The unpredictable nature of labour and birth: A qualitative investigation regarding expectations of Italian parents to-be.

OBJECTIVE: to explore first-time Italian parents' expectations of labour and birth. DESIGN: qualitative Husserlian phenomenological approach, using face-to-face focus groups for parents during the late third trimester of pregnancy. Data analysis, using Colaizzi's phenomenological method, included the processes of reading and re-reading the text to extract relevant statements in order to identify themes and finally member checking was performed to validate participants' expressions SETTING: consultant-led maternity unit in Northern Italy, with approximately 2500 births per annum. PARTICIPANTS: purposive sample of eight first-time parents-to-be, with a straightforward singleton pregnancy, who participated in two focus groups during pregnancy, one for women and one for their partners, to explore their expectations of birth. FINDINGS: uncertainties, doubts and fears were reported by all women. Although they expected to have a normal birth, they remained open-minded due to the awareness of the unpredictable nature of childbirth. One of the strongest emotions expressed by women was that of fear, especially of labour. They found different strategies to cope with those fears and to anticipate their potential disappointment and frustration regarding a childbirth experience that potentially could differ from their expectations. Women wanted their partner with them to share the birth experience and they valued their presence as essential. The midwife was expected to be a supportive guide. Fathers-to-be, although happy about the idea to be present at birth, were also concerned about their reaction to an unknown experience, about the woman's labour pain and were worried about not being helpful to her. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: to our knowledge this is the first such study to be conducted in Italy. In order to support families as a whole, the importance of the father in a supportive role and as an essential parent himself should be addressed, considering his wishes. Midwives should strive to provide family centre-care, to be supportive and sensitive. Antenatal education classes should be conducted with both parents in order to understand their expectations, give information about duration and stages of labour and birth, prepare for parenthood, addressing fears and enhancing a positive experience of birth.

Women's attitude towards the use of complementary and alternative medicines (CAM) in pregnancy.

BACKGROUND: the popularity of non-prescription, over-the counter (OTC) medicines, vitamins, minerals, homoeopathic remedies and herbal supplements (CAM) has grown significantly in recent years. However, we have limited knowledge relating to why pregnant women use CAM and how this may relate to the provision of maternity care. Using an interview approach this study explored the nature of over-the-counter and complementary medicines use in a sample of pregnant women. METHODS: this interview study formed part of a larger self-administered questionnaire survey on the extent of CAM use in pregnancy at large NHS Trust in England. The questionnaire provided the opportunity for women to complete a contact information reply slip if they were happy for follow-up interview. Audio recorded, face to face interviews were undertaken with a sample of 10 women. RESULTS: the reasons the women who were interviewed gave for using CAM broadly fell into two areas centred essentially on the contrasting advantages of CAM and disadvantages of conventional medicine. Doctors or midwives were rarely informed about the use of CAM medicines during pregnancy. CONCLUSION: the women saw CAM as outside of biomedicine and part of a holistic approach to health and well-being over which they are able to maintain their personal control. Non-disclosure of CAM use was common, a feature of which, appears to be some health-care professionals' lack of realisation of the importance, to women, of a holistic approach to their health, key to which is a desire to retain control over decisions associated with their well-being.