Dear Sue,
Thanks for this information. Would you let me know when and where it iw published?
Pat
Patricia Burkhardt, CNM, DrPH
NYU Midwifery Program Coordinator
Tel: 212 998-5895
Fax: 212 995-4679
----- Original Message -----
From: Matt Fenwick <[log in to unmask]>
Date: Wednesday, November 17, 2004 4:29 am
Subject: Re: CS and social pathology
> Hi Pat,
>
> I will outline the demographics of the study sample. 21 women were
> interviewed. The interviews were unstructured. The participants
> came from
> three hospitals in the South West of England. Exclusion criteria
> included a
> history of PND, adverse outcome etc.
> The initial purposive sample was as follows:
> First time mothers (primigravida) 7 - Emergency CS
> Second time mothers (multigravida) - 5 Elective CS following
> emergency CS
> " " - 4 TOL
> followingemergency CS
>
> I was unable to recruit women who had a CS maternal request, this
> could mean
> two things either they were not willing to volunteer or there are
> not many
> of them! The results of the National Sentinel CS Audit suggest
> that women
> choosing to have a CS without obstetric indication is low around
> 7%. The
> participants were recruited by community midwives who were known
> to woman
> and her family. I did not approach women in hospital. Second time
> motherswere identified by their Community Midwife at 34-36 weeks
> gestation. I then
> made arrangements to interview post delivery. First time mothers were
> interviewed at least six weeks post delivery. These women were given
> information on the study by the Community Midwife during postnatal
> visiting.
> As data collection and analysis progressed, to gain greater depth and
> insight I interviewed two women who had a previous normal delivery
> followedby an emergency CS.
> Also in the initial stages of the study women were interviewed who
> had an
> emergency CS during labour - 2 of these women had a breech
> presentation. I
> decided to include women who had a breech presentation but who had not
> laboured. This process is known as theoretical sampling. It
> enabled me to
> widen to focus of the initial sample.
>
> This study has generated rich data about the women's experience of
> CS and
> the impact it has upon their physical and emotional well being.
> Moreover,including second time mothers enabled me to gain an
> insight into decision
> making.
>
> I hope this is helpful. Please contact me again if you have more
> questions.
> Regards
> Sue
>
>
> ----- Original Message -----
> From: "Patricia Burkhardt" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Tuesday, November 16, 2004 3:59 PM
> Subject: Re: CS and social pathology
>
>
> > Sue,
> > Could you give us the demographics of your study sample? Your
> findings> are critical to this on-going issue of c sections as if
> they are an equal
> > substitute for a spontantous vaginal birth.
> >
> > Thanks, Pat
> >
> >
> > Patricia Burkhardt, CNM, DrPH
> > NYU Midwifery Program Coordinator
> > Tel: 212 998-5895
> > Fax: 212 995-4679
> >
> > ----- Original Message -----
> > From: Matt Fenwick <[log in to unmask]>
> > Date: Tuesday, November 16, 2004 9:54 am
> > Subject: CS and social pathology
> >
> >> I am currently in the final stages of a qualitative study using
> >> Grounded Theory on women's experience of caesarean section. You
> >> may be interested in some of the key themes to emerge from
> >> analysis of the data.
> >> I interviewed first time mothers who had experienced an emergency
> >> caesarean. I also interviewed second time mothers who had
> either a
> >> trial of labour or an elective CS.
> >>
> >> Most of women said that they 'expected the normal' and emergency
> >> CS left them with feelings of disappointment, sometimes anger and
> >> feelings of failure. Women felt they had missed out on normal
> >> birth. Women in this study associated 'normal birth' as 'part of
> >> being a woman' ; a 'normal process' and one that they expected.
> >> Birth is seen as a 'rite of passage' I have used inverted commas
> >> to indicate codes identified in the data. 'Feelings of failure'
> >> were linked to a sense of the 'failing body' and 'failing as a
> >> mother' because they had found caring for a newborn baby difficult
> >> after CS.
> >>
> >> Another theme to emerge from the data was that of 'being in
> >> control'. First time mothers who experienced an emergency CS
> >> described how they had lost control over the birth process.
> >> Second time mothers describe how their experience of previous CS
> >> impacts upon their decision making in a subsequent pregnancy.
> >> Regaining control is an important theme in this study because
> >> women who chose a trial of labour saw this as a way of regaining
> >> control. However, women who opted for an elective CS also saw
> >> this as regaining control. Women who chose to have a CS did so
> >> because they would 'be prepared', it meant 'minimizing
> >> uncertainty' and 'avoiding an emergency'. Women feared going
> >> through labour only to end up with another CS.
> >>
> >> Other themes in this study reflect the 'reality of caesarean' and
> >> the impact it has on women's lives. Women describe their
> >> interaction with care givers and others in their kinship network.
> >> For example,
> >> Women feel their is a lack of support for women who experience CS
> >> from professionals. Women are critical of the care they receive
> >> on the postnatal ward. They feel that midwives forget they have
> >> experienced major abdominal surgery. Some women feel they need for
> >> care and attention but many are too frightened to ask, or don't
> >> want to take up the midwives time. Women have unanswered questions
> >> about the decision to do the CS. Women also feel they are
> >> 'different' from women who have a normal delivery. This can lead
> >> to a sense of isolation and exclusion from 'normal mothers'.
> >>
> >> It must be said that all women have a negative view of CS and the
> >> care they received and this is documented in the thesis. In this
> >> study women tell their stories of CS. This provides an insight
> >> into the lived experience of CS and implications for transition to
> >> motherhood.
> >> Sue Fenwick
> >>
> >>
> >>
> >>
> >>
>
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