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The Role of Women’s Attitudinal Profiles in Satisfaction with the Quality of their Antenatal and Intrapartum Care
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell sexuell och reproduktiv hälsa/Larsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell sexuell och reproduktiv hälsa/Larsson)
The University of Melbourne, Rural Health Academic Centre .
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell sexuell och reproduktiv hälsa/Larsson)
2013 (English)In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 42, no 4, 428-441 p.Article in journal (Other academic) Published
Abstract [en]

Objective

To compare perceptions of antenatal and intrapartum care in women categorized into three profiles based on attitudes and fear. 

Design

Prospective longitudinal cohort study using self-report questionnaires. Profiles were constructed from responses to the Birth Attitudes Profile Scale and the Fear of Birth Scale at pregnancy weeks 18 to 20. Perception of the quality of care was measured using the Quality from Patient's Perspective index at 34 to 36 weeks pregnancy and 2 months after birth.

Setting

Two hospitals in Sweden and Australia. 

Participants

Five hundred and five (505) pregnant women from one hospital in Vasternorrland, Sweden (n=386) and one in northeast Victoria, Australia (n=123). 

Results 

Women were categorized into three profiles: self-determiners, take it as it comes, and fearful. The self-determiners reported the best outcomes, whereas the fearful were most likely to perceive deficient care. Antenatally the fearful were more likely to indicate deficiencies in medical care, emotional care, support received from nurse-midwives or doctors and nurse-midwives'/doctors' understanding of the woman's situation. They also reported deficiencies in two aspects of intrapartum care: support during birth and control during birth. 

Conclusions 

Attitudinal profiling of women during pregnancy may assist clinicians to deliver the style and content of antenatal and intrapartum care to match what women value and need. An awareness of a woman's fear of birth provides an opportunity to offer comprehensive emotional support with the aim of promoting a positive birth experience.

Place, publisher, year, edition, pages
2013. Vol. 42, no 4, 428-441 p.
Keyword [en]
Fear of birth, attitudes, profiling, satisfaction, childbirth
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
URN: urn:nbn:se:uu:diva-185080DOI: 10.1111/1552-6909.12221ISI: 000321822800007OAI: oai:DiVA.org:uu-185080DiVA: diva2:570595
Available from: 2012-11-20 Created: 2012-11-20 Last updated: 2017-12-07Bibliographically approved
In thesis
1. ‘No worries’: A longitudinal study of fear, attitudes and beliefs about childbirth from a cohort of Australian and Swedish women
Open this publication in new window or tab >>‘No worries’: A longitudinal study of fear, attitudes and beliefs about childbirth from a cohort of Australian and Swedish women
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Much is known about childbirth fear in Sweden including its relationship to caesarean birth. Less is understood about this in Australia. Sweden has half the rate of caesarean birth compared to Australia. Little has been reported about women’s beliefs and attitudes to birth in either country. The contribution of psychosocial factors such as fear, attitudes and beliefs about childbirth to the global escalation of caesarean birth in high-income countries is an important topic of debate.

The overall aim of this thesis is to investigate the prevalence and impact of fear on birthing outcomes in two cohorts of pregnant women from Australia and Sweden and to explore the birth attitudes and beliefs of these women.  

A prospective longitudinal cohort study from two towns in Australia and Sweden (N=509) was undertaken in the years 2007-2009. Pregnant women completed self-report questionnaires at mid-pregnancy, late pregnancy and two months after birth. Fear of birth was measured in mid-pregnancy with a tool developed in this study: the Fear of Birth Scale (FOBS). The FOBS showed promise as a clinically practical way to identify women with significant fear. A similar prevalence of fear of birth (30 percent) was found in the Australian and Swedish cohorts (Paper I). 

The Swedish women had attitudes indicating a greater concern for the personal impacts of birth and a belief system that situated birth as a natural event when compared to the Australian women (Paper II). Finally, when women’s attitudes and levels of fear were combined, three profiles were identified: Self determiners, Take it as it comes and Fearful (Paper III). Belonging to the Fearful profile had the most negative outcomes for women including higher rates of elective caesarean, more negative feelings in pregnancy and post birth and poorer perceptions of the quality of their antenatal and intra-partum care (Paper IV).

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 100 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 843
Keyword
Fear of birth, attitudes, beliefs, Australia, Sweden, cluster analysis, profiles
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:uu:diva-185081 (URN)978-91-554-8547-4 (ISBN)
Public defence
2013-01-18, Auditorium Minus, Gustavianum, Akademigatan 3, Uppsala, 09:00 (English)
Opponent
Supervisors
Available from: 2012-12-19 Created: 2012-11-20 Last updated: 2013-02-11Bibliographically approved

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Haines, HelenHildingsson, IngegerdRubertsson, Christine

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