Search results

There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of dignified treatment during birth contributes to a salient, under-examined aspect of women’s childbirth experiences.

We use a two-part conceptualization of dignity, respect and autonomy, to understand how birth experiences and interactions either facilitate or undermine women’s perceived dignity. Data came from the Listening-to-Mothers I survey, the first nationally representative study of postpartum women in the United States (n = 1,406). Through linear regression analysis, we separately modeled women’s perception of respectful treatment and women’s perception of medical autonomy during birth.

Overall women reported high scores for both autonomy and respect. Differences between the models emerged related primarily to the role of interventions and provider support. While women’s perceived dignity is related to elements that she brings in to the delivery room (e.g., birth knowledge, health status), much variation was explained by the medical encounter itself (e.g., type of medical interventions, pain management, nurse support, and number of staff present).

This study is cross-sectional, and required either a telephone or internet access, thus limiting the full generalizability of findings. Two findings have direct practical relevance for promoting women’s dignity in childbirth. First, the number of staff persons present during labor and birth was negatively associated with both respect and autonomy. Second, that women with high levels of knowledge about their legal rights during childbirth were more likely to report high scores on the dignity scale. Limiting staff in the delivery room and including knowledge of legal rights in childbirth education or during prenatal visits may be two mechanisms to promote dignity in birth.

These findings address an important, under-examined aspect of women’s childbirth experiences. This study investigates how different birth experiences and interactions either promote or violate childbearing women’s perception of dignity, and has significant implications for the provision of maternal healthcare. The results reinforce the importance of focusing on the socio-psychological dimensions of childbirth.

The purpose of this paper is to make a case for novel and innovative reentry programs focused on women of color and to describe policy recommendations that are necessary to support the sustainability of these programs and in turn the success of the women who participate in them.

A review and analysis of the literature that described job-training opportunities specifically targeted to women exiting jail and the impact on recidivism provided limited information. The authors developed, implemented, and evaluated doula training program for low-income and women of color to determine if birth work could provide stable income and decrease recidivism.

Training low-income formerly incarcerated women to become birth doulas is an innovative strategy to solve employment barriers faced by women reentering communities from jail. Realigning women within communities via birth support to other women also provides culturally relevant and appropriate members of the healthcare team for traditionally vulnerable populations. Doulas are important members of the healthcare workforce and can improve birth outcomes. The authors’ work testing doula training, as a reentry vocational program has been successful in producing 16 culturally relevant and appropriate doulas of color that experienced no re-arrests and to date no program participant has experienced recidivism.

To be successful, the intersections of race, gender, and poverty, for women of color should be considered in the design of reentry programs for individuals exiting jail. The authors’ work provided formerly incarcerated and low-income women of color with vocational skills that provide consistent income, serve as a gateway to the health professions, and increase the numbers of well-trained people of color who serve as providers of care.

Confidentiality in adoption has been the norm in this country since the 1930s. Traditionally, it has been perceived as beneficial to all sides of the adoption triangle: the adoptive parents, the adoptee, and the birth parents. Adoption agencies have supported the policy of confidentiality, and as a result the practice of concealment is almost universal in the United States. Alaska, Hawaii, and Kansas are the only states that allow adult adoptees access to their birth and adoption information.

This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters.

A mixed-methods study was undertaken that involved observations of support groups and peer support supervision sessions (n = 9); audio recorded interviews (n = 33) with prison and health-care staff, women in prison, peer supporters and BC staff; analysis of existing routinely collected data by BC and notes undertaken during regular meetings (n = 10) with the BC Project Manager. Thematic analysis was undertaken supported by MAXQDA qualitative data analysis software.

BC provided instrumental/practical support, emotional support, information support, signposting to services and advocating for women to the prison concerning their perinatal needs and rights. Key themes revealed that support had an impact on the lives of perinatal women by creating a safe place characterised by meaningful interactions and women-centred approaches that facilitated access to wider care and support. The service made a difference by empowering women and providing added value for peer supporters, prison, health-care and BC staff. Key enablers and strategies for the care of perinatal women and the delivery of perinatal support are also detailed.

Through longitudinal data and the involvement of a range of stakeholders, this study evidences the subtleties of support provided by BC and the potential it has to make a difference to perinatal women in prison and those volunteering or working within the prison system.

The purpose of this paper is to describe what it is like to be a midwife in the professionally isolated and marginalised arena of home birth in Ireland and to explore whether the organisation of home birth services and professional discourse might be undermining the autonomy of home birth midwives.

This paper is drawn from auto-ethnographic field work, with 18 of the 21 self-employed community midwives (SECMs) offering home birth support to women in Ireland from 2006 to 2009. The data presented are derived from field notes of participant observations and from interviews digitally recorded in the field.

Home birth midwives must navigate isolated professional practice and negotiate when and how to interface with mainstream hospital services. The midwives talk of the dilemma of competing discourses about birth. Decisions to transfer to hospital in labour is fraught with concerns about the woman's and the midwife's autonomy. Hospital transfers crystallise midwives’ sense of professional vulnerability.

Maternity services organisation in Ireland commits virtually no resources to community midwifery. Home birth is almost entirely dependent upon a small number of SECMs. Although there is a “national home birth service”, it is not universally and equitably available, even to those deemed eligible. Furthermore, restrictions to the professional indemnification of home birth midwives, effectively criminalises midwives who would attend certain women. Home birth, already a marginal practice, is at real risk of becoming regulated out of existence.

This paper brings new insight into the experiences of midwives practicing at the contested boundaries of contemporary maternity services. It reveals the inappropriateness of a narrowly professional paradigm for midwifery. Disciplinary control of individuals by professions may countermand claimed “service” ideologies.

Frequently women are attended by someone other than their chosen doctor during labor and delivery, that is, an “on-call” doctor. This chapter draws from interviews with 19 women who gave birth in a Mid-Atlantic state during late 1995 and early 1996. Of these women, 13 received care from an on-call doctor. Using existing social–psychological perspectives, the authors analyze situations in which an on-call doctor was present, and how this provider influenced women's birth experiences as well as satisfaction with those experiences. In general, women do not expect or desire on-call doctors’ presence. As a result, they may rely on obstetric nurses, rather than these unfamiliar doctors, when they need information or support.

The purpose of this paper is to develop a psychometric scale – the birth satisfaction scale (BSS) – for assessing women's birth perceptions.

Literature review and transcribed research‐based perceived birth satisfaction and dissatisfaction expression statements were converted into a scored questionnaire.

Three overarching themes were identified: service provision (home assessment, birth environment, support, relationships with health care professionals); personal attributes (ability to cope during labour, feeling in control, childbirth preparation, relationship with baby); and stress experienced during labour (distress, obstetric injuries, receiving sufficient medical care, obstetric intervention, pain, long labour and baby's health).

Women construct their birth experience differently. Views are directed by personal beliefs, reactions, emotions and reflections, which alter in relation to mood, humour, disposition, frame of mind and company kept. Nevertheless, healthcare professionals can use BSS to assess women's birth satisfaction and dissatisfaction. Scores measure their service quality experiences.

Scores provide a global measure of care that women perceived they received during labour.

Finding out more about what causes birth satisfaction and dissatisfaction helps maternity care professionals improve intra‐natal care standards and allocate resources effectively. An attempt has been made to capture birth satisfaction's generalised meaning and incorporate it into an evidence‐based measuring tool.

This chapter examines birth outcomes of patients enrolled in Familias Sanas (Healthy Families), an educational intervention designed to reduce health disadvantages of low-income, immigrant Latina mothers by providing social support during and after pregnancy.

Using a randomized control-group design, the project recruited 440 pregnant Latina women, 88% of whom were first generation. Birth outcomes were collected through medical charts and analyzed using regression analysis to evaluate if there were any differences between patients enrolled in Familias Sanas compared to those patients who followed a typical prenatal course.

Control and intervention groups were found to be similar with regard to demographic characteristics. In addition, we did not observe a decrease in rate of a number of common pregnancy-related complications. Likewise, rates of operative delivery were similar between the two groups as were fetal weight at delivery and use of regional anesthesia at delivery.

The lack of improvements in birth outcomes for this study was perhaps because this social support intervention was not significant enough to override long-standing stressors such as socioeconomic status, poor nutrition, genetics, and other environmental stressors.

This study was set in an inner-city, urban hospital with a large percentage of patients being of Hispanic descent. The study itself is a randomized controlled clinical trial, and data were collected directly from electronic medical records by physicians.

There has been substantial interest in US cesarean rates, which increased from 5% of deliveries in the 1970s to nearly one-third of births by the mid-2000s. Explanations typically emphasize individual risk factors (e.g., advanced maternal age, increased BMI, and greater desire for control over delivery) of women giving birth, or address institutional factors, such as the medicalization of childbirth and the culture of liability leading physicians to practice defensive medicine. We focus here on another non-medical explanation – childbirth education (CBE). CBE is an important, underexplored mechanism that can shape women’s expectations about labor and birth and potentially lead them to expect, or desire, a cesarean delivery as a normalized outcome. We analyze data from three waves (2002, 2006, 2013) of the Listening to Mothers national survey on US women’s childbearing experiences (n = 3,985). Using logistic regression analysis, we examined both mode of delivery (vaginal versus cesarean), and attitudes about future request for elective cesarean among both primiparous and multiparous women. Despite previous research suggesting that CBE increased the likelihood of vaginal delivery, we find that CBE attendance was not associated with likelihood of vaginal delivery among either primiparous or multiparous women. However, both primiparous and multiparous women who attended CBE classes were significantly more likely to say they would request a future, elective cesarean. Furthermore, these effects were in the opposite direction of effects for natural birth attitudes. Our findings suggest that contemporary CBE classes may be a form of “anticipatory socialization”, potentially priming women’s acceptance of medicalized childbirth.

This chapter considers the mobilities of families subject to child protection involvement at the threshold of the birth of a new baby. The author presents data arising from an ethnographic study of child protection social work with unborn babies. This study aimed to draw near to social work practice within the Scottish context through mobile research methods and included non-participant observations of a range of child protection meetings with expectant families. Research interviews were sought with expectant mothers and fathers, social workers and the chair persons of Pre-birth Child Protection Case Conferences. Case conferences are formal administrative meetings designed to consider the risks to children, including unborn children. This chapter focusses on the experiences of expectant parents of navigating the child protection involvement with their as yet unborn infant. The strategies that parents adopted to steer a course through the multiple possibilities in relation to the future care of their infant are explored here. Three major strategies: resistance, defeatism and holding on are considered. These emerged as means by which expectant parents responded to social work involvement and which enabled their continued forwards motion towards an uncertain future.