The childbirth expectations of a self-selected cohort of Western Australian women

Objectives: to explore and describe the tabour and birth expectations of a cohort of Western Australian women, and to identify the factors that influence these expectations. Design: a qualitative study using an explorative descriptive design and techniques associated with constant comparison. Data were collected from tape-recorded telephone interviews. Setting: Perth, Western Australia. Participants: two hundred and two women who were pregnant or who had birthed within the last 12 months. Findings: five major themes were identified. Three of the five themes reflected a positive outlook on birth. These were labelled, 'owning and believing in birth as a natural event', 'satisfaction with the birth process and outcome' and 'involvement and participation in the birthing experience'. The remaining two themes 'birth is a negative event' and 'birth is a medical event' encapsulated the women's statements that described childbirth as a potential negative and unaffirming experience. Particularly influential on the formation of childbirth expectations were the public and private discourses of childbirth, especially those related to books and magazines, and the stories of mothers and sisters. Professional discourses, women's own history, and factors such as age and life-style choices also influenced decisions and contributed to how women perceived their experiences. Implications for practice: the findings of the study challenge the anecdotal evidence that many contemporary western women willingly and knowingly choose or expect birth to be a medicalised event. Although midwives and other maternity healthcare providers need to help women develop realistic expectations, there is also a need to examine the influence of healthcare professionals in perpetuating a technical approach to birth. The findings do, however, confirm that some women are anxious, scared and frightened of the childbirth experience. It is essential that research continues to focus on developing strategies to assist women confront and deal with these fears. (c) 2004 Elsevier Ltd. All rights reserved.