Table 2 Themes and sub themes of birth experience’s determinants perceived by women
From: Iranian women’s perception on the determinants of birth experience: a qualitative study
Sample quotes or Positive birth experience | Categories for Positive birth experience | Main themes (Sub themes) | Categories for Negative birth experience | Sample quotes for Negative birth experience |
|---|---|---|---|---|
Possessing an internal control | Internal control | Loss of internal control | ||
“Now that I remember the moment when they brought the baby and put it on my chest, I wouldn’t change that juncture with nothing. It felt really good and it greatly affected my sense of satisfaction with the birth.” “I was always praying and begging to God for a vaginal birth. Thank God it went well.” “My cervix opened sooner because of the exercises I did. I searched for all of the pregnancy exercises on the Internet and did them two or three times a week. I walked for 30 minutes every morning and night. I think exercising was an important factor in making my birth easier. I returned to my daily activities five days after birth and started doing everything myself.” “I myself wanted to feel what a woman feels as a mother during a vaginal birth. I thought that C-section would not give me such feeling and that the mother-child relationship would be stronger after vaginal birth. I wanted to sense that feeling. I wanted to experience the labour pain.” “I didn’t scream at all when I felt pain. My mind was at peace. I didn’t yell. I think yelling cannot solve anything. The staff was pleased with me (she chuckles), and the doctor told me that I was really good at pain endurance” | - Maternal and child attachment - Praying and trusting in God - Preparedness before labor - Woman’s positive attitude towards vaginal birth - Feeling of self-control | (Sense of security and trust) (Sense of power) | - Feeling of fear and worry - Feeling of powerlessness | “Thinking that I would die, I was saying my last prayers. Everybody is afraid of vaginal birth, especially a person like me who was experiencing it for the first time.” “I lose my power quickly and feel tired soon. I’m not physically very strong.” |
Balanced external control | External control | Imbalanced external control | ||
“I took hot showers at my back, and it had a really good effect. It relieved my pains so much that I thought I could give birth to my child at that moment. It soothed my nervous system. I was really pleased with the hot shower they provided for me.” “It was good that I was given only one examination in the clinic by my midwife. I only had another one vaginal examination at hospital by same midwife.” “The room was designed for only one woman. I stayed there from the moment I felt pain until I gave birth to my child. There were no other women in my room so that I would feel embarrassed.” “I visited a midwife’s office for an examination. After examination, she said it was not the time. She then advised me to return home and take a hot shower. I endured most of my pain at home. We went to the hospital at 7 PM and had my son born at 8:30 PM. I am very happy with spending most of my time at home and taking a warm bath and massage by my sister.” “I had no bleeding and complications the morning after I gave birth. I know that you couldn’t be the same as before, but I managed to do my tasks myself and take care of my baby, which was pretty satisfactory.” “The presence of my sister was really pleasurable for me (she chuckles). The doctor asked me who I was comfortable with and who I wanted to be with. I said that I was fine with my sister. They asked my opinion.” | - Satisfaction with pain relief methods - Convenience and satisfaction with the necessary interventions - Appropriate physical and psychological environment of hospital - Short stay in the labour room - Woman’s satisfaction with the childbirth outcomes - Woman’s participation in care process | (Quality of procedural Maternity care) (Quality of Communicational and respectful Maternity care) | - No use of pain relief methods - Discomfort from unnecessary interventions - Inappropriate physical and psychological environment of hospital - Maternal-neonatal complications - Not having a touch with the baby after birth - Women’s expectation and variation from normal labour and birth - Non-participation of woman and her family in care process | “They put stitches and then they realised that the placenta remained inside the uterus. They put their hands inside my womb and after removing the placenta, they fixed my stitches, again, it was very painful.” “I felt pain when the doctor pushed my belly, but they said I wouldn’t be able to give birth to my child if they didn’t push. It drives me nuts whenever I remember the scene!” “When I entered the birth room, I felt that I was in a slaughterhouse. Because women were screaming and every table had many metal instruments including knives and scissors. I wish they were hidden somewhere.” “The baby went completely black. They took the baby away soon after birth. My kid did not cry, and I heard her cry after 11 days.” “They showed me the baby for only one moment but didn’t put it on my chest. I really wanted them to dry the baby and put it on my chest. I kept raising my head to see what my baby looked like on the other side of the room on the bed.” “It took three days. I stayed there from morning until night, but nothing happened. Once in a while, I had some spasms which did not feel like labour pain. I was mentally tired, perhaps because I had been in the hospital for a long time. I thought I could not give birth anymore. I was expecting someone to tell me that the waiting time will end soon or that I was going to have labour in one day. I needed hope.” “Most of the decisions were made by the hospital staff rather than myself. I was told in the hospital that since it was public, I had to have a vaginal birth. My husband was willing to pay the cost of a C-section, but they said it was not possible because it was a public hospital. We were not aware of this. I told them I wouldn’t have gone there if they had told us in the first place.” |
Receiving support | Support | Not receiving support | ||
“I’m very pleased with my husband, whom I love very much. During pregnancy, I wanted him to be with me all the time. The fact that I love my husband had a very good effect on me. I was happy with my labour because I loved my husband so much that I wanted to have a baby with him. My husband’s kindness, affection, and love had a positive effect on me, so I am happy with my labour and love my son.” “I really didn’t like anybody but my midwife to be with me at the time of birth. I needed specialised help which could only be provided by a midwife. My midwife was not accompanying me just for money. I think she personally liked to help. She had good manners and did whatever I wanted her to do. I spoke to her harshly when I had pain, but she didn’t respond badly.” “I’m very pleased with my husband, whom I love very much. During pregnancy, I wanted him to be with me all the time. The fact that I love my husband had a very good effect on me. I was happy with my labour because I loved my husband so much that I wanted to have a baby with him. My husband’s kindness, affection, and love had a positive effect on me, so I am happy with my labour and love my son.” | - Receiving professional support - Preserving personal dignity by care provider - Receiving family support | (Professional support) (Family support) | - Disrespect and offensive behavior - Lack of support in meeting individual needs and preferences - Lack of support about labour and birth options - Negative attitude of the physicians towards vaginal birth | “After the birth, they took me for the ultrasound scan. I had a urinary catheter. The caregiver pushed the bed so fast that it suddenly hit the wall, and the tube was broken. I became very sad and ashamed. I may not be able to verbally express the treatment I received at the hospital. They treated us as if those giving childbirth were not human.” “The caregivers were always writing reports and looking at their computers. They were just focused on writing their reports.” “It was my first childbirth experience. I had literally no information about it. Neither did I read about it before, nor did anybody tell me about it.” “There is not a good attitude towards vaginal birth now among specialists at hospitals. My doctor asked me why I chose vaginal birth while criticising me. He asked about my job and that of my husband and told us we had the financial status to choose C-section. I told him that it was not because of the financial problems that I had chosen vaginal birth.” |