Security associated with pregnancy and childbirth--experiences of pregnant women

Mothers' and fathers' sense of security in the context of pregnancy, childbirth and the postnatal period: an integrative literature review

Background

From the individual perspective, security, which is essential to life quality, is characterised as an elementary human need that requires fulfilment. During the transition to parenthood, mothers and fathers are confronted with changes in physical and psychosocial processes that are accompanied by uncertainty and insecurity. Feelings of insecurity may have consequences affecting their pregnancy and childbirth experiences as well as their adaption to the parental role in the first weeks following childbirth. In this context, it is important to understand how parents express and interpret their sense of security to effectively support their security needs. This integrative review aimed to provide a critical synthesis of existing research on parents’ experiences of their sense of security associated with pregnancy, childbirth and the postnatal period.

Methods

A literature search of the PubMed, CINAHL, PsycINFO and GESIS Sowiport databases was performed. Peer-reviewed papers that were published in English or German between 1990 and 2017 focusing on mothers’ and fathers’ experiences of sense of security in the context of maternity care were included. A thematic analysis was performed to organise and describe the findings.

Results

Eleven research-based papers met the inclusion criteria. Four key themes among the data were analysed: the meaning and manifestation of sense of security, sense of security in relation to confidence and control, lack of feeling secure and coping strategies, and factors influencing sense of security.

Conclusions

The findings revealed a complex profile of the perception of security associated with pregnancy, childbirth and the postnatal period. Sense of security can depend on multiple internal and external factors, which can differ between mothers and fathers. Research on the experiences and perceptions associated with fathers’ sense of security is lacking. Further research focused on the experiences of security from the parents’ perspective is necessary. Midwives and other involved health professionals should be aware of their role in creating a sense of security among parents. Based on a local specific understanding of security experiences, professional caregivers have the opportunity to support parents more effectively with regard to their specific security needs.

Important variables for parents' postnatal sense of security: evaluating a new Swedish instrument (the PPSS instrument)

OBJECTIVE

to evaluate dimensions of both parents' postnatal sense of security the first week after childbirth, and to determine associations between the PPSS instrument and different sociodemographic and situational background variables.

DESIGN

evaluative, cross-sectional design.

PARTICIPANTS AND SETTINGS

113 mothers and 99 fathers with children live born at term, from five hospitals in southern Sweden.

MEASUREMENTS AND FINDINGS

mothers and fathers had similar feelings concerning postnatal sense of security. Of the dimensions in the PPSS instrument, a sense of midwives'/nurses' empowering behaviour, a sense of one's own general well-being and a sense of the mother's well-being as experienced by the father were the most important dimensions for parents' experienced security. A sense of affinity within the family (for both parents) and a sense of manageable breast feeding (for mothers) were not significantly associated with their experienced security. A sense of participation during pregnancy and general anxiety were significantly associated background variables for postnatal sense of security for both parents. For the mothers, parity and a sense that the father was participating during pregnancy were also significantly associated.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

more focus on parents' participation during pregnancy as well as midwives'/nurses' empowering behaviour during the postnatal period will be beneficial for both parents' postnatal sense of security.

Decision making in laboring women: ethical issues for perinatal nurses

The decision-making process in childbearing women regarding birth preferences raises ethical dilemmas related to caring for women during labor and birth. Giving birth is a powerful, life-changing event that leaves a lasting impact on the childbearing woman. The birth experience may be perceived positively or negatively or with feelings of ambivalence. This descriptive qualitative study asked what factors influence a woman's change in her stated birth preference from an unmedicated birth to a medicated birth. A purposive convenience sample of 33 primiparous and multiparous childbearing women who had changed their stated birth preference for pain management during labor participated in interviews conducted within a month of giving birth. Themes included wanting an unmedicated birth; changing to a medicated birth; feeling disappointed, ambivalent, or satisfied; and reflecting on the change. Changing birth preferences is a result of many complex factors, including the influence of professional support by nurses. Ethical principles such as autonomy, veracity, beneficence, informed consent, standard of best interest, and obligations should be applied when caring for laboring women, framed by the ethics of caring.

How delivery ward staff exercise power over women in communication

BACKGROUND

Power is a central element in all social interactions. In order to act appropriately in different care situations, it is important to understand the meaning of power.

AIM

This paper reports a study whose aim was to describe delivery ward staff opinions about the exercise of power over women in communications.

METHODS

Data were collected in 2000 using a questionnaire developed for the study with a convenience sample of 155 midwifery and nursing professionals in delivery wards in four Finnish hospitals.

RESULTS

The results showed that in respondents' opinions they worked for women's good and aimed at relationships based on a sense of equality and individuality. Negative power was used in situations where women's well-being was threatened. The power used was verbal or non-verbal.

CONCLUSIONS

The exercise of power is not only negative in nature. There are times, such as in life-threatening situations, when it is crucial that the professional takes control and makes decisions immediately, and in that sense exercises power.