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Releasing and relieving encounters: Experiences of pregnancy and childbirth
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The experience of childbirth is an important life event for women, which may follow them throughout life. The overall aim of this thesis has been to describe and analyse these experiences from the women's perspective as well as the encounter between the woman and the midwife, and the possibility that a birth plan might improve women's experience of childbirth. The setting has been the ABC-centre (Alternative Birth Care), antenatal clinics and Sahlgrenska University hospital in Göteborg, and Karolinska hospital in Stockholm, Sweden. The studies have used both qualitative (phenomenological and hermeneutic) and quantitative approaches. The essential structure of the experiences of pregnancy and childbirth may be conceptualised under the heading ‘releasing and relieving encounters’, which for the woman constitutes an encounter with herself as well as with the midwife, and includes stillness as well as change. Stillness is expressed as being in the moment; exemplified as presence and being one's body. Change is expressed as transition; to the unknown and to motherhood. In the releasing and relieving encounter, for the midwife stillness and change equals being both anchored and a companion. To be a companion is to be an available person that listens to and follows the woman through the process of childbirth. To be anchored is to be the person that in the transition process respects the limits of the woman's ability as well as her own professional limits. The releasing and relieving encounter is not improved for women by a birth plan. Instead, in some aspects the relationship between the woman and her midwife during childbirth is reported as less satisfactory if preceded by a birth plan although some experiences of fear, pain and concerns for the child might be improved.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2002. , p. 75
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1143
Keyword [en]
Obstetrics and gynaecology, pregnancy, childbirth, women's experiences, encounter, pain, birth plan, hermeneutic, phenomenological, intervention study
Keyword [sv]
Obstetrik och kvinnosjukdomar
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:uu:diva-2022ISBN: 91-554-5292-2 (print)OAI: oai:DiVA.org:uu-2022DiVA, id: diva2:161654
Public defence
2002-05-23, Rosén-salen, Akademiska sjukhuset, Uppsala, 09:15
Opponent
Available from: 2002-04-26 Created: 2002-04-26Bibliographically 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. Women's experience of pain during childbirth
Open this publication in new window or tab >>Women's experience of pain during childbirth
1998 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 14, no 2, p. 105-110Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To describe women's experience of pain during childbirth.

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

SETTING: An Alternative Birth Care Centre at a university hospital in Sweden in 1995.

PARTICIPANTS: Nine women, four primiparous and five multiparous who were two to four days post delivery.

KEY FINDINGS: Four themes were identified in the meanings of experience: (1) pain is hard to describe and is contradictory; (2) trust in oneself and one's body; (3) trust in the midwife and husband; and (4) transition to motherhood. The essential structure of the studied phenomenon was described as 'being one's body', which includes a non-objectifying view of the body, a presence in the delivery process, and a meaning connected to the transition to motherhood.

IMPLICATIONS FOR PRACTICE: The women felt that pain was a natural part of the delivery process, and that the strength and power to cope with it came from within the women. A conclusion is that midwives can help birthing women to find their own ability to cope, and should interfere only if the woman asks or if the natural process is disturbed, e.g. by complications. The experience of pain during childbirth, together with the experience of strength during childbirth, gives meaning to the transition to motherhood.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-89843 (URN)10382479 (PubMedID)
Available from: 2002-04-26 Created: 2002-04-26 Last updated: 2017-12-14Bibliographically approved
3. The experience pregnancy: a hermeneuticaal/phenomenological study
Open this publication in new window or tab >>The experience pregnancy: a hermeneuticaal/phenomenological study
1999 (English)In: The Journal of Perinatal Education, Vol. 8, no 3, p. 12-20Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe women's experience of pregnancy. The setting was the Alternative Birth Center at Sahlgrenska University Hospital in Göteborg, Sweden, from 1996 to 1997. Anonymous diaries were written by 12 women and analyzed using a hermeneutical/phenomenological approach. The essential structure and interpretation of women's experience of pregnancy can be expressed as “transition to the unknown,” which includes three themes: (1) meeting one's life situation, (2) meeting something inevitable, and (3) preparing for the unknown.The essential structure and interpretation of women's experience of pregnancy can be expressed as “transition to the unknown” …

Keyword
pregnancy, women's experience, qualitative research, diaries
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-89844 (URN)10.1624/105812499X87196 (DOI)3431786 (PubMedID)
Available from: 2002-04-26 Created: 2002-04-26 Last updated: 2013-08-01Bibliographically approved
4. Midwive's experience of the encounteer with women and their pain during childbirth
Open this publication in new window or tab >>Midwive's experience of the encounteer with women and their pain during childbirth
2002 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 18, no 2, p. 155-164Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: to describe midwives' experience of the encounter with women and their pain during childbirth.

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

SETTING: Sahlgrenska University Hospital, Göteborg, and Karolinska Hospital, Stockholm, Sweden in 2000.

PARTICIPANTS: nine experienced midwives between 12 and 28 years of midwifery practice.

KEY FINDINGS: the essential structure was described as a striving to become an 'anchored companion'. 'To be a companion' was to be available to the woman, to listen to and see her situation mirrored in her body, and to share the responsibility of childbirth. To be 'anchored' was to show respect for the limits of the woman's ability as well as one's own professional limits. Five constituents can further describe the essential structure: listening to the woman; giving the woman an opportunity to participate and to be responsible; a trusting relationship; the body expresses the woman's situation; and to follow the woman through the process of childbirth.

IMPLICATIONS FOR PRACTICE: the basis for maternity care should give an opportunity for midwives to be anchored companions. This could be done by emphasising listening to the woman, participation, responsibility, a trusting relationship and a clear understanding of the professional limits and the limits of the woman's ability.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-89845 (URN)10.1054/midw.2002.0302 (DOI)12139913 (PubMedID)
Available from: 2002-04-26 Created: 2002-04-26 Last updated: 2017-12-14Bibliographically approved
5. Is childbirth experience improved by a birth plan?
Open this publication in new window or tab >>Is childbirth experience improved by a birth plan?
2003 (English)In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 48, no 5, p. 322-328Article in journal (Refereed) Published
Abstract [en]

From antenatal clinics in Sweden, 271 women were recruited after week 33 of pregnancy and given a questionnaire designed to assess their attitudes and feelings about the coming childbirth. Thereafter, they formulated a birth plan. The midwife in attendance at the birth was able to refer to this plan. Women who followed this program were compared with women from the same clinics who were asked to complete a questionnaire during the first postpartum week to assess their birth experience. A questionnaire at the end of pregnancy, followed by a birth plan, was not effective in improving women's experiences of childbirth. In the birth plan group, women gave significantly lower scores for the relationship to the first midwife they met during delivery, with respect to listening and paying attention to needs and desires, support, guiding, and respect. Although a birth plan did not improve the experience of childbirth in the overall group, there may be beneficial effects with regard to fear, pain, and concerns about the newborn for certain subgroups of women.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-89846 (URN)10.1016/S1526-9523(03)00278-2 (DOI)14526345 (PubMedID)
Available from: 2002-04-26 Created: 2002-04-26 Last updated: 2017-12-14Bibliographically approved

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