Hi Ruth ( and others),

I can only say that my results are about the same. My main categories were
Responsibility, Autonomy ( or call it sense o mastery) and Confidence. Then
these were grouped together in something called " picture, scenario, image"
and it took a long time to see what women meant, but it is about their own
Identity and these categories are the main elements. I can see the picture
change in the data. Very interesting is the fact, that with less information
the picture is smaller and probably the identity change is not that
enormous. The largest changes could be seen in women who had a full
professional life before- everything had to change, also their whole social
envrionment.
I can not say that it was a negative experience, but it is an immense
change. No woman actually regretted ANY thing about it, but I do not think,
that anybody without children can imagine it. My first image in order to
explain it to men, was to describe it as going into a war in some other
country. There is someone online telling you what to do, but you are heading
into a foreign field and you believe in what you do.

I can not say a true word about postnatal depression, as I did not interview
women who had that, but the amount of factors might influence. A
professional in Switzerland told me this week, that she saw major problems
in women who had to change into a family environment and did not know
anybody there, so they were isolated.

My findings were that it takes about 3 months to a year to fit the gained
real identity to the presumed image, that women had when getting pregnant or
before ( they create a picture at the beginning, just small and it get
broader through pregnancy and information of the care providers). If this is
the same, it takes little time. If this is totally different it takes a long
time. Somebody actually said to me she still could not get the two together,
but would try it in this second pregnancy. She said, in order to do so, she
had to have to write a letter of complaint, which she did not feel confident
enough to do so ( which is logic, because to get the new identity, you have
to gain confidence in doing so).
To me it is very similar to educating new midwives and a professional
identity. The role model will play a part in there too. I have been thinking
very long about the fact, whether obstetricians can be role models.. I do
not know, but they have to in some countries.

Thanks for sharing, Ruth. The discussion is great.

Ans

-----Oorspronkelijk bericht-----
Van: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]]Namens jenny hall
Verzonden: Montag, 15. November 2004 18:42
Aan: [log in to unmask]
Onderwerp: Re: RE CS on Request


Hello Ruth
You may fin it helpful to look at some work that was one back in the
early 1980's by Reva Rubin 1984 Maternal Identity and the maternal
experience New York: Springer books   It may be out of print but you may
get it from a library.
Also Vangie Bergum's work Woman to mother: a transformation (1989) again
more likely from a library. I also have a section on self-development in
relation to spirituality in Midwifery mind and spirit: emerging issues
of care (2001) Butterworth heinemann

Hope that leads you somewhere else

On your comments it seems that the women you have interviewed have a
very negative view of the whole experience of birth. Were there no women
for whom their expectations were met and they had a positive experience?
I agree that there is this process of change takes place but I am sure
it is not all totally negative and can be a positive affect of growth-
and that's from my mother's view as opposed to my  midwife's one!!

Best wishes

jenny

Jennifer Hall
The Practising Midwife
For information on subscriptions, advertising and contributors guides
please contact [log in to unmask]
See TPM at www.midwivesonline.com/midwivesindex.htm

-----Original Message-----
From: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]] On Behalf Of Ruth
Darvill
Sent: 15 November 2004 16:22
To: [log in to unmask]
Subject: Re: RE CS on Request

Hi,

My name is Ruth Darvill and I am doing a Phd on women's experiences of
childbearing from a psychological perspective.  I am not a midwife and
so my research has been very much using the immigrant mentality.

I have been fascinated by the recent debate about CS and fear.  I think
fear is a central part of our lives today, and it is how society is
controlled by those in power. The fear of childbirth could be related to
the argument regarding the male medical model maintaining control over
women's reproductive system, and would explain fear on both sides
(controlling and controlled.

 In my current research I have done some qualitative interviews with
first time mums and have concluded that there is a process which women
go through from the moment they fall pregnant whereby their self concept
(beliefs about the self) begins to fragment. All the beliefs that women
have about how they will be when pregnant, through labour and when they
have the baby are eroded one by one as all their expectations are not
met.  I suspect that the self concept remains fragmented until some time
after the baby is born, at which point it must be reintegrated if an
individual is to remain psychologically healthy.  This new self concept
must include new, previously unthought of, beliefs about the self and
include a realistic concept of self as mother.  A lack of reintergration
of the self concept could lead to the development of post natal
depression.

I would love to hear anyones views on this theory as I am in the process
of planning the next part of the research.  All thoughts gratefully
received.



Ruth Darvill



-----Original Message-----
From: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]] On Behalf Of kathy
Carter-Lee
Sent: 10 November 2004 10:22
To: [log in to unmask]
Subject: RE CS on Request


I congratulate Else for her proposed study as it is obviously something
that really gets people talking!  May we have more.

I have no research but have heard a woman about 14 weeks pregnant
hospitalised in (New Zealand) with hyperemesis talking about how more
than 50% of her "coffee group" had been offered CS by their
obstetricians... So...is it the chicken or the egg which is influencing
the change in societal attitudes?  Is the fear coming from women
themselves and their experiences and their friends and relatives
experiences? Or is also (or otherwise) coming from professionals who
themselves are afraid of normal birth for whatever reason?

Another angle is whether women are operating an "informed" choice in
asking, or are reflecting what they have been told by family or
professionals. This is shown here in Afghanistan, where oftentimes women
with money will "ask" for a quick labour and be given oxytocin "to
help". Fear of childbirth is rather more evident here than most
countries I have worked in. Both here and in the West, one big reason
for fear is perhaps linked to a lack of control on the process and on
circumstances.

Thanks
from
Kathy Carter-Lee
RN RM MSc MCH
Women's & Reproductive Health Advisor
SCA, Afghanistan.