Jennifer L. Hamilton and Professor Troy Carlton, College of Nursing

Nurses provide essential care and support during labor and the lack of such support has been equated with decreased patient satisfaction. Satisfaction of laboring women has been found to be important because women most commonly will make future health care decisions for their families. The intent of this study was two parts. 1. To identify factors which influence women to change their birth preference and 2.To identify how nurses’ personal bias and perceptions of the birth experience influence a women change in their birth preference.

The first part of the study has two purposes; the primary purpose was qualitative descriptive study to identify and understanding factors which influence women who change their birth preference. A secondary purpose was to inform nurses and other clinicians about reasons why changes are made to birth preferences so women can be more supported and have a positive birthing experience. The second part of the study’s purpose was to identify and understand nurses’ perceptions of laboring women’s birth experiences and factors that influence change in birth preference during active labor. The objective was to use the voices of nurses to inform the research, it was our assumption that identifying and comparing common themes with current available theory, nurses and other providers will be better informed, provide better support and assistance, and promote positive birth experiences for women.

To identify and understand both women and their nurses’ perceptions of the birthing experience and factors that influence change in birth preference, a convenient sample of women who had been admitted to the Labor and Delivery unit identifying their birth preference as “un-medicated” or “wait and see” and later change that preference to a medicated birth and nurses currently working in Labor and Delivery unit were planned to be interviewed. Participants for this sample were to be patients who have had a recent birth experience at St. Luke’s Hospital, Charlton Memorial Hospital, or Tobey Hospital in the state of Massachusetts and nurses who worked in the these facilities. The reason for choosing these facilities in a state other than Utah was to add to the data that had already been collected in Utah County. This study replicated work already completed by Carlton, Callister, and Stoneman (2005) and interviewing participants from another geographical area of the country was intended to provide depth to their already established research program.

I first established a relationship with the Massachusetts hospitals’ nursing staff over research and went though the process of obtaining IRB approval to interview twenty patients and ten nurses in a semi-structured interview process. I worked with nurses experience in research in the area to develop demographic forms that what be appropriate for that specific population. After making contact with the nursing managers and nursing educators at St. Luke’s Hospital, Charlton Memorial Hospital, and Tobey Hospital, I worked with these professionals to create a system to identify patients that fit the inclusion criteria without breaching patient rights to confidentiality. They were also helpful in recruiting their staff to volunteering to be interviewed for the nursing perceptions aspect of the studying.

For a period of four weeks I made daily contact with the nursing staff at St. Luke’s Hospital, Charlton Memorial Hospital, and Tobey Hospital in order to identify women that fit in the inclusion criteria. During this period only four women meet our criteria. These women consented, while in the hospital, to be contacted by phone a week later to set up a time to be interviewed by me. Two of these women choose to not participate after being discharged from the hospital. One the women was unable to participate due to postpartum health complications. After month in Massachusetts I interviewed one patient and ten nurses.

I am currently still in the process of the transcribing these interviews and analyzing them using qualitative techniques to identify common themes. The plan is to finish analysis and present my findings at the Brigham Young University College of Nursing 30th Annual Research Conference.

This research grant allowed my many learning experiences, some of them very frustrating. I found that research has many obstacles, hoops to jump through, and things do not always go as planned. I found that the process of obtaining IRB approval, while vital to safe research, can be difficult and time consuming. The most difficult aspect of this experience was the frustration of not being able to have the sample size I originally planned on in the limited time fame I had in Massachusetts. It was discouraging not to have the time or resources to complete the data collection process.

Overall, I feel that this has been an important experience that enabled me to learn about professional nursing and nursing research in a very hands on way. I feel that I was able to stretch and grow as both a student and a nurse. I learned to present my ideas and projects in a professional manner in professional arenas where really changes in healthcare can be made. I truly appreciate the opportunity I had to conduct research myself. I am grateful to my faculty member and everyone else that helped me through this process.