Melody Kuhre and Dr. Lynn Callister, College of Nursing
Giving birth is a life changing experience for women throughout the world. While its significance is universal, women’s perceptions of childbearing are unique depending on their socio-cultural context. The purpose of this qualitative descriptive study was to describe the unique perceptions of childbearing women in Australia. Our research question was, what is the meaning of giving birth to Australian women?
Prior to conducting my research, I spent time learning about socio cultural trends and healthcare delivery in Australia. In Australia, current socio cultural trends include a declining birth rate and smaller nuclear families. Many Australian women are choosing to delay childbirth until after they are 35 years of age. In order to encourage more women to have children, the Australian government has recently instituted a “baby bonus” of 5,000 dollars. Australia has a universal health care system and basic care is covered regardless of socio-economic status. Women with low risk pregnancies are managed by nurse midwives. Women with higher risk pregnancies are co managed by a team of obstetricians and nurse midwives. During the delivery, most Australian women choose not to get an epidural. Most Australian women breastfeed and take a full year’s leave from work following the deliveries of their babies.
In April of 2008, I travelled to Geelong, Australia in order to conduct interviews with Australian women who had recently given birth. Only women who had given birth within the last 12 months were invited to participate in the study. Due to Australia’s low fertility rate, initially it was very difficult to find women who matched this qualification. However, after I contacted a few women, they referred me to friends who had also recently given birth. In total, a convenience sample of 17 women participated in audio taped interviews. During these interviews, Study participants were asked questions which invited them to reflect on the emotions they felt and the insights they gained during their pregnancy, labor, and postpartum experiences. Questions included, “what was it like to see your baby for the first time?”, “what did your nurse do that was most helpful to you during your delivery?” and “what would you do differently if you had another baby?”
Following their completion, each interview was transcribed verbatim and preliminary themes were indentified. Trustworthiness of the data was ensured by member checks and other strategies. As we analyzed the transcriptions of the interviews, several common themes began to emerge. Themes included being empowered by giving birth, defining the spiritual dimension of giving birth, feeling more concerned about the child than themselves, experiencing the pivotal moment of birth, and the role of the nurse in the provision of care.
One of the most interesting themes that we identified from the interviews was the Australian women view birth as an empowering experience. Most of the women that I interviewed were strong, articulate women who viewed childbirth as a life changing, wellness experience. Many study participants preferred to avoid having epidural anesthesia because they wanted to be an active part of the birthing process. Several women expressed their view that the challenges of childbirth are symbolic of challenges across the lifespan. One participant said, “[Giving birth] makes you more resilient. You know you are able to handle things that you didn’t think you could. I think it gives you strength because if you know if you can get through that, you can cope with a lot of other things.” It was very interesting to contrast these women’s views with the views of women often expressed in the United States. Often in the U.S., women view birth as an almost pathological event, rather than a wellness event. Unlike women in Australia, many women in the U.S. prefer to have an epidural rather than being a more active participant in their labor.
Another interesting theme that we identified was experiencing the pivotal moment of birth. When asked to describe the most rewarding part of giving birth, each of the women described the moment when they first saw their child. One women described her feelings beautifully, she said, “My husband had tears in his eyes, and he’s a pretty tough sort of bloke. And that was lovely. It’s just something I hadn’t felt until I had children. It’s something primal, a gut feeling of protection, of just pure love. It’s amazing. It was for me, instant.” Many of the participants expressed their feeling that the pain of child birth seemed insignificant at the moment they saw their babies.
Another significant theme that emerged from the data was the important role each woman’s nurse played in helping her to have a positive experience with childbirth. Many mothers expressed their opinions that nursing interventions such as acting as an advocate, allowing space and privacy, expressing confidence, and providing individualized care were helpful and allowed them to feel a sense of shared control with health care providers. When describing her nurse, one woman said, “I don’t even remember her name, but I know her face. She was awesome. She did everything. She was very personal. I didn’t feel like just another patient. She individualized. I can’t even remember the doctors. I knew they were there but the nurse is the one that sticks out in my mind.”
Conducting this research was a wonderful learning experience for me. I have just graduated as a registered nurse and will begin working on a mother/baby unit next month. During my practice as a registered nurse, I will encounter patients from many different cultural backgrounds. Completing this research has helped me to understand how important it will be for me to spend time talking with my patients so that I can provide individualized and culturally competent nursing care. I know that as I provide this individualized and culturally competent care, I will be better able to bless the lives of my patients and help them to achieve positive health outcomes.