Exploring childbirth experiences through a Salutogenic lens

Abstract

Women's experiences of childbirth have generally been considered through a pathological lens. Wider sociological arguments associated with salutogenesis stress the need to depict health on a continuum to help understand what constitutes positive health as well as ill-health. Similarly, to fully understand women's experiences of childbirth, it needs to be explored on a continuum, considering salutogenic and pathogenic factors. In this paper we report on qualitative data collected as part of a wider mixed-methods study to describe the continuum of women's different childbirth experiences (‘positive’ ‘neutral’ or ‘traumatic’). A mixed-method explanatory sequential design was undertaken comprising validated measures and in-depth interviews. Primiparous women who were expecting a healthy term infant were recruited and participated in an in-depth semi-structured interview at 12 weeks postnatal. Thematic analysis was used to analyse the data. Ten women took part in an interview and three main themes were identified. The first theme ‘before it all started’ showed how stories impacted women, with women trying to ‘keep an open mind’ or ‘accepting and expecting the worst’. The second theme ‘arriving at the destination’ emphasised the importance of midwifery support through ‘continuous compassionate presence’ while others reported ‘feeling forgotten’. Finally, ‘the days that followed’ highlighted how women tried to ‘focus on the outcome’ while others ‘wished it had gone better’. This study identified how women's subjective appraisals of childbirth are on a continuum and influenced by several factors including birth narratives and the quality of midwifery care from the early onset of labour. The kinds of experiences associated with reports that the birth was ‘neutral’ are reported for the first time.