Choices for childbirth: The role of psychological and social factors in the nature and extent of women's decisions for labour and delivery and their influence on post-natal outcomes
AbstractResearch into birth plans has considered women’s experiences of their usefulness as an aid to communicating preferences for childbirth. It has also evaluated implications for post-natal well-being based on the realisation of expressed preferences in labour and delivery. The current study aimed to identify the psychosocial profile of birth planners and to explore the outcomes for these women as compared with non-planners post-natally. It also compared the psychological constructs measured in the sample with a non-pregnant population to see differences between pregnant, post-natal and non-pregnant women on these dimensions. A sample of 140 women who had not been pregnant in the past year completed a questionnaire measuring: Age, occupational group; ethnic group; general health status, health knowledge, attitudes towards doctors and medicines; locus of control; coping style; perceived social support; and beliefs about pain control. A questionnaire was also given to 120 women in four antenatal clinics across a primary care trust in the North West of England. This questionnaire produced data on all of the variables in the comparison questionnaire, plus: Parity; antenatal education; birth plan use; medical conditions; information seeking; and childbirth self-efficacy. Women also described in text their preferences for birth. At least four weeks after delivery these women completed a further questionnaire consisting of the seven measures used in both the previous two questionnaires, plus: experience of birth; usefulness of birth plan; and post-natal depression. They also described in text their experience of birth. Results showed that birth planners were younger and had lower levels of internal health control than non-birth planners. Birth planners tended to use problem focussed coping styles, perceived less support from their significant other and perceived doctors as more powerful in pain control than non-birth planners. More positive psychological post-natal outcomes were experienced by women who valued their birth plans if they had one but overall birth planners experienced more negative psychological post-natal outcomes than non-birth planners. The non-pregnant sample was comparable in demographic terms to the pregnant sample but differed in most subscales across all measures to the pregnant sample pre-natally and to a lesser extent post-natally. The factors implicated in birth planning and psychological post-natal outcomes are discussed both in terms of the literature and possible implications for the training and practice of midwives.
CitationHayes, L. D. (2014). Choices for childbirth: The role of psychological and social factors in the nature and extent of women's decisions for labour and delivery and their influence on post-natal outcomes. (Doctoral dissertation). University of Liverpool, United Kingdom.
PublisherUniversity of Liverpool
TypeThesis or dissertation
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