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The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Halland Hospital Halmstad, Halmstad, Sweden & Karolinska Institutet, Stockholm, Sweden.ORCID iD: 0000-0001-8354-3382
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
Karolinska Institutet, Stockholm, Sweden.
2015 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, no 10, 1000-1007 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors.

DESIGN: a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records.

SETTING: data were recruited from antenatal health-care clinics in Halland, Sweden.

PARTICIPANTS: a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42.

MEASUREMENTS: five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States.

FINDINGS: results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy.

KEY CONCLUSIONS: this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth. © 2015 Elsevier Ltd.

Place, publisher, year, edition, pages
London: Elsevier, 2015. Vol. 31, no 10, 1000-1007 p.
Keyword [en]
Childbirth, Epidural, Obstetric outcomes, Pregnancy, Self-efficacy, Well-being
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hh:diva-29233DOI: 10.1016/j.midw.2015.05.005ISI: 000362093300016PubMedID: 26094071Scopus ID: 2-s2.0-84942549892OAI: oai:DiVA.org:hh-29233DiVA: diva2:847022
Available from: 2015-08-18 Created: 2015-08-18 Last updated: 2017-08-18Bibliographically approved
In thesis
1. The movement towards birth: A study of women's childbirth self-efficacy and early labour
Open this publication in new window or tab >>The movement towards birth: A study of women's childbirth self-efficacy and early labour
2014 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to increase the understanding of early labour, the latency phase of labour, based on women’s experiences and ability to handle the situation. Furthermore, the aim was to perform a psychometric testing of an instrument measuring childbirth self-efficacy and to explore the relationships to women´s well-being and number of obstetric interventions and birth outcomes.

Methods: In study I, a grounded theory method was used to obtain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour. The same method, grounded theory was used in study II, but in this study, the aim was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset before admission to maternity ward. In both these studies (I & II) interviews were used to collect data. Study III and IV were cross sectional studies with a  consecutive data collection. In study III, a forward-backward translation was used to translate the childbirth self-efficacy inventory (CBSEI) into a Swedish version. An explorative factor analysis with principal component analysis was used to test the psychometric properties of the inventory and reliability tests with Cronbach's alpha and inter item total correlation was performed. In study IV, chi-2 test, Fisher's exact test and student's t-test for independent samples was performed between women´s estimated childbirth self-efficacy and demographics, obstetric interventions and birth outcomes. Correlations were also performed between different scales measuring well-being during pregnancy and childbirth self-efficacy. Finally a logistic regression analysis was performed to predict the probability for low or high childbirth self-efficacy.

Findings: Being in a safe place is essential for the women in the early labour process. But a safe place has different meanings for different women, depending on how they assess their own ability to handle their impending labour. For some women, the hospital is a secure place, a place where somebody else can take over the responsibility for themselves, the labour process or their child’s well-being. Some women choose to remain in their homes, which they consider as a kind of base camp which they can leave and go back to whenever they please. There is also a difference in how women ascribe ability to their own bodies and women´s belief in their own ability to cope and deal with the impending birth, their self-efficacy. These differences together with the women´s choice of seeking care or not, during the early labour process, affect the women´s experience of the labour process. The women's experience during the early labour process varies from feeling powerful and strong, to perceiving themselves as victims and feeling totally powerless. Women with high self-efficacy as measured by CBSEI had less previous mental illness and had more often been told their sister´s birth story. During the labour process, women with a higher childbirth self-efficacy have a lower frequency of epidural analgesia than women with low childbirth self-efficacy.

Conclusion: Women´s belief in their childbirth self-efficacy affects their choice of place to be, during the early labour process. The place in turn, affects the women´s experiences and the way they handle the early labour process. The early labour process is a sensitive period that requires attention and should not be neglected. Through increased knowledge and understanding of the problematic issues related to the early labour process, the birth preparation and antenatal obstetric care, as well as the care during labour can be improved.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2014. 65 p.
Keyword
Childbirth self-efficacy, early labour, factor analysis, grounded theory, logistics regression, pregnancy, well-being
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-25949 (URN)978-91-7549-498-2 (ISBN)
Public defence
2014-06-05, Samuelssonsalen, Schelelaboratoriet, Tomtebodavägen 6, Solna, Stockholm, 13:00 (Swedish)
Opponent
Supervisors
Note

Examen: Medicine doktorsexamen

Available from: 2016-01-22 Created: 2014-06-27 Last updated: 2017-08-18Bibliographically approved

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