Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and trauma
Abstract Background Birth is a significant event in women’s lives. As Mansfield notes (2008) many women aim for a birth that avoids pharmacological pain relief because they are advised it is better for them and their baby. For women having their first baby, this may not be realistic as 3/4 of primip...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-06066-7 |
| _version_ | 1797629926739804160 |
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| author | Elizabeth Sutton Karen Detering Christine East Andrea Whittaker |
| author_facet | Elizabeth Sutton Karen Detering Christine East Andrea Whittaker |
| author_sort | Elizabeth Sutton |
| collection | DOAJ |
| description | Abstract Background Birth is a significant event in women’s lives. As Mansfield notes (2008) many women aim for a birth that avoids pharmacological pain relief because they are advised it is better for them and their baby. For women having their first baby, this may not be realistic as 3/4 of primiparous women in Australia will use pharmacological pain relief. This study examines the expectations that a group of women had regarding pain relief, how these expectations developed and what happened to requests for pain relief in labour. Methods A longitudinal prospective study design was used to recruit 15 women who were having their first baby. Women having low risk pregnancies, hoping for a ‘natural birth’ (vaginal, no/minimal pharmacological pain relief) were eligible. A semi-structured interview tool was used across all three interviews that asked women about their expectations, then actual labour experience, pain management requests and how these were responded to by carers. Fifteen women were interviewed – at 36 weeks gestation; as soon after delivery of their baby as possible, then six months post-delivery (N = 43 interviews). Interviews were recorded and transcribed and coded by ES using NVivo software with hierarchical thematic analysis used. Results The study found that women appear to experience a mismatch between expectations they had developed pre-birth, versus actual experience. This appears to cause a specific form of dissonance – which we have termed ‘birth dissonance’ leaving them feeling traumatised post birth. This is because what women expected to happen in birth was often not realised. In particular, some women requested pain relief in birth and felt that their request was not responded to as hoped, and also seemed to develop post-birth trauma. We proposed that this may have resulted from dissonance arising from their expectations about being able to birth without significant pain relief. Interventions and technology may also contribute to this sense of mismatch and post-birth trauma. Conclusions Low risk birthing women birthing in a hospital may have to engage with higher levels of technology, intervention and pain relief than that which they expected pre-birth. This could possibly be avoided with four simple changes. Firstly, better pre-birth education for women about how painful labor is likely to be. Secondly, pre-birth education which includes a detailed explanation of the utility of pharmacological and non-pharmacological pain relief. Thirdly, more egalitarian decision-making during labour and finally delivering upon women’s requests for pain relief in labor, at the time that they ask for it. Further research is required to determine the extent of birth dissonance and how women making the transition to motherhood can avoid it. |
| first_indexed | 2024-03-11T11:00:43Z |
| format | Article |
| id | doaj.art-f5ca648100cb4f0fa7d0f38660703f02 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-11T11:00:43Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-f5ca648100cb4f0fa7d0f38660703f022023-11-12T12:32:53ZengBMCBMC Pregnancy and Childbirth1471-23932023-11-0123111310.1186/s12884-023-06066-7Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and traumaElizabeth Sutton0Karen Detering1Christine East2Andrea Whittaker3Monash Bioethics Centre – Monash UniversityMonash Bioethics Centre – Monash UniversityNursing and Midwifery – La Trobe UniversitySociology and Anthropology – Monash UniversityAbstract Background Birth is a significant event in women’s lives. As Mansfield notes (2008) many women aim for a birth that avoids pharmacological pain relief because they are advised it is better for them and their baby. For women having their first baby, this may not be realistic as 3/4 of primiparous women in Australia will use pharmacological pain relief. This study examines the expectations that a group of women had regarding pain relief, how these expectations developed and what happened to requests for pain relief in labour. Methods A longitudinal prospective study design was used to recruit 15 women who were having their first baby. Women having low risk pregnancies, hoping for a ‘natural birth’ (vaginal, no/minimal pharmacological pain relief) were eligible. A semi-structured interview tool was used across all three interviews that asked women about their expectations, then actual labour experience, pain management requests and how these were responded to by carers. Fifteen women were interviewed – at 36 weeks gestation; as soon after delivery of their baby as possible, then six months post-delivery (N = 43 interviews). Interviews were recorded and transcribed and coded by ES using NVivo software with hierarchical thematic analysis used. Results The study found that women appear to experience a mismatch between expectations they had developed pre-birth, versus actual experience. This appears to cause a specific form of dissonance – which we have termed ‘birth dissonance’ leaving them feeling traumatised post birth. This is because what women expected to happen in birth was often not realised. In particular, some women requested pain relief in birth and felt that their request was not responded to as hoped, and also seemed to develop post-birth trauma. We proposed that this may have resulted from dissonance arising from their expectations about being able to birth without significant pain relief. Interventions and technology may also contribute to this sense of mismatch and post-birth trauma. Conclusions Low risk birthing women birthing in a hospital may have to engage with higher levels of technology, intervention and pain relief than that which they expected pre-birth. This could possibly be avoided with four simple changes. Firstly, better pre-birth education for women about how painful labor is likely to be. Secondly, pre-birth education which includes a detailed explanation of the utility of pharmacological and non-pharmacological pain relief. Thirdly, more egalitarian decision-making during labour and finally delivering upon women’s requests for pain relief in labor, at the time that they ask for it. Further research is required to determine the extent of birth dissonance and how women making the transition to motherhood can avoid it.https://doi.org/10.1186/s12884-023-06066-7WomenLaborPain managementNatural childbirthNormal childbirthMidwifery |
| spellingShingle | Elizabeth Sutton Karen Detering Christine East Andrea Whittaker Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and trauma BMC Pregnancy and Childbirth Women Labor Pain management Natural childbirth Normal childbirth Midwifery |
| title | Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and trauma |
| title_full | Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and trauma |
| title_fullStr | Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and trauma |
| title_full_unstemmed | Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and trauma |
| title_short | Women’s expectations about birth, requests for pain relief in labor and the subsequent development of birth dissonance and trauma |
| title_sort | women s expectations about birth requests for pain relief in labor and the subsequent development of birth dissonance and trauma |
| topic | Women Labor Pain management Natural childbirth Normal childbirth Midwifery |
| url | https://doi.org/10.1186/s12884-023-06066-7 |
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