| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 90 === Abstract
The main purpose of this study, from the viewpoint of expectant mothers who have experience of a Caesarean birth and decided to have vaginal birth, is to thoroughly understand the pregnancy progresses before birth. By utilizing Field Method, as nursing staffs and observer being the participant, 10 such multigravidas were recruited and relevant information was collected from 28 weeks of pregnancy to procreation. During the routine pregnant checks at an interval of one or two weeks, research subjects were contacted, provide with required nurse care and consultation. After the strategy was definitive, home visits were scheduled for profound interviews and instructions of birth, respiration and relaxation. All contacts, spontaneous talking and non-verbal actions of expectant mothers during this period were recorded as records of behavior and process. The verbal actions related to behavior process were then systemically sorted, analyzed, and concluded by Content Analysis.
From these research results, the pregnant process of expectant mothers, who have experience of a Caesarean birth and decided to have vaginal birth, could be concluded into 3 stages:
Stage 1: the stage for vaginal birth being undecided
1.Unification negative experience of the first birth
(1)Feeling helpless from the starting of labor pain to
decision of operation
(2)Cold and horrible experiences of a Caesarean section
(3)Horrible and perplexed experience of post-operative
hospitalization
(4)Suffering from slow recovery after returning home and doubt
about incapable of giving natural birth
2.Thinking of the purpose for choosing natural birth
A.In psychological aspect:
(1)Being afraid of the recurrence of profound and unforgettable
pain
(2)Expecting to experience the real procreation
(3)Anxiety for achieving the procreation
(4)For the purpose of self-approval
(5)Considering for birth in future
B.In physical aspect:
(1)Hoping to maintain the physical integrity
(2)Keeping the health of self and the baby
Stage 2: the transitional stage for deciding to have a natural
birth
1.Vacillating decision and struggle
(1)Confliction of VBAC information
(2)Doubtfulness on the safety of mother and baby to be through
the procreation process
(3)Uncertainty on the capability of giving natural birth
(4)Worry about the sequela of loose vagina
2.Devoting to search for information and assurance
(1)Exerting to search VBAC related knowledge for evaluation
(2)Searching supporting system for adopting VBAC manner of
giving birth
(3)Seeking safety assurance on VBAC from medical staffs.
Stage 3: the stage post transition for deciding to have a
natural birth
self preparation for challenge
1.Exerting to search for knowledge related to VBAC birth
2.Referring to the experience of predecessors for references
3.Self-encouraging to augment the self-confidence
4.Adopting the life styles beneficial for easy delivery
From the analysis results of this study, it was known that there was a sequential variation for pregnant processes of expectant mothers, who have experience of a Caesarean birth and decided to have vaginal birth. Different experiences and desires of expectant mothers in various stages were also overall presented. These processes were rather arduous and lonely but they faced these difficulties with extreme persistence and effort. This will be helpful for clinical nursing staffs to understand the inner world of expectant mothers, who have experience of a Caesarean birth and decided to have vaginal birth, as well as to provide consultation for adequate nursing cares.
Key words: vaginal birth after a caesarean birth, decision,
pregnant process
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