Empowerment or discouragement: women's experience of caring and uncaring encounters during childbirth.

The objective of this study was to explore the essential structure of caring and uncaring encounters with nurse-midwives and other health professionals during labor and delivery as perceived by women who have given birth. The phenomenological perspective of qualitative research theory guided the methodological approach to the study, in which true dialogues were entered into with 10 mothers in Akureyri and Reykjavik, Iceland. The overriding theme of the women's experience of caring and uncaring was "empowerment or discouragement." Within that theme, four major categories were identified: (a) the nurse-midwife perceived as caring--an indispensable companion on the journey through labor and delivery; (b) the woman's perception of the effects of the encounter with the caring nurse-midwife--the sense of being empowered; (c) the nurse-midwife perceived as uncaring--an unfortunate hindrance to a successful birth experience; (d) the woman's perception of the effects of the encounter with the uncaring nurse-midwife--the sense of being discouraged. Findings indicate that the nurse-midwife who satisfies a woman's need for professional caring during the birth experience is likely to be more effective in meeting nursing and midwifery care goals than the nurse-midwife who does not and is perceived as uncaring.

Journeying through labour and delivery: perceptions of women who have given birth.

OBJECTIVE: The aim of this study was to explore the essential structure of the lived experience of childbearing, as seen from the perspective of women who have given birth. DESIGN, SETTING, AND PARTICIPANTS: The phenomenological perspective of qualitative research theory guided the methodological approach to the study, in which interactive interviews were conducted with a purposeful sample of fourteen mothers of healthy babies in Akureyri and Reykjavik, the two most inhabited places in Iceland. FINDINGS: The metaphor of a woman journeying through labour and delivery was chosen to symbolize the lived experience of giving birth to a healthy baby. This encompasses four major categories: influences of circumstances and expectations before the journey's commencement; a sense of self during the journey which encompasses a sense of being in a private world, the sense of control, the need for caring and understanding and the need for a sense of security; the journey through labour and delivery itself; and finally the first sensitive hours of motherhood and the perception of the uniqueness of birth as a life experience at the journey's end. The study has the potential of increasing the knowledge and understanding of giving birth as a life experience, and therefore, has implications for midwives and nurses, as well as for women and their supporters. KEY CONCLUSIONS: The lived experience of giving birth is a powerful life experience which is coloured by circumstances and expectations of the woman, her sense of self during the journey, the journey itself, as well as the first sensitive hours of motherhood. IMPLICATIONS FOR PRACTICE: The study has the potential of increasing the knowledge and understanding of giving birth as a life experience, and therefore, has implications for midwives/nurse, as well as for women and their supporters.