Anesthesia, analgesia for vaginal childbirth. Differences in maternal perceptions.

An exploratory study of 77 primiparous women during the first 48 hours postpartum tested for differences between those who had received epidural anesthesia, those who had received analgesia during labor with local or pudendal block for delivery, and those who had received no analgesia and either no anesthesia or local or pudendal block for delivery. No group differences were found in self-esteem, feelings about the childbirth experience at the time of delivery, or maternal perception of her infant as compared to her perception of an average infant. Those receiving epidural anesthesia had less positive feelings about the childbirth experience at the time of the interview, but they described their views of their infants at birth more positively and with more identifying remarks than either of the other two groups. No differences were found in self-esteem, feelings about the childbirth experience at time of delivery or at the time of interview, or maternal perception of the newborn compared to that of an average infant by those who attended childbirth classes and those who did not.

The cesarean birth experience: implications for nursing.

A comparative field study was done to collect both quantitative and qualitative data to determine if women perceived their childbirth experience less positively when they had cesarean deliveries and in what ways. The hypothesis, primiparas having an emergency cesarean birth will have a less positive perception of their birth experience than those who deliver vaginally, was supported at the .01 level of significance (t test). Perceptions of 20 primiparas having an emergency cesarean birth and 30 primiparas having a vaginal birth were measured by a 29 item questionnaire within 48 hours postpartally. More cesarean delivered women had not named their infants; this difference was significant at the 0.005 level. Within the cesarean group, those who had general anesthesia had less positive perceptions of their experience than those who had regional anesthesia (0.05 level of significance). The presence of a support person with them during surgery did not significantly affect perceptions, but further research is recommended. The qualitative analysis of the data revealed a number of concepts. There was an underlying theme that a cesarean delivery signified weakness in relation to her potential mothering ability. Cesarean delivered mothers suffered a loss in self-esteem, possibly due to unfulfilled expectations for a vaginal delivery and the physical trauma and corresponding loss of control due to the surgery. These women experienced a sense of failure due to the procedure and expressed doubts that the infant was their own newborn. As a group they exhibited little physical or emotional energy for mothering.

Comparison of primiparas' perceptions of vaginal and cesarean births.

Twenty primiparous mothers who had cesarean births were compared with 30 primiparous mothers who had vaginal deliveries to determine differences in their perceptions of the birth experience. The effect of general versus regional anesthesia on the satisfaction level of the cesarean mothers was also investigated. All subjects were between 20 and 32 years of age, were interviewed within 48 hours postpartum, and completed a 29-item questionnaire that measures maternal perceptions about the labor and delivery experience. Satisfaction with the birth experience was significantly lower among cesarean mothers and among those who had general anesthesia. The cesarean group displayed greater hesitancy in naming their infants and tended to view their deliveries as abnormal and having social stigma. The presence of a support person in the operating room for a cesarean birth seemed to lessen anxiety among these mothers. These findings suggest that a cesarean birth has a negative impact on the mother's perceptions of her labor and delivery experience. There is a need for further study of factors that can enhance this experience for families.