Abstract
Objective: To assess pre-labor attitudes and post-labor experiences of the use of vacuum extraction during delivery. To seek associations between traumatic labor experience and personal preparation, physiology of labor and treatment during labor.
Methods: A total of 205 women filled in a questionnaire within five days of vacuum extraction delivery. The questionnaire was designed to distinguish the group of women having experienced their labor as traumatic from those not having such an experience. The association between explanatory variables grouped as background factors, physiological factors of labor and treatment-related factors in relation to traumatic experience status was studied by bivariate analysis by the chi-square test or Student's t-test. Logistic regression analysis was carried out to examine simultaneous effects of factors. In the first phase, each of the previously chosen groups was analyzed separately, and in the second, all risk factors thus emerging as significant were entered into the final model.
Results: Forty-two women (20%) regarded their childbirth experience as traumatic. Of the background factors, insufficient pre-labor training and a pre-labor desire for extra strong pain relief during the coming labor were significantly more common in the traumatic birth group. Of the physiological factors of labor, unsatisfactory pain relief and a difficult third stage of labor were associated with a traumatic birth experience. The treatment-related factors showed mutual correlation and were strongly associated with birth experience. After logistic regression analysis only four independent risk factors emerged as significant: insufficient support immediately after delivery, the experience of being poorly listened to during labor, insufficient doctor's support during the first stage of labor, and pre-labor training classes considered insufficient.
Conclusions: Treatment-related factors were the most powerful predictors of an adverse birth experience after vacuum extraction delivery, exceeding those related to labor physiology. Thus, the role of treatment and care before, during and after vacuum extraction is emphasized.
References
1 Bernazzani O, A Bifulco: Motherhood as a vulnerability factor in major depression: the role of negative pregnancy experiences. Soc Sci Med56 (2003) 1249Search in Google Scholar
2 Czarnocka J, P Slade: Prevalence and predictors of post-traumatic stress symptoms following childbirth. Br J Clin Psychol39 (2000) 35Search in Google Scholar
3 Gottvall K, U Waldenström: Does a traumatic birth experience have an impact on future reproduction? Br J Obstet Gynaecology109 (2002) 2542Search in Google Scholar
4 Harvey S, D Rach, M Stainton, J Jarrell, R Brant: Evaluation of satisfaction with midwifery care. Midwifery18 (2002) 260Search in Google Scholar
5 Johnson J, R Figueroa, D Garry, A Elimian, D Maulik: Immediate maternal and neonatal effects of forceps and vacuum-assisted deliveries. Obstet Gynecol103 (2004) 513Search in Google Scholar
6 Lindow S, A Dhillon, S Husaini, I Russell: A randomised double-blind comparison of epidural fentanyl versus fentanyl-bupivacaine for pain relief in the second stage of labor. BJOG111 (2004) 1075Search in Google Scholar
7 Menage J: Women's perception of obstetric and gynaecological examination. BMJ306 (1993) 112710.1136/bmj.306.6885.1127-dSearch in Google Scholar PubMed PubMed Central
8 Parturients, births and newborns 2003. Statistical summary 26/2004. National Research and Development Centre for Welfare and Health in Finland, Helsinki 2004Search in Google Scholar
9 Saisto T, O Ylikorkala, E Halmesmäki: Factors associated with fear of delivery in second pregnancies. Obstet Gynecol94 (1999) 679Search in Google Scholar
10 Saisto T, K Salmela-Aro, J Nurmi, E Halmesmäki: Psychosocial predictors of disappointment with delivery and puerperal depression. Acta Obstet Gynecol Scand80 (2001) 39Search in Google Scholar
11 Schindl M, P Birner, M Reingrabner, E Joura, P Husslein, M Langer: Elective cesarean section vs. spontaneous delivery: a comparative study of birth experience. Acta Obstet Gynecol Scand82 (2003) 834Search in Google Scholar
12 Söderquist J, K Wijma, B Wijma: Traumatic stress after childbirth: the role of obstetric variables. J Psychosom Obstet Gynaecol23 (2002) 31Search in Google Scholar
13 Waldenström U, I Borg, B Olsson, M Skold, S Wall: The childbirth experience: a study of 295 new mothers. Birth23 (1996) 144Search in Google Scholar
14 Wijma K, J Söderquist, B Wijma: Posttraumatic stress disorder after childbirth: a cross-sectional study. J Anxiety Disord11 (1997) 587Search in Google Scholar
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