Westergren Agneta, Edin Kerstin, Christianson Monica
Department of Nursing, Umeå University, SE-901 87, Umeå, Sweden.
The Graduate School of Gender Studies, Umeå University, Umeå, Sweden.
BMC Pregnancy Childbirth. 2021 Apr 14;21(1):300. doi: 10.1186/s12884-021-03758-w.
Given the significance of the birth experience on women's and babies' well-being, assessing and understanding maternal satisfaction is important for providing optimal care. While previous research has thoroughly reviewed women's levels of satisfaction with the childbirth experience from a multitude of different angles, there is a dearth of papers that use a gender lens in this area. The aim of this study is to explore through a gender perspective the circumstances attributed to both women's assessment of a positive birth experience and those which contribute to a lack of satisfaction with their birth experience.
Through the use of a local birth evaluation form at a Swedish labour ward, 190 women gave written evaluations of their birth experiences. The evaluations were divided into groups of positive, ambiguous, and negative evaluations. By means of a latent and constructionist thematic analysis based on word count, women's evaluations are discussed as reflections of the underlying sociocultural ideas, assumptions, and ideologies that shape women's realities.
Three themes were identified: Grateful women and nurturing midwives doing gender together demonstrates how a gender-normative behaviour may influence a positive birth experience when based on a reciprocal relationship. Managing ambiguous feelings by sympathising with the midwife shows how women's internalised sense of gender can make women belittle their negative experiences and refrain from delivering criticism. The midwifery model of relational care impeded by the labour care organisation describes how the care women receive during labour and birth is regulated by an organisation not always adapted to the benefit of birthing women.
Most women were very satisfied, predominantly with emotional support they received from the midwives. The latent constructionist thematic analysis also elicited women's mixed feelings towards the birth experience, with the majority of negative experiences directed towards the labour care organisation. Recognising the impact of institutional and medical discourses on childbirth, women's birth evaluations demonstrate the benefits and challenges of gender-normative behaviour, where women's internalised sense of gender was found to affect their experiences. A gender perspective may provide a useful tool in unveiling gender-normative complexities surrounding the childbirth experience.
鉴于分娩经历对女性和婴儿福祉的重要性，评估和理解产妇满意度对于提供最佳护理至关重要。虽然先前的研究已从众多不同角度全面审视了女性对分娩经历的满意度水平，但在这一领域使用性别视角的论文却很匮乏。本研究的目的是从性别视角探索导致女性对积极分娩经历进行评估的情况以及那些导致她们对分娩经历不满意的情况。
通过在瑞典一家产科病房使用当地的分娩评估表，190名女性对她们的分娩经历进行了书面评估。这些评估被分为积极、模糊和消极评估组。通过基于词频的潜在建构主义主题分析，将女性的评估作为塑造女性现实的潜在社会文化观念、假设和意识形态的反映进行讨论。
确定了三个主题：感恩的女性与悉心照料的助产士共同践行性别规范，展示了基于互惠关系的性别规范行为如何影响积极的分娩经历。通过同情助产士来处理模糊情感，表明女性内化的性别观念如何使她们轻视自己的负面经历并避免提出批评。分娩护理组织阻碍下的关系性护理助产模式，描述了女性在分娩期间所接受的护理如何受到一个并非总是为分娩女性利益而设的组织的规范。
大多数女性非常满意，主要是对她们从助产士那里得到的情感支持感到满意。潜在建构主义主题分析还揭示了女性对分娩经历的复杂感受，其中大多数负面经历指向分娩护理组织。认识到制度和医学话语对分娩的影响，女性的分娩评估展示了性别规范行为的益处和挑战，发现女性内化的性别观念会影响她们的经历。性别视角可能是揭示分娩经历周围性别规范复杂性的有用工具。
