Background: Respect to women's autonomy in vaginal child birth is a key factor of maternity care. Engaging women in decisionmaking in vaginal delivery helps women have a positive experience of delivery. Objectives: In this content analysis of qualitative study we explored experiences of mothers and midwives in women's role in normal vaginal childbirth. Methods: This study was conducted in 2013 -2014 in Iran. Overall 23 women and midwives were evaluated in this study. Data collected from 12 women and 11 midwives via in-depth semi structured interviews. Participants were selected from governmental and private hospitals in Mashhad and Kerman, Iran. Data analysis was performed using conventional content analysis with MAXqda software (version, 2007). Results: Mothers' and midwives' experiences about women's role in vaginal childbirth could be organized and categorized in one theme, referred to "Empowerment of women in vaginal childbirth". This theme consists of two subthemes: "attempts to exhibit self-assertion" and "quest for information" and four categories of compromise with the labor process, cooperation with midwife, finding delivery sources during pregnancy and seeking delivery information in labor. Conclusions: Attention to women active role in vaginal child birth could improve women experience of vaginal delivery.
Background:Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear.Objectives:The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery.Patients and Methods:This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth.Results:In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95).Conclusions:The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management.
Interaction between mothers and midwives during natural childbirth is one of the important factors in relationship between mothers and midwives in natural childbirth. In this qualitative study we explored experiences of mothers and midwives in interaction with each other in natural childbirth. This study was a part of a larger study which was carried out in Iran in 2013-2014. A total of 23 participants participated in this study. 12 primiparous and multiparous women planned to have natural deliveries and 11 midwives were purposefully included for semi-structured in-depth interviews in this study. For analysis and interpretation of mothers' and midwives' experience, conventional content analysis was used. Data were coded in MAXqda software (version 2). Interaction between mothers and midwives could be organized and categorized in one theme "relationship". This theme consists of two subthemes: "respect for the mother" and "interaction" and five categories: "Feeling confidence, Feeling satisfaction, Associated with sensory relationship, Understanding mother's situation, Understanding the meaning of interaction". Good relationship between mothers and midwives in natural childbirth could improve the experience of natural childbirth for mothers. This experience could increase woman's tendency toward natural birth instead of cesarean section in future pregnancies. Findings of this study can be seen as a challenge for health care professionals and policy makers to upgrade care of natural childbirth based on women's preferences and needs.
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