childbirth is an important life event and how women feel in retrospect about their first childbirth may have long‐term effects on the mother, child, and family. In this study, we investigated the association between mode of delivery at first childbirth and birth experience, using a new scale developed specifically to measure women's affective response. Methods: This was a prospective cohort study of 3006 women who were interviewed during pregnancy and 1‐month postpartum. The First Baby Study Birth Experience Scale was used to measure the association between mode of delivery and women's postpartum feelings about their childbirth, taking into account relevant confounders, including maternal age, race, education, pregnancy intendedness, depression, social support, and maternal and newborn complications by way of linear and logistic regression models. Results: Women who had unplanned cesarean delivery had the least positive feelings overall about their first childbirth, in comparison to those whose deliveries were spontaneous vaginal (P < .001), instrumental vaginal (P = .001), and planned cesarean (P < .001). In addition, those who delivered by unplanned cesarean were more likely to feel disappointed (adjusted odds ratio [OR] 6.21 [95% confidence interval (CI) 4.62‐8.35]) and like a failure (adjusted OR 5.09 [95% CI 3.65‐7.09]) in comparison to women who had spontaneous vaginal delivery; and less likely to feel extremely or quite a bit proud of themselves (adjusted OR 2.70 [95% CI 2.20‐3.30]). Conclusions: Delivering by unplanned cesarean delivery adversely affects how women feel about their first childbirth in retrospect, and their self‐esteem. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of primary midwife-led care ('caseload midwifery') on women's experiences of childbirth.Design: Randomised controlled trial.Setting: Tertiary care women's hospital in Melbourne, Australia.Population: A total of 2314 low-risk pregnant women.Methods: Women randomised to caseload care received antenatal, intrapartum and postpartum care from a primary midwife, with some care provided by a 'back-up' midwife. Women in standard care received midwifery-led care with varying levels of continuity, junior obstetric care or community-based medical care.Main Outcome Measures: The primary outcome of the study was caesarean section. This paper presents a secondary outcome, women's experience of childbirth. Women's views and experiences were sought using seven-point rating scales via postal questionnaires 2 months after the birth.Results: A total of 2314 women were randomised between September 2007 and June 2010; 1156 to caseload and 1158 to standard care. Response rates to the follow-up questionnaire were 88 and 74%, respectively. Women in the caseload group were more positive about their overall birth experience than women in the standard care group (adjusted odds ratio 1.50, 95% CI 1.22-1.84). They also felt more in control during labour, were more proud of themselves, less anxious, and more likely to have a positive experience of pain.Conclusions: Compared with standard maternity care, caseload midwifery may improve women's experiences of childbirth.Tweetable Abstract: Primary midwife-led care ('caseload midwifery') improves women's experiences of childbirth. [ABSTRACT FROM AUTHOR]

Objective To investigate women's experiences of attending existing counseling programs for childbirth-related fear and the effect of this counseling over time. Design A longitudinal survey. Setting Three hospitals in the central north of Sweden. Sample A selected sample of 936 women. Of these, 70 received counseling due to fear of childbirth (study-group). Methods Data were collected with questionnaires 2 months and 1 year after giving birth with background data collected during midpregnancy. Comparisons were made between women with or without counseling. Crude and adjusted odds ratios ( OR) were calculated. Main outcome measures Self-reported childbirth fear, experience of counseling, birth experience and preferred mode of birth. Results Women in the counseling group reported higher childbirth fear 1 year after giving birth ( OR 5.0, 95% confidence interval (95% CI) 2.6-9.3), they had a more negative birth experience that did not change over time ( OR 2.1, 95% CI 1.2-3.9) and they preferred cesarean section to a greater extent ( OR 12.0, 95% CI 5.1-28.1) in the case of another birth. Also, they were more often delivered by planned cesarean section ( OR 4.7, 95% CI 2.4-9.1). However, 80% were satisfied with the given support. Conclusion Although women were satisfied with the treatment, this study shows that counseling had a minor effect on fear of childbirth, birth experiences or cesarean section rates. To help women with their fear of childbirth, more effective methods of treatment are needed. [ABSTRACT FROM AUTHOR]

Background The optimal mode of breech birth remains controversial. In Finland, a trial of vaginal delivery is possible if strict selection criteria are met. As clinical practice in managing vaginal breech birth differs from that in normal delivery, the birth experience may also be different. This cohort study compares the childbirth experience between term breech and vertex deliveries. Methods Intended vaginal term breech births from 2008 to October 2012 were included, and for every breech delivery, a vertex control was selected. The proportions of deliveries ending in a cesarean section and of mothers who had given birth vaginally before were equal in both groups. Three hundred eight mothers were sent the childbirth experience questionnaire and 170 returned it. Results The birth experience does not differ between breech and vertex births, except for aspects with respect to the choice of birthing position. Indications of an even more positive experience were observed in the breech group, with the exception of the choice of analgesia, but these were not statistically significant. Primiparity, emergency cesarean section, infant birth trauma and prolonged hospital stay were identified as risk factors for a negative birth experience. Conclusion The birth experience of vaginal breech birth seems to be at least as positive as the vaginal vertex birth experience. [ABSTRACT FROM AUTHOR]

Objective To investigate which factors related to the first birth influence subsequent reproduction within 5 years after the birth. Design Prospective cohort study. Setting University hospital, Stockholm, Sweden. Sample Cohort of 547 first-time singleton mothers with a normal pregnancy recruited prospectively of whom 451 women consented to follow-up 5 years later. Methods Data were collected by several questionnaires on sexual, reproductive and childbirth-related factors as well as on personality, postnatal depression, fear of childbirth and contact between mother/child. Medical records were also used. Associations between these factors and having a second child were analyzed using logistic regression. Main outcome measures Women's subsequent reproduction. Results Planning a second child at 9 months postpartum was most important in determining to have a second child. Women who had restored their sex life 9 months after birth and women who had a high score in the personality monotony avoidance scale, were less likely to give birth to a second child. No differences were observed regarding mode of delivery, factors related to birth and having a second child, nor was there an association between postnatal depression, fear of childbirth, a negative birth experience and self-estimated contact with the child and subsequent reproduction. Conclusions Circumstances in relation to the first birth, such as mode of delivery and a negative birth experience, did not affect subsequent reproduction. Planning another child by 9 months after birth was the strongest factor correlated with having a second child. [ABSTRACT FROM AUTHOR]

Background Fear of childbirth and mode of delivery are two known factors that affect birth experience. The interactions between these two factors are unknown. The aim of this study was to estimate the effects of different levels of fear of birth and mode of delivery on birth experience 1 month after birth. Methods As part of an ongoing prospective study, we interviewed 3,006 women in their third trimester and 1 month after first childbirth to assess fear of birth and birth experience. Logistic regression was performed to examine the interactions and associations between fear of birth, mode of delivery and birth experience. Results Compared with women with low levels of fear of birth, women with intermediate levels of fear, and women with high levels of fear had a more negative birth experience and were more affected by an unplanned cesarean section or instrumental vaginal delivery. Compared with women with low levels of fears with a noninstrumental vaginal delivery, women with high levels of fear who were delivered by unplanned cesarean section had a 12-fold increased risk of reporting a negative birth experience (OR 12.25; 95% CI 7.19-20.86). A noninstrumental vaginal delivery was associated with the most positive birth experience among the women in this study. Conclusions This study shows that both levels of prenatal fear of childbirth and mode of delivery are important for birth experience. Women with low fear of childbirth who had a noninstrumental vaginal delivery reported the most positive birth experience. [ABSTRACT FROM AUTHOR]

Objective To examine the effect of a brief course in self-hypnosis for childbirth on duration of the labor and other birth outcomes. Design A randomized, controlled, single-blind trial. Setting Aarhus University Hospital Skejby, Denmark. Population A total of 1222 healthy nulliparous women. Methods A hypnosis group receiving three 1-h lessons in self-hypnosis with additional audio-recordings to ease childbirth, a relaxation group receiving three 1-h lessons in various relaxation methods and mindfulness with audio-recordings for additional training, and a usual-care group receiving only the usual antenatal care were compared. Main outcome measures Duration of labor, birth complications, lactation success, caring for the child, and preferred future mode of delivery. Results No differences were found across the three groups on duration from arriving at the birth department until the expulsive phase of second stage of labor, the duration of the expulsive phase, or other birth outcomes. Fewer emergency and more elective cesarean sections occurred in the hypnosis group. No difference was seen across the groups for lactation success or caring for the child but fewer women in the hypnosis group preferred a cesarean section in future pregnancies because of fear of childbirth and negative birth experiences. Conclusions Learning self-hypnosis to ease childbirth taught as a brief course failed to show any effects on duration of childbirth and other birth outcomes. [ABSTRACT FROM AUTHOR]

Childhood abuse affects adult health. The objective of this study was to examine the association between a self-reported history of childhood abuse and fear of childbirth. A population-based, cross-sectional study was conducted of 2,365 pregnant women at five obstetrical departments in Norway. We measured childhood abuse using the Norvold Abuse Questionnaire and fear of childbirth using the Wijma Delivery Expectancy Questionnaire. Severe fear of childbirth was defined as a Wijma Delivery Expectancy Questionnaire score of ≥85. Of all women, 566 (23.9%) had experienced any childhood abuse, 257 (10.9%) had experienced emotional abuse, 260 (11%) physical abuse, and 290 (12.3%) sexual abuse. Women with a history of childhood abuse reported severe fear of childbirth significantly more often than those without a history of childhood abuse, 18 percent versus 10 percent ( p = 0.001). The association between a history of childhood abuse and severe fear of childbirth remained significant after adjustment for confounding factors for primiparas (adjusted OR: 2.00; 95% CI: 1.30-3.08) but lost its significance for multiparas (adjusted OR: 1.17; 95% CI: 0.76-1.80). The factor with the strongest association with severe fear of childbirth among multiparas was a negative birth experience (adjusted OR: 5.50; 95% CI: 3.77-8.01). A history of childhood abuse significantly increased the risk of experiencing severe fear of childbirth among primiparas. Fear of childbirth among multiparas was most strongly associated with a negative birth experience. (BIRTH 37:4 December 2010) [ABSTRACT FROM AUTHOR]

Background: Since the 1970s, the movement to “humanize” birth in North America has evolved into “family-centered maternity care,” which has focused on providing evidence-based maternity care that is responsive to the needs of women and their families. The objective of this research was to explore women’s birth experiences within the context of the numerous changes that have occurred in perinatal care and to determine how information and knowledge acquired about pregnancy and birth influenced women’s birth experiences. Methods: Semi-structured interviews were conducted in prenatal health clinics in Montreal and Vancouver with 36 women before and after birth. Results: Most study participants were unaware of the range of available providers and birth settings. Of the women who were more aware of their options, those selecting a birth center or home birth and midwives had different notions of risk than those who planned a hospital birth. Study participants felt generally well informed, but thought that information sharing, collaborative decision making, or both were inadequate during labor and birth within the hospital setting. Conclusions: Despite positive changes in recent years, family-centered maternity care in Canada still needs to be improved. Women’s ability to use their acquired prenatal knowledge to feel satisfied by their birth experience continues to be undermined by a system of care that does not prioritize women’s informed choice. Further systemic change is required to align maternity care with the needs of Canadian birthing women and their families. (BIRTH 37:2 June 2010) [ABSTRACT FROM AUTHOR]

lyberg a. & severinsson e. (2010) Journal of Nursing Management 18, 383–390 Fear of childbirth: mothers' experiences of team-midwifery care – a follow-up study Aim The aim of this study was to illuminate mothers’ fear of childbirth and their experiences of the team-midwifery care model during pregnancy, childbirth and the postnatal period. Background Maternal anxiety and fear of childbirth lead to emotional suffering and affected women’s well-being. A previous negative experience of childbirth may result in postnatal depression or avoidance of future pregnancies. Methods This hermeneutic study comprised interviews with 13 women, which were audio-taped and transcribed verbatim, after which interpretative content analysis was performed. Ethical approval was granted. Results The findings revealed one main theme: The woman’s right to ownership of the pregnancy, childbirth and postnatal care as a means of maintaining dignity and three themes; Being aware of barriers and reasons for fear; Being prepared for childbirth and Being confirmed and treated with dignity by the midwife. Each theme contained several sub-themes. Conclusion The findings contribute insights into how midwives can be educated to reduce fear of childbirth and promote positive birth experiences, despite the existence of negative memories of previous births. Implication for nursing management In order to achieve continuity and a trusting relationship it is necessary to organise leadership and to adopt models that are flexible and support women’s health. [ABSTRACT FROM AUTHOR]

Aim: This study sought to identify fathers' feelings and thoughts about their partners, babies, and medical staff when an emergency cesarean section (c-section) is required. Information was gathered on fathers' reactions when they first learned of the need for surgery, during surgery, and on first seeing their babies and partners post-surgery. Methods: Japanese men whose partners delivered a live baby by emergency c-section , without having planned to, at a private maternity hospital were interviewed. The men had semistructured interviews within 1 week post-partum, alone or together with their partners, according to the couples' wishes. The interviews were recorded, transcribed, and analyzed both descriptively and inductively. Results: All participants had their first babies with their present partners. The indications for a c-section were classified into two groups: a fetal distress group and a prolonged labor group. Although the fathers understood the need for surgery when the decision was made, they were anxious and felt that the lives of both their partner and baby were at risk. Moreover, they were frustrated that they could do nothing. In general, they also tried to remain calm so that their partners would not become agitated. The indications for surgery seemed to produce different feelings among the fathers and research interviews with the couples might provide a better opportunity to review and share birth experiences. Conclusion: Midwives who care for women prior to surgery must be aware of fathers' complex feelings and needs in emergency c-section cases. Knowing their reactions to this type of surgery might help to strengthen the support from fathers and facilitate an understanding of couples' concerns and needs. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this study was to investigate first-time mothers undergoing cesarean section in the absence of medical indication, their reason for the request, self-estimated health, experience of delivery, and duration of breastfeeding. We also aimed to study if signs of depression postpartum are more common in this group. Method. In a prospective cohort study 357 healthy primiparas from two different groups, "cesarean section on maternal request" (n=91) and "controls planning a vaginal delivery" (n=266) completed three self-assessment questionnaires in late pregnancy, two days after delivery and 3 months after birth. Symptom scores from the Edinburgh postnatal depression scale at three months after birth were also investigated. Results. Women requesting cesarean section experienced their health ass less good (p<0.001) and were more often planning for one child only (p<0.001). They more often reported anxiety for lack of support during labor (p<0.001), for loss of control (p<0.001), and concern for fetal injury/death (p<0.001). After planned cesarean section women in this group reported a better birth experience compared to women planning a vaginal birth (p<0.001). They were breastfeeding to a lesser extent three months after birth (p<0.001). There were no differences in signs of postpartum depression between the groups three months after birth (p=0.878). Conclusion. The knowledge gained from this study may help in understanding why some women prefer to give birth with elective cesarean section. It also elucidates the need for awareness of professional support during vaginal birth. [ABSTRACT FROM AUTHOR]

Background: To investigate birth experience and medical outcome in women with elective cesarean section (CS) compared with women with intended vaginal delivery.Methods: A total of 1050 pregnant women were included in this prospective trial. Psychological factors, pain levels and birth experience were investigated using a self-designed questionnaire and three established psychological tests in gestational week 38, and 3 days and 4 months postpartum. In addition, medical data were evaluated from the records.Results: Out of 903 women with planned vaginal birth, in 484 women (53.6%) minimal perineal surgery had to be performed after birth, 41 women (4.5%) had vacuum deliveries, and in 93 cases (10.3%) emergency CS had to be performed. In the 147 elective CS (103 based on medical and 44 on psychological factors), a significantly lower rate of maternal and fetal complications was observed when compared with vaginal birth (5.4% vs. 19.3%; p < 0.0001). Birth experience (Salmon test) was significantly better in elective CS compared with vaginal delivery, but worse in women with emergency CS and worst in those with vacuum delivery. We found that 83.5% of women with vaginal delivery would choose the same mode of birth again, 74.3% of women with CS on demand, and 66% of women with medically necessary CS. Only 30.1% of women with emergency CS wanted to receive CS at the next birth.Conclusions: Elective CS is a safe and psychologically well tolerated procedure. The results are comparable with uncomplicated vaginal delivery and far superior to secondary intervention such as vacuum delivery or emergency CS. [ABSTRACT FROM AUTHOR]

Most of what is known about the meaning women assign to the experience of childbirth in the United States is based primarily on studies of Euro American, highly educated, married women of middle to higher income levels. Yet almost half a million adolescents give birth annually. This exploratory, qualitative study was conducted with 25 adolescents in an alternative school, partnered with the juvenile justice system, who had given birth. An open-ended question format was used for the interviews, and analysis was conducted by using extended case methodology. The study revealed a number of differences between the existing literature reports about women’s interpretations of birth and the meanings assigned to childbirth experiences by the adolescents in this study. A key difference was the relationship between the pain of childbirth and responsibility for their child. The results provide an entre´e into understanding unique characteristics of giving birth as an adolescent and potential roles health care providers can play to promote a positive experience. [Copyright &y& Elsevier]