Bryanton, J., Gagnon, A. J., Johnston, C., & Hatem, M. (2008). Journal of Obstetric, Gynecologic and Neonatal Nursing, 37, 24-34.
Nurses have the most contact with childbearing women during their labor and birth and have a unique opportunity to create a positive birth experience. The purpose of this study was to identify factors that predict women's perceptions of the childbirth experience and examine whether they vary with the type of birth a women experiences. Few previous studies have examined several predictors simultaneously to determine the relative importance of one factor over another, and none has examined predictors of birth perception by type of birth. The investigators conducted a prospective cohort study in the Canadian province of Prince Edward Island, recruiting a sample of 652 women who gave birth to healthy, term, singleton infants. Most of the mothers were white, married or in a common-law relationship, and had some college or university education. Birth perception was measured using the Questionnaire Measuring Attitudes About Labor and Delivery (QMAALD) for women giving birth vaginally or by emergency cesarean section, whereas women giving birth by planned cesarean completed the modified QMAALD. Multiple linear regression models were developed using 26 variables. The five variables most predictive of the birth experience (for all births) were degree of awareness, helpfulness of partner support, being together with the infant, degree of relaxation, and type of birth. Predictors varied by type of birth. Many of these predictors are amenable to nursing interventions. The investigators suggested "because of the importance women placed on being aware of events during birth, nurses present during labor and birth can encourage women to talk about their experience immediately afterwards and help them fill in events that are not clearly remembered." Other implications for nursing practice include teaching women about relaxation techniques, educating partners about how to provide a supportive role during labor and birth, and ensuring that women have their babies with them immediately after birth.
Maureen Heaman