| Summary: | Pregnancy and childbirth are important life experiences in a woman’s
psychosocial and psychological development. For many women, vaginal birth is
still considered an integral part of being a woman and becoming a mother.
Furthermore, it is thought to promote maternal well-being through helping women
to match their expectations to experiences. For these women, a failed natural
birth can be a psychological, psychosocial, and existential challenge that can
result in significant and far-reaching consequences for their psychological wellbeing.
Research, especially recent research, on the experiences of women who most
wanted to, but were unable to deliver their babies naturally is relatively rare. This
is surprising given the potential implications of these experiences on a mother’s
emotional well-being, as well as for her feelings towards her new baby.
Nevertheless, literature on the topic presents a coherent perspective on the
problem and indicates that these women experience difficulties in adapting to not
being able to fulfill their dream of delivering their baby naturally. There is no
existing research on the subjective experiences of South African women who delivered their babies by unplanned Caesarean section. This study therefore
aimed to contribute to knowledge that may fill this gap to some extent.
Through purposeful sampling, ten mothers who had wanted to deliver their
babies naturally, but had not been able to for whatever reason, were selected as
the study sample. Various aspects of their birth experiences were explored in indepth
phenomenological interviews. This allowed the researcher to probe certain
aspects offered by participants in order to understand and explore their
contributions in as much depth as possible. A semi-structured, open-ended
approach allowed for the exploration of relevant opinions, perceptions, feelings,
and comments in relation to the women’s unplanned Caesarean experiences.
The transcribed data was synthesized within a framework of phenomenological
theory, where women’s experiences were analyzed and explored in an attempt to
understand how participants made sense of their experiences.
The different aspects of women’s experiences were explored in three substudies.
The results are reported in three manuscripts/articles.
Research suggests that post-partum adjustment difficulties are influenced by the
potentially virulent stress reactions generated in response to a perceived birth
trauma. The objective of the first article was to explore women’s labour and
birthing accounts with specific regard to the subsequent stress responses
experienced. The stress responses experienced by the women in this study both prior to, and during the Caesarean section were predominantly anxiety-based.
This was distinguished from the post-partum period, where women described
having experienced more depressive symptoms. Post-traumatic stress
responses are associated with negative perceptions of the birth, self and infant.
The experience of adverse emotional consequences during the post-partum
period can undermine a woman’s ability to successfully adapt to her role as a
mother, meet the needs of her infant, and cope with post-partum challenges.
The second article highlighted the possible impact of women’s unexpected and
potentially traumatic childbirth experiences on initial mother-infant bonding. The
unplanned Caesarean sections left mothers feeling detached from the birthing
process and disconnected from their infants. Passivity, initial separation, and
delayed physical contact further compromised mother-infant interaction. Postpartum
physical complications and emotional disturbances have important
implications for a woman’s perceptions of herself as a mother and her ability to
provide for her infant, her self-esteem, and feelings of relatedness with her baby.
Adverse responses to a traumatic birth experience could therefore influence the
establishment of a maternal role identity, the formation of balanced maternal
attachment representations, the caregiving system, and ultimately initial motherinfant
bonding.
In the third article, women’s experiences were contextualized in relevant coping
resources and strategies. The processes occurring during a traumatic birth experience, such as during an unplanned Caesarean section, could be
influenced by perceived strengths when coping with the stress related to the
incident. The mothers in this study described several factors and coping
strategies that they perceived to have been effective in reducing the impact of
their traumatic birth experiences. These included active coping strategies,
problem-focused coping strategies, and emotion-focused coping strategies.
Coping strategies could result in reassessment of the birth process, and be
associated with a more positive, acceptable and memorable experience.
This study contributes to nursing, midwifery and psychological literature, by
adding to the professional understanding of the emotional consequences of
surgical delivery on South African childbearing women. This exploration therefore
has important implications for preventative measures, therapeutic intervention,
and professional guidance. However, the restricted sample may limit the
generalizability of results. Further investigation of the experiences of a larger,
more biographically and culturally diverse population could be instrumental in the
development of knowledge and understanding in this field of study. === Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013
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