The cesarean birth experience: implications for nursing

A comparative field study was done to collect both quantitative and qualitative data to determine if women perceived their childbirth experience less positively when they had cesarean deliveries and in what ways. The hypothesis, primiparas having an emergency cesarean birth will have a less positive perception of their birth experience than those who deliver vaginally, was supported at the .01 level of significance (t test). Perceptions of 20 primiparas having an emergency cesarean birth and 30 primiparas having a vaginal birth were measured by a 29 item questionnaire within 48 hours postpartally. More cesarean delivered women had not named their infants; this difference was significant at the 0.005 level. Within the cesarean group, those who had general anesthesia had less positive perceptions of their experience than those who had regional anesthesia (0.05 level of significance). The presence of a support person with them during surgery did not significantly affect perceptions, but further research is recommended. The qualitative analysis of the data revealed a number of concepts. There was an underlying theme that a cesarean delivery signified weakness in relation to her potential mothering ability. Cesarean delivered mothers suffered a loss in self-esteem, possibly due to unfulfilled expectations for a vaginal delivery and the physical trauma and corresponding loss of control due to the surgery. These women experienced a sense of failure due to the procedure and expressed doubts that the infant was their own newborn. As a group they exhibited little physical or emotional energy for mothering.