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Genuine Caring in Caring for the Genuine: Childbearing and high risk as experienced by women and midwives
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The experience of pregnancy and childbirth is a central life event with special implications for women at high risk. This thesis describes the meaning of pregnancy, childbirth and midwifery care in four qualitative interview studies based on the lifeworld theory. Women were interviewed during pregnancy and within one week after childbirth. Midwives were interviewed concerning midwifery care for women at high risk. In an intervention study, childbirth experience as reported through a post partum questionnaire was compared between women receiving standard care and women who had formulated a birth plan preceded by a questionnaire on their expectations and feelings about childbirth.

The findings emphasise that childbearing women at high risk live in an extremely vulnerable situation. The vulnerability is obvious in the use of an individual birth plan, where negative feelings become more frequent in women at high risk than in those with normal pregnancy and childbirth. During pregnancy the women feel a moral commitment towards the child, including feelings of objectification and of exaggerated responsibility. During an obstetrically complicated childbirth the essential meaning is the women’s desire to be recognised and affirmed as individual persons. Like women with normal pregnancy and childbirth, they need an emotionally present midwife who sees, give trust and supports.

Good midwifery care of childbearing women at high risk is synthesised as "genuine caring in caring for the genuine". The ethos of caring constitutes the basis of caring. Women’s transition during pregnancy and childbirth is described as a genuinely natural process. Midwives have a special responsibility to encourage and preserve this process within women at high risk. The caring relationship is the core and the most essential tool in the care. Distinctive features in the midwifery care are embodied knowledge, physical as well as emotional presence, sensitivity, a mutual dialogue including shared control between midwife and woman, and confirmation and support of the genuine in each woman. The midwifery care is a struggle and a balance between natural and medical perspectives.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2002. , p. 71
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1146
Keywords [en]
Obstetrics and gynaecology, High risk, childbearing, pregnancy, childbirth experience, midwifery, lifeworld research, phenomenology, hermeneutics, motherhood, birth plan, caring relationsship
Keywords [sv]
Obstetrik och kvinnosjukdomar
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:uu:diva-2021ISBN: 91-554-5299-X (print)OAI: oai:DiVA.org:uu-2021DiVA, id: diva2:161648
Public defence
2002-05-22, Rosén-salen, Akademiska sjukhuset, Uppsala, 13:15
Opponent
Available from: 2002-04-26 Created: 2002-04-26 Last updated: 2013-08-01Bibliographically approved
List of papers
1. Women's experience of the encounter with the midwife during childbirth
Open this publication in new window or tab >>Women's experience of the encounter with the midwife during childbirth
1996 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 12, no 1, p. 11-15Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: to describe women's experience of the encounter with the midwife during childbirth.

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

SETTING: the Alternative Birth Care Centre, Sahlgrenska University Hospital, Gothenburg, Sweden in 1994.

PARTICIPANTS: 18 women, six primiparous and 12 multiparous who were two to four days post delivery.

KEY FINDINGS: the essential structure of the studied phenomenon was described as 'presence' and included three themes: to be seen as an individual, to have a trusting relationship and to be supported and guided on one's own terms.

IMPLICATIONS FOR PRACTICE: the need to be seen as an individual can be realised by affirmation and familiarity with the midwife and surroundings. A trusting relationship can be obtained by good communication and proficient behaviour. By providing a sense of control the women can be supported and guided on their own terms. Above all they must feel that the midwife is present.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-89842 (URN)10.1016/S0266-6138(96)90033-9 (DOI)8715931 (PubMedID)
Available from: 2002-04-26 Created: 2002-04-26 Last updated: 2017-12-14Bibliographically approved
2. A phenomenological study of women's experiences of complicated childbirth
Open this publication in new window or tab >>A phenomenological study of women's experiences of complicated childbirth
1998 In: Midwifery, Vol. 14, p. 23-29Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-89838 (URN)
Available from: 2002-04-26 Created: 2002-04-26Bibliographically approved
3. Pregnancy and diabetes - a hermeneutic phenoomenological study of women's experiences
Open this publication in new window or tab >>Pregnancy and diabetes - a hermeneutic phenoomenological study of women's experiences
2000 In: J Psychosom Obstet Gynaecol, Vol. 21, p. 39-48Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-89839 (URN)
Available from: 2002-04-26 Created: 2002-04-26Bibliographically approved
4. Swedish midwives' care of women who are at high obstetric risk or who have obstetric complications
Open this publication in new window or tab >>Swedish midwives' care of women who are at high obstetric risk or who have obstetric complications
2001 In: Midwifery, Vol. 17, p. 259-266Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-89840 (URN)
Available from: 2002-04-26 Created: 2002-04-26Bibliographically approved
5. Childbirth experience in women at high risk: Is it improved by use of a birth plan?
Open this publication in new window or tab >>Childbirth experience in women at high risk: Is it improved by use of a birth plan?
2003 (English)In: The Journal of Perinatal education, Vol. 12, no 2, p. 1-15Article in journal (Refereed) Published
Abstract [en]

Women at obstetric high risk more often experience negative feelings related to childbirth than women with normal outcomes. For these high-risk women, an individual birth plan does not appear to improve the overall experience of childbirth; rather, it seems to intensify the negative feelings in several aspects. The increased vulnerability in women at high risk warrants special attention to the possibility that types of care routinely offered to all women may negatively influence the experiences of high-risk women.

Keywords
birth plan, childbirth experience, high-risk pregnancy, high-risk childbirth
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-89841 (URN)10.1624/105812403X106784 (DOI)1595149 (PubMedID)
Available from: 2002-04-26 Created: 2002-04-26 Last updated: 2013-08-01Bibliographically approved

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