Confinement in nulliparous women in the Netherlands: Subjective experiences related to actual events and to post-partum well-being

Abstract

Subjective delivery experiences, obstetrical outcomes and post-partum well-being were studied in 170 nulliparous women who participated in a prospective study on the transition to parenthood. All of the women initially received antenatal care by midwives. Women who gave birth at home and those who gave birth in hospital voluntarily without referral did not differ either with regard to objective outcomes or subjective delivery experiences. Negative experiences were related to referrals during labour; other subjective experiences seemed to be related to the duration of the first and second stages of labour. Variables measured during pregnancy hardly predicted these experiences. Post-partum well-being was strongly related to well-being at the start of pregnancy, subjective experiences showing a minor predictive capacity of only 4%. As far as mode of delivery is concerned, the least well-being 6 weeks post-partum was found in women who had an instrumental delivery; low well-being at 34 weeks' gestation could be partially attributed to this phenomenon. Differences in post-partum well-being between women who delivered at home and those who gave birth in hospital were found; these differences probably depended more, however, on attitudinal characteristics than on the location of confinement. With regard to evaluations of the location of confinement, home confinements were assessed as most positive. Preferences for the location of confinement for a next pregnancy were, in the majority of cases, the same as for the present pregnancy, independent of actual events during the present pregnancy and confinement.