Table 2 Synoptic view of papers included in the review

Côté-Arsenault and Donato [76], USA

To describe women’s late pregnancy after loss experiences

Purposive sampling;

n = 69 pregnant women

Qualitative, longitudinal study

Pregnancy calendar entries and field notes provided from 10 to 17 weeks gestation to birth

Thematic analysis

Previous experiences influenced the sense of security in the subsequent pregnancy. Assessing foetal movements and regular feedback from a care provider contributed to a sense of security.

Relatively unstructured and extensive data collection

Ekström et al. [85], Sweden

To explore fathers’ feelings and experiences during pregnancy and childbirth

Purposive sampling; n = 8 first-time and experienced fathers

Qualitative, inductive approach

Written interviews (data collection after birth)

Content analysis

Being prepared to welcome the baby gave first-time fathers a sense of security. The confidence in healthcare professionals contributed to paternal sense of security. The lack of control over the beginning of the childbirth created insecurity.

Recruitment by midwives at two maternity wards

Small sample size

Only five of twenty fathers returned their written interviews

Data from the pilot study was included in the analysis

Halldorsdottir and Karlsdottir [77], Iceland

To explore the essential structure of the experience of childbearing from the perspective of women

Purposive sampling; n = 14 mothers

Qualitative, phenomenological approach

Interactive interviews

Thematic analysis

Feeling safe was perceived as a need while in labour and delivery. Fulfilment through the support and presence of a midwife and the partner reduced fear and encouraged admittance to the birth.

Small sample

No statement about the period of data collection

The results refer to a limited geographic area, and thus, a cultural and social group of participants was represented in this study

Karlström et al. [78], Sweden

To describe women’s experiences of a very positive birth experience

Purposive sampling; n = 26 first-time and experienced mothers

Qualitative (part of a prospective longitudinal cohort study)

Focus group discussions

(6–7 years after giving birth)

Thematic analysis

Feeling safe was an essential part of positive birth experiences and was confirmed by the presence of the child’s father, a trustful relationship with the midwife, and a positive atmosphere in the birthing suite. Feeling safe was essential to gaining control during birth.

The timing of recruitment: 6–7 years after the index birth

Relatively homogenous sample group

Melender and Lauri [79], Finland

To describe security associated with pregnancy and childbirth

Convenience sampling; n = 20 Finnish women (primiparous and multiparous) during pregnancy

Qualitative

Semi-structured interviews (23–36 weeks of gestation)

Content analysis

The elements creating security associated with pregnancy and childbirth were maternity healthcare, social support, a sense of control and one’s own attitudes. If the feeling of security was lessened during pregnancy, a search for support was performed through the women’s social network and contact with the midwife or obstetrician.

The sampling strategy is insufficiently described

Namey and Lyerly [81], USA

To deconstruct the term “control” as used by childbearing women

Purposive sampling; 101 mothers n = 39 (primiparous women) and n = 62 (multiparous women) who had given birth in various birthplaces and experienced different modes of delivery

Qualitative

Semi-structured interviews (between April 2006 and July 2009)

Data analysed using NVivo software. Method of key word concept analysis by Quinn

Part of the definition of control relates to personal security, which encompasses feelings of physical safety and emotional and psychological attributes of security, such as comfort and confidence in one’s surroundings. Management of the birth experience and minimisation of anxiety or fear are associated with feelings of personal security.

Sample: Only parous women

Recruitment primarily from a defined geographical area

The recruitment method was held constant across the predefined sampling characteristics

Persson and Dykes [83], Sweden

To reveal factors that influence the experiences of mothers and fathers when they choose to return home

Purposive sampling; n = 12 (first-time and experienced) parents

Qualitative. Grounded theory

Open interviews (2–3 weeks after giving birth)

Coding by Strauss and Corbin

The most important factors for creating a sense of security for the parents were the midwife’s empowering behaviour, affinity within the family, autonomy and sense of control and physical well-being.

Purposive recruitment from one hospital by using theoretical sampling strategy

Restricted variety of experiences by only healthy participants

Persson et al. [82], Sweden

To describe factors influencing mothers’ sense of security during the first postnatal week

Purposive sampling; n = 14 mothers

Qualitative descriptive design

Open interviews and focus group discussions (2–11 weeks after giving birth)

Thematic content analysis by Burnard

Mother’s postnatal sense of security was dependent on support from staff, support from the partner, and the mother’s and baby’s physical health and well-being.

Variation in time span for conducting the interviews

Participants with lower educational levels were under-represented

Persson et al. [86], Sweden

To explore and describe factors that influence fathers’ sense of security during the first postnatal week

Purposive sampling; n = 13 fathers

Qualitative

Open interviews and focus group discussions (3–9 weeks after childbirth)

Thematic content analysis by Burnard

Participation in the processes of pregnancy, birth and early parenthood fostered fathers’ postnatal sense of security. Fathers felt secure when they had someone knowledgeable to ask and when they were heard and taken seriously.

Variation in time span for conducting the interviews

Authors and country

Objective

Study sample and inclusion criteria

Research design and data collection method(s), instrument(s)

Method(s) of analysis

Key findings

Limitations

Melender and Lauri [80], Finland

To describe elements creating a sense of security associated with pregnancy and childbirth, the manifestation and the influence of background factors

n = 329 (primiparous and multiparous) women who were 16–40 weeks pregnant; 69% response rate

Quantitative, descriptive design

Structured questionnaire

Development of the instrument was based on a pilot study and review of the literature

Factor analysis, Kruskal-Wallis test, and Mann-Whitney U-test

Elements that created a sense of security

1. Support from relatives (REP 12.4%)

2. Knowledge about pregnancy, childbirth and childcare (REP 10.5%)

3. Prenatal healthcare experiences and support from healthcare professionals (REP 8.8%)

4. Support from the partner (REP 8.5%)

5. Livelihood (REP 7.6%)

6. Positive stories heard about pregnancy, childbirth and baby care (REP 7.5%)

Elements creating security in relation to background factors

Knowledge about pregnancy, childbirth and childcare was reported significantly more often by experienced mothers.

Prenatal healthcare experiences create security significantly more often in women without pregnancy-related problems compared to those with such problems.

Support from the partner was reported significantly more often by women without pregnancy-related problems than those with such problems.

Limitations were not stated

Persson and Dykes [84], Sweden

To evaluate dimensions of both parents’ postnatal sense of security during the first week after childbirth

n = 113 mothers and n = 99 fathers of every fifth baby born live at term at five hospitals in southern Sweden; 71% response rate (mothers) and 63% response rate (fathers)

Evaluative, cross-sectional design

Postal questionnaire consisted of background questions, parents’ postnatal sense of security (PPSS) instrument and State Trait Anxiety Inventory (STAI) trait instrument (8 weeks postpartum)

Mann-Whitney U-test and multiple regression analysis

First-time mothers felt significantly less postnatal security than experienced mothers.

A sense of midwives’ empowering behaviour and a sense of personal well-being (for mothers) were significantly associated with security.

For mothers, parity was significantly associated with security together with a sense of participation in care, a sense of the partner’s participation during pregnancy, expected positive childbirth and security experienced during birth. For fathers, a sense of participation during pregnancy was significantly associated with security.

There was no analysis of the dropouts due to the study design