Developing a woman‐centered, inclusive definition of positive childbirth experiences: A discussion paper

Abstract

Introduction: A positive childbirth experience promotes women's health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research. Aim: To formulate an inclusive woman-centered definition of a positive childbirth experience. Methods: A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women's feedback (n = 42). Results: The following definition was formulated: "A positive childbirth experience refers to a woman's experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman's psychosocial well-being." Conclusions: This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making.

From a phenomenology of birth towards an ethics of obstetric care

“…92 As the birth narrative and phenomenological accounts on birth have shown, women in labour are ideally supported by the birth attendants and their significant others in such a way that the limit situation during labour is not experienced as an existentially threatening loss of agency, as alienation and reification, but as a process in which she feels safe due to the support she receives, and in which she experiences an empowering 'I can' accompanied by positive feelings such as joy, satisfaction, or pride. 60 A positive birth experience depends on whether the woman giving birth feels respected, supported and protected by the birth attendants or whether she feels disregarded, patronised and left alone. 15,57 Thus, the actual task of the obstetricians and midwives does not (only) lie in the artful supervision of birth, but 'in the accompanying and caring relationship formation of an existentially significant situation'.…”

“…50 (p. 33) Like Heyes’ account, Tömmel's narration reads like the perfect illustration of a recent definition of positive birthing experiences. 60 Although Heyes, Tömmel or the woman quoted by Lundgren might have felt ‘becoming possessed’, 29 (p. 162) too, the transformative experience they underwent was rather sublime than terrifying, empowering instead of paralysing, leading to feelings of joy and connection instead of estrangement. Despite being radically different from everyday experiences in many ways, Trigg's 41 conclusion ‘that the affective tonality of childbirth is best captured as a form of strangeness’ seems to be too one-sided to do justice to the diverse experiences of different women.…”

Basic psychological needs: A framework for understanding childbirth satisfaction

“…This, in turn, predicts negative outcomes for both mother and child 3,4 . However, there is no consensus regarding the precise dimensions that engender positive birth experiences 5‐7 . In this paper, we argue that Basic Psychological Needs Theory, an existing framework, provides an optimal way to organize the vast literature on this topic.…”

“…summarized birth satisfaction as coming from internal factors (confidence and preparedness; feeling in control) and external factors (supportive relationships with caregivers, being seen and heard, and caregiver providing adequate information/guidance). Recently, Leinweber et al., 6 using a literature review and feedback from birth experts, defined a positive childbirth this way: “A woman's experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long‐term positive impacts on a woman's psychosocial well‐being” (p. 364).…”

Exploring home births in Catalonia (Spain): A cross‐sectional study of women's experiences and influencing factors

“…Different authors have identified various elements related to childbirth experiences, such as the mother's individual factors (parity, experiences of female support during childbirth, cultural background and expectations of childbirth); interpersonal factors related to companions and healthcare professionals attending the birth, and factors related to the sense of control and perceived safety, both physically and emotionally (Chabbert et al., 2021; Leinweber et al., 2022; Vedeler et al., 2022).…”