Perspective of risk in childbirth, women’s expressed wishes for mode of delivery and how they actually give birth
Year: 2009
Type: dissertation
Abstract: Aims: The main aim of this thesis was to study a perspective of women`s expressed wishes for mode of delivery and how they actually give birth. Additional aims were to examine the notion of risk applied to childbirth, to examine what characterizes women who want to give birth as naturally as possible without painkillers or intervention and the characteristics of women who would, if possible, choose to have a cesarean section. Material and methods: The notion of risk was examined in an essay. Self-rating instruments were completed by 55,858 MoBa participants during week 30 of their pregnancy and available from The Norwegian Mother and Child Cohort Study (MoBa) by April, 2007. Individually reported information on socioeconomic factors, lifestyle factors, feelings related to childbirth, factors concerning psychosocial health, physical, psychological and sexual harassment and information on satisfaction with antenatal care health services were collected from a MoBa questionnaire. Data on the mother’s age, parity, physical health before and during the pregnancy, previous cesarean sections and actual mode of delivery were collected through a linkage to the The Medical Birth Registry of Norway. Findings: General perspectives on risk differ depending on both the person and the profession. More and more childbearing women are in danger of being considered deficient and in the danger zone. Figures on risk are not objective values, and the association between risk and security is socially and culturally determined. Personal symbols can be basic assumptions about the life one leads, and the childbearing woman has preferences of her own. Interest in natural childbirth was expressed by 72 percent and a wish for caesarean section was expressed by ten percent of the women. Positive experience from previous childbirths, first birth or third or later birth, no dread of giving birth, and reporting positive intra-psychic phenomena are significantly associated with the wish for natural birth. Negative experiences from previous childbirths and fear of giving birth are two of the strongest factors associated with a wish for a caesarean section.Overall, 47 percent of the women who wanted ”as natural a birth as possible” had their preference fulfilled. The figures differed largely for primiparas and multiparas; the risk of acute caesarean sections was high among primiparas and the effects of the predictors of natural birth were stronger for primiparas than for multiparas. Conclusions:The factors that influence the chance of having a natural birth are different for primiparas and multiparas. The high rate of non-natural births among first time mothers who actually want to have a vaginal birth without interventions should call attention to the increasing incidence of cesarean section in Norway. The chance of actually having a natural birth for women with a preference for a natural birth is much larger for multiparas. Negative experiences from previous childbirths and cesarean section are, however, important factors associated with non-natural birth and should be taken into consideration in public health
Author: Tone Kringeland
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2129175488