Virtual Reality as a Method to Cope With Labor Pain: What Do Women Want?

This study aimed to determine what childbearing women want when using virtual reality as an intrapartum pain management method. Researchers performed a qualitative exploratory study using content analysis. Two focus groups were organized including pregnant women anticipating a vaginal birth and women who recently had given birth, no longer than 6 months ago. The focus groups included a 30-minute virtual reality demo. In total, 10 women participated. Five themes emerged: (1) "try, test and explore": the need to receive information and to get acquainted with virtual reality during the antenatal period; (2) "variety and diversity in physical and digital options": the preference for a variety in virtual content and view virtual reality as a complementary method to methods for intrapartum pain management; (3) "distraction versus focus": virtual reality as a method to distract from pain, from the clinical context or to help them focus; (4) "comfort both physical and digital": measures to ensure a comfortable physical and virtual experience; and (5) "birthing partner": the potential need to include partners. This study is an essential step informing the development, implementation, and research of labor-specific virtual reality and informing antenatal healthcare providers when offering women virtual reality as intrapartum pain management.

Factors associated with the intention of pregnant women to give birth with epidural analgesia: a cross-sectional study.

BACKGROUND: In Belgium most women receive epidural analgesia during labour. Although, it offers satisfactory pain relief during labour, the risk on a series of adverse advents has been reported. The objective of this study was to determine factors associated with the intention of pregnant women, anticipating a vaginal birth, of requesting epidural analgesia during labour. METHODS: A cross-sectional study, using an online self-report questionnaire was performed, including socio-demographic and personal details. Associated factors were examined with the HEXACO-60 questionnaire, the Mental Health Inventory-5, the Tilburg Pregnancy Distress Scale and the Labour Pain Relief Attitude Questionnaire for pregnant women. The level of intention to request epidural analgesia was based on two questions: Do you intend to ask for epidural analgesia (1) at the start of your labour; (2) at some point during labour? Data were collected predominantly during the second and third trimester of pregnancy. Descriptive analysis and a multiple linear regression analysis were performed. RESULTS: 949 nulliparous (45.9%) and multiparous (54.1%) pregnant women, living in Flanders (Dutch-speaking part of Belgium) anticipating a vaginal birth completed the questionnaires. Birth-related anxiety (ß 0.096, p < 0.001), the attitude that because of the impact of pregnancy on the body, asking for pain relief is normal (ß 0.397, p < 0.001) and feeling more self-confident during labour when having pain relief (ß 0.034, p < 0.001) show a significant positive relationship with the intention for intrapartum epidural analgesia. The length of the gestational period (ß - 0.056, p 0.015), having a midwife as the primary care giver during pregnancy (ß - 0.048, p 0.044), and considering the partner in decision-making about pain relief (ß - 0.112, p < 0.001) show a significant negative relationship with the intention level of epidural analgesia. The explained variability by the multiple regression model is 54%. CONCLUSIONS: A discussion during pregnancy about the underlying reason for epidural analgesia allows maternity care providers and partners to support women with pain management that is in line with women's preferences. Because women's intentions vary during the gestational period, pain relief should be an issue of conversation throughout pregnancy.

On cloud nine? Maternal emotional wellbeing six weeks up to one year postpartum - A cross-sectional study.

BACKGROUND: Little is known about the full scope of emotional wellbeing of mothers up to one year postpartum, to adequately support women during transition to motherhood. Reduced emotional wellbeing (REW) affects women's adaption to the changes and challenges in becoming a mother. We aimed to increase the knowledge and understanding of mothers' emotional wellbeing and the influencing factors. METHODS: This cross-sectional study includes 385 Flemish mothers up to one year postpartum. Online data were collected with the General Health Questionnaire-12, Postpartum Bonding Questionnaire, Personal Well-Being Index-Adult, The Basic Psychological Needs Scale, Sense of Coherence-13 and Coping Operations Preference Enquiry. RESULTS: A total of 63.9% of the participants reported REW. Mothers with REW more often had (a history of) psychological problems compared to mothers with healthy emotional wellbeing (p = 0.007). Multiple linear regression analysis showed negative associations between emotional wellbeing and satisfaction (p = 0.002; p < 0.001), comprehensibility (p = 0.013) and positive associations between emotional wellbeing and bonding (p < 0.001), manageability (p = 0.033), problem solving (p = 0.030) and avoidance (p = 0,011) - with an explained variance of 55.5%. LIMITATIONS: Some limitations of our study are the GHQ-12 cut-off value, the nature and implication of (a history of) psychological problems and the self-selected population. CONCLUSION: It would be of worth for midwives to discuss with mothers (to be) what to expect. This - to support mothers in making sense of their life as a mother and how various factors might influence their emotional wellbeing. The high prevalence of REW is worrying, but needs to be interpreted with caution.

Flemish midwives' perspectives on supporting women during the transition to motherhood - A Q-methodology study.

OBJECTIVE: In this study we aimed to reveal midwives' distinct perspectives about midwifery support of women in their transition process during the continuum from pregnancy to one-year postpartum. DESIGN: A Q-methodology study, a mixed quantitative-qualitative approach, was conducted. Participants (P-set) rank-ordered 36 statements (Q-set) about how midwives provide support during the woman's transition to motherhood, followed by interviews to motivate their ranking. To extract the perspectives/factors on support during this transition process, centroid by-person factor analysis and varimax rotation was used. The transcripts of the interviews were interpreted per factor. SETTING: Independent (self-employed) and employed, community and hospital-based practising midwives in Flanders, Belgium. PARTICIPANTS: 83 practicing midwives participated, selected on: variation in practice setting, years of experience, views on the woman's domestic role in family life, and motherhood status. FINDINGS: Two distinct perspectives (factors) on supporting women in transition to motherhood emerged. The job-focused midwife acts according to evidence, knowledge and guidelines and adheres to the scope and tasks within the professional profile (Factor 1). The woman-focused midwife acts within a relationship of trust emphasizing the one-on-one connection while supporting transition to motherhood and the woman's needs (Factor 2). Both factors showed an explained total variance of 59% of the Q-set. KEY CONCLUSIONS: Both the job-focused midwife and the woman-focused midwife represent distinct perspectives about the midwife's execution of supporting transition to motherhood, including salotugenic elements. This provides an understanding of midwives' thoughts and experiences about why and how support is given. IMPLICATIONS FOR PRACTICE: More awareness about the subjective distinct ways of thinking about supporting transition to motherhood should be integrated in practice, midwifery education and professional development.