Confinement in nulliparous women in the Netherlands: Subjective experiences related to actual events and to post-partum well-being

Abstract

Subjective delivery experiences, obstetrical outcomes and post-partum well-being were studied in 170 nulliparous women who participated in a prospective study on the transition to parenthood. All of the women initially received antenatal care by midwives. Women who gave birth at home and those who gave birth in hospital voluntarily without referral did not differ either with regard to objective outcomes or subjective delivery experiences. Negative experiences were related to referrals during labour; other subjective experiences seemed to be related to the duration of the first and second stages of labour. Variables measured during pregnancy hardly predicted these experiences. Post-partum well-being was strongly related to well-being at the start of pregnancy, subjective experiences showing a minor predictive capacity of only 4%. As far as mode of delivery is concerned, the least well-being 6 weeks post-partum was found in women who had an instrumental delivery; low well-being at 34 weeks' gestation could be partially attributed to this phenomenon. Differences in post-partum well-being between women who delivered at home and those who gave birth in hospital were found; these differences probably depended more, however, on attitudinal characteristics than on the location of confinement. With regard to evaluations of the location of confinement, home confinements were assessed as most positive. Preferences for the location of confinement for a next pregnancy were, in the majority of cases, the same as for the present pregnancy, independent of actual events during the present pregnancy and confinement.

Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study

“…This is in line with a study that found a significantly negative association between referral and the birth experience 10 days postpartum (Kleiverda et al, 1991). Another study found referral as a significant risk factor for a negative recall of birth experience in women 3 years postpartum (Rijnders et al, 2008).…”

A trend analysis in referrals during pregnancy and labour in Dutch midwifery care 1988–2004

“…Referral during labour has been shown to lead to more negative perceptions of birth experiences in the short and long term compared to not being referred 39–42 . Further research is required to address women’s expectations and attitudes towards birth, birthplace and caregiver.…”

“…Referral during labour has been shown to lead to more negative perceptions of birth experiences in the short and long term compared to not being referred. [39][40][41][42] Further research is required to address women's expectations and attitudes towards birth, birthplace and caregiver. Furthermore, it has to be explored whether the antenatal criteria for the assessment 'low risk at start labour' can be improved, to decrease the referral rate during delivery.…”

Evaluation of 280 000 cases in Dutch midwifery practices: a descriptive study

“…Evaluative studies have shown that referral during home delivery does not adversely affect women's perception of the birth process and that 72% of women would again opt for home delivery in a subsequent birth. 18,49,50 It is nevertheless important that women (and, given their high referral rate, nulliparous women in particular) should be informed that risk selection continues up to and during the puerperium, with the ensuing probability of referral even during labour.…”

“…18,49,50 It is nevertheless important that women (and, given their high referral rate, nulliparous women in particular) should be informed that risk selection continues up to and during the puerperium, with the ensuing probability of referral even during labour.…”