Thacker Shelley and Dr. Lynn Callister, College of Nursing
Previous research on labor and birth in Australia has focused on mortality rates in hospitals and birthing centers. Gathering qualitative research is important to improve nurses’ culturally based care towards childbearing women. I knew of Dr. Callister’s similar research in various countries. I was in the process of applying to study in Australia with the college of nursing, and she expressed that neither she nor any students had previously conducted this research in Australia. I then made preparations to find women who would be willing to interview while I was studying there for one month.
The purpose of my research was three-fold: 1) to research women’s perceptions of their pregnancy and labor, 2) to provide women an opportunity to share their thoughts regarding this most intimate and emotional experience, 3) and to identify implications to improve nursing care. I was aware that Australia had a public and private health care system. The private system often cares for women who deliver with an obstetrician; whereas, the public system cares for women who deliver with registered nurse midwives. With Australia and the United States’ health care system differences, the thoughts and feelings women had about their experiences in the hospitals and birth centers intrigued me.
Following institutional review board approval, I interviewed Australian women who had given birth within the last 12 months. The 11 women interviewed were sought out by snowball and convenience sampling. I originally contacted a nurse midwife in Australia before leaving for my studies. She gave me a few contacts, and as I interviewed them, they each gave me a couple more contacts. I traveled to Australia desiring to interview 20 women, and only interviewed 11 because of a lack of time. I would have had enough women to interview 20, and initially, I was surprised by their willingness to participate in an hour-long interview. Unfortunately, my month-long study in Australia was not long enough to complete as many interviews as I desired.
I interviewed the women for 45-60 minutes using a semi-structured interview guide involving open-ended questions about their pregnancy, labor, and postnatal experiences. I did some preliminary analysis while in Australia, but did most of the transcription and analysis of the interviews upon my return to the United States. Each woman openly described her thoughts, and they expressed appreciation for the opportunity to share their experiences.
My clinical hours in Australia through the BYU college of nursing did not include any labor & delivery experiences, so I researched, read, and asked questions during the interviews to better understand the differences between labor in the United States and Australia. We attended two meetings with prestigious members of Australian health organizations, and they were able to answer many questions related to the public and private sectors of care. According to the Medical Journal of Australia, there are no national guidelines for how many routine antenatal (prenatal) visits women should have.2 The average number of prenatal visits among the interviewees was 9.5 throughout their pregnancies.
Australia’s government provides postnatal care for each child in the home. Home care nurses travel around to assess babies’ feeding routines and general health free of charge to the family. Directly after birth, the Australian government places women in a “mother’s group” with other mothers who live in the same area and have the same ages of children. This provides women and children with an automatic support network outside of the family unit.
Another piece of data that I gathered was what types of facilities the women delivered in (private hospital, public hospital, or birthing center) and who attended the births (nurse midwife or obstetrician). Researchers conducted a study in Australia on the mortality associated with giving birth in a birth center.1 A general conclusion they found is that the mortality was lower in alongside hospital birth centers than in the hospitals. This is interesting because many of the women I interviewed expressed positive feelings towards the nurse midwives in the family birthing centers as opposed to obstetricians in the private hospitals.
The most interesting part of my research was the invaluable advice I received from the interviewees to pass along to nurses who care for childbearing women. The women described labor and birth as “empowering, exciting, and rewarding.” These overwhelming feelings of joy are what nurses need to amplify when providing care. When asked what nurses should know, one woman said, “Give women accurate information. Tell them exactly how it is and what their body is doing. Lay out the options and during labor just be encouraging.”
I learned many important things while in Australia including how to conduct qualitative research, how to immerse myself into another culture, and how to better care for childbearing women based on their responses during the interviews. Dr. Callister and I completed analysis of common themes separately and then reviewed them for further analysis. I continue to review and analyze the common themes as I prepare to present at the Utah Conference on Undergraduate Research in February.
References
- Tracy, Sally; Dahlen, Hannah; Caplice, Shea; Laws, Paula; Wang, Yueping; Tracy, Mark; Sullivan, Elizabeth. (2007). Birth Centers in Australia: A National Population-Based Study of Perinatal Mortality Associated with Giving Birth in a Birth Center. Birth, 34(3), 194-201.
- Hunt, Jennifer; Lumley, Judith. (2002). Are recommendations about routine antenatal care in Australia consistent and evidence based? The Medical Journal of Australia, 176(6), 255-259.