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Facilitating positive birth experience when preferences are not met: A qualitative analysis
Tiwadeye Lawal1,2, Laura E Dodge1,2, David Toffey1,2
1Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Birth (Berkeley, Calif.)
|October 25, 2023
Summary
Practitioner support through preparation, communication, and comfort can improve the birth experience for women undergoing labor induction, even when preferences differ from medical indications.
Area of Science:
- Obstetrics and Gynecology
- Patient-Centered Care
- Health Services Research
Background:
- High-quality health systems prioritize patient preferences for improved experiences.
- Birth preferences can conflict with medically indicated procedures during labor.
- Understanding patient experiences with unplanned labor procedures, like induction, is crucial.
Purpose of the Study:
- To identify how practitioners can support patients experiencing unplanned labor procedures, specifically labor induction.
- To explore women's and birthing people's experiences with labor induction when it diverges from their initial preferences or expectations.
Main Methods:
- A study was conducted at a large US academic center involving prenatal and postpartum surveys.
- Participants experiencing discordance between wanting/expecting and receiving labor induction were interviewed.
- Interviews were analyzed using a modified grounded theory approach to understand attitudes toward birth preferences and outcomes.
Main Results:
- 73% of participants reported discordance between wanting and experiencing induction; 54% between expecting and experiencing.
- Two key themes emerged: negative experiences without mitigation and the buffering effect of practitioner interaction.
- Patients prefer support through preparation, communication, and care/comfort to foster autonomy.
Conclusions:
- Positive birth experiences are possible even when patient preferences are not fully met.
- Practitioner preparation, communication, and responsive care can mitigate negative experiences during labor induction.
- These supportive measures enhance patient autonomy and can lead to more positive birth outcomes.
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