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      Giving Birth With Epidural Analgesia: The Experience of First-Time Mothers

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      The Journal of Perinatal Education

      Springer Publishing Company

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          Abstract

          The purpose of our qualitative descriptive study was to describe the birth experiences of women using epidural analgesia for pain management. We interviewed nine primiparas who experienced vaginal births. Five themes emerged: (a) coping with pain, (b) finding epidural administration uneventful, (c) feeling relief having an epidural, (d) experiencing joy, and (e) having unsettled feelings of ambivalence. Although epidural analgesia was found to be effective for pain relief and may contribute to some women’s satisfaction with the birth experience, it does not guarantee a quality birth experience. In order to support and promote childbearing women’s decision making, we recommend improved education on the variety of available pain management options, including their risks and benefits. Fostering a sense of caring, connection, and control in women is a key factor to ensure positive birth experiences, regardless of pain management method.

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          Most cited references 52

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          Pain and women's satisfaction with the experience of childbirth: a systematic review.

           Ellen Hodnett (2002)
          To summarize what is known about satisfaction with childbirth, with particular attention to the roles of pain and pain relief. A systematic review of 137 reports of factors influencing women's evaluations of their childbirth experiences. The reports included descriptive studies, randomized controlled trials, and systematic reviews of intrapartum interventions. Results were summarized qualitatively. Four factors-personal expectations, the amount of support from caregivers, the quality of the caregiver-patient relationship, and involvement in decision making-appear to be so important that they override the influences of age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions, and continuity of care, when women evaluate their childbirth experiences. The influences of pain, pain relief, and intrapartum medical interventions on subsequent satisfaction are neither as obvious, as direct, nor as powerful as the influences of the attitudes and behaviors of the caregivers.
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            Factors related to childbirth satisfaction.

            A woman's satisfaction with the childbirth experience may have immediate and long-term effects on her health and her relationship with her infant, but there is a lack of current research in this area. This paper reports a study to examine multiple factors for their association with components of childbirth satisfaction and with the total childbirth experience. A correlational descriptive study was conducted with 60 low-risk postpartum women, aged 18-46 years, with uneventful vaginal deliveries of healthy full-term infants at two medical centres in the south-eastern United States. The Labor Agentry Scale, McGill Pain Questionnaire and Mackey Childbirth Satisfaction Rating Scale and a background questionnaire were completed by women. Obstetrical data were collected from the medical record. Personal control was a statistically significant predictor of total childbirth satisfaction (P = 0.0045) and with the subscale components of satisfaction (self, partner, baby, nurse, physician and overall). In addition, having expectations for labour and delivery met was a significant predictor of satisfaction with own performance during childbirth. Personal control during childbirth was an important factor related to the women's satisfaction with the childbirth experience. Helping women to increase their personal control during labour and birth may increase the women's childbirth satisfaction.
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              Prevalence and predictors of women's experience of psychological trauma during childbirth.

              The increased acceptance of the prevalence of trauma in human experience as well as its psychological consequences has led to revisions of diagnostic criteria for the disorder. The three purposes of this study were to examine the rates at which women experienced psychological trauma in childbirth, to explore possible causal factors, and to examine possible factors in the development of the disorder. One hundred and three women from childbirth education classes in the Atlanta metropolitan area completed a survey in late pregnancy and a follow-up interview approximately 4 weeks after the birth. The childbirth experience was reported as traumatic by 34 percent of participants. Two women (1.9%) developed all the symptoms needed to diagnose posttraumatic stress disorder, and 31 women (30.1%) were partially symptomatic. Regression analysis showed that antecedent factors (e.g., history of sexual trauma and social support) and event characteristics (e.g., pain in first stage of labor, feelings of powerlessness, expectations, medical intervention, and interaction with medical personnel) were significant predictors of perceptions of the childbirth as traumatic. The pain experienced during the birth, levels of social support, self-efficacy, internal locus of control, trait anxiety, and coping were significant predictors of the development of posttraumatic stress disorder symptoms after the birth. These findings suggest several intervention points for health care practitioners, including careful prenatal screening of past trauma history, social support, and expectations about the birth; improved communication and pain management during the birth; and opportunities to discuss the birth postpartum.
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                Author and article information

                Journal
                The Journal of Perinatal Education
                J Perinat Educ
                Springer Publishing Company
                1058-1243
                1548-8519
                January 01 2012
                2012
                2012
                January 01 2012
                : 21
                : 1
                : 24-35
                Article
                10.1891/1058-1243.21.1.24
                © 2012

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