Experiences of success and failure in childbirth

Figures & data

Table 1. Background characteristics of the sample (N = 113).

		M (SD)	n (%)
Age		31.1 (4.46)
Primiparous			67 (59.3)
Multiparous			46 (40.7)
Level of education
	university or college degree		83 (73.5)
	technical college degree		29 (25.7)
	no formal education after compulsory schooling		1 (0.8)
Family form
	nuclear family		104 (92.1)
	blended family		7 (6.1)
	other		2 (1.8)
Perceived financial situation
	better than average		25 (22.3)
	average		78 (68.8)
	poorer than average		9 (8.0)
	poor		1 (0.9)
Fear of childbirth (W-DEQ A)
	all participants	58.71 (19.47)
	primiparous	59.34 (15.27)
	multiparous	57.96 (21.65)

Figure 1. Number of expressions of success by parity.

Table 2. Hierarchical structure of the categories.

Overarching category	Categories	Subcategories
The diversity of childbirth	Personal factors	Physical factors Psychological factors Tolerance for pain Previous experience
	The course of childbirth	Duration of birth Pain Pain relief Complications Mode of birth Medical procedures
	Support	Hospital staff’s Spouse’s or support person’s

Table 3. Examples of quotes.

		Quotes
Category and subcategories		Success	Failure
Personal factors
	Physical	‘I knew how to push, and I gave it all I could. I’m really happy that I focused on every moment (of delivery) and gave all I could without panicking’. Roosa (primipara, moderate FOC)	‘We tried, with the staff, a vaginal delivery (without pain relief, as the labour advanced so quickly) but the baby was born only on their feet and got stuck in my pelvis from the bottom [n.b. this participant had a breech birth]. I felt at the delivery that I betrayed everyone present when I couldn’t push the child out. The guilt still crosses my mind from time to time’. Anni (primipara, moderate FOC)
	Psychological	‘Several doctors stated that the baby was big and even suggested a C-section but somehow I just trusted myself that everything would go well – as it did in the end. In my opinion, the second stage of delivery went quickly without a ventouse or episiotomy, even though the doctors claimed I would need them. That made me feel victorious even though I got a few small stitches’. Jenna (primipara, moderate FOC)	‘Fortunately the midwives were lovely and the birth was not an entirely negative experience, thanks to them. I was, however, disappointed because the experience was hard and painful and not such an empowering one that I had been hoping for. To recall the birth only makes me weep … ’ Elisa (primipara, moderate FOC)
	Tolerance for pain	‘The birth was a very empowering experience to me because I tolerated the severe pain of contractions using only a painkiller until the cervix was 8 cm open. … When contractions strengthened, I tolerated the pain with a low moaning … ’ Roosa (primipara, moderate FOC)	‘I was not afraid of birth beforehand, but I was a little bit nervous: I only hoped that the child would have all well and I would not be badly torn myself. I realised in labour that I am bad at tolerating pain. For that reason, the opening phase was difficult, but I don’t remember it in a bad way now … ’ Maria (primipara, severe FOC)
	Previous experience	‘A very positive experience. The things that bothered me with my first birth now came true very successfully. The welcome at the hospital was nice and calm. The midwife knew her job and was encouraging in a way that suited me. In addition, I received pain relief according to my wishes and it was timed successfully. I knew how to control my body and be an active participant. My husband also had a better experience now that the birth wasn’t unnecessarily prolonged, and the baby wasn’t in any trouble at any point’. Maarit (multipara, low FOC)	‘The midwife was lovely and regarded my wishes. It was not her fault that none of the anaesthesia worked and I had to suffer the pain that already in the first birth left me with fear … ’ Krista (multipara, high FOC)

Table 4. Examples of quotes.

	Quotes
Category and subcategories	Success	Failure
Course of childbirth
Duration	‘Truly great. I couldn’t have thought or hoped that the birth would be so easy and quick. It was a pain-free experience. I remember everything of the birth, and I could whenever return to that moment … ’ Suvi (primipara, moderate FOC)	‘The birth was really fast, 3.5 hours total. We barely got to the hospital with my husband. I was in the delivery room for about 2 minutes before the baby was born. Because of that, the experience was chaotic. I couldn’t feel any sense of control, and it took a couple of hours after the birth to understand what had happened. The chemistry with the midwife didn’t match, so I didn’t get enough help from her before, during, or after the situation’. Outi (multipara moderate FOC)
Pain	‘It was a very positive experience. It wasn’t as painful as I expected. The pain during contractions was, of course, the worst pain I have ever experienced but luckily the epidural anaesthesia helped me and worked also at the second stage of delivery’. Inka (multipara, moderate FOC)	‘The birth was in my opinion long and painful. I received several anaesthetics, until our daughter was born after 23 hrs of suffering. There were pain-free periods but also intolerable pain that I would not have expected … ’ Jenna (primipara, moderate FOC)
Pain relief	‘The experience was empowering and good for me, because I didn’t need/have time to get medical pain relief. “Natural birth” has been a dream, but I didn’t think I could do it, and still, I could!’ Kiia (multipara, moderate FOC)	‘Terrible. My only wish was that I would not need to go to C-section, I was prepared for pain, and I think that my expectations for birth were realistic. However, the labour did not advance after the beginning, the heartbeat of the child dropped once greatly, and I developed a fever (infection of the membranes). Pain relief was insufficient (the epidural block worked only on one side). After about 24 h, the child was born by C-section, where pain relief was inadequate (the spinal block was inserted in the epidural space). After the exertion of the child, they attempted to strongly medicate the pain for 30 minutes while the operation continued, but the operating pain was severe, and, finally, I was anaesthetised unconscious. The only positive thing was that I did not experience the C-section as preposterous, but there were indications to proceed into it, and there was no sense of hurry. The event itself and it’s being prolonged and fear for the child’s well-being and operating without adequate anaesthesia were not nice’. Johanna (primipara, severe FOC)
Complications	‘Everything went reasonably fast and well. I had wait for the pain relief only. I didn’t have any complications’. Emilia (multipara, moderate FOC)	‘However, there was one complication during the birth, where the baby’s heart rate dropped and we ended up in resuscitation. The situation shocked me, and my thoughts are still stuck in the situation. I am very worried about the baby’s health. I also got some kind of injury during the birth, which has affected my mood and made everyday life difficult’. Maria (primipara, severe FOC)
Mode of birth	‘Wonderful and empowering, painful, but gorgeous. I had the water birth I wanted, a spouse with me, a doula (also a good friend), and a midwife. I trusted myself and everyone else seemed to trust my body, and it worked just like by itself. I found it easier to give birth than I did with the firstborn’. Saija (multipara, moderate FOC)	‘I ended up in emergency C-section at 37 + 6. To end up in a caesarean was a shock at first, because we had been waiting with my spouse for a birth experience together and the operation and recovery made me nervous. It was a huge disappointment that we could not experience a normal vaginal birth. We had many expectations for the birth because the child was the first for us both. In addition, because of the exceptional situation (COVID), the father could not be present at the operation, which caused even more feelings of disappointment’. Sini (primipara, moderate FOC)
Medical procedures	‘Unlike expectations, it was quite long and heavy. I had thought that the baby would come out … The induction of labour lasted about two days, which made me very powerless and tired by the time I got to the delivery room. We were about ten hours in the delivery room, and the pushing lasted 2 h 15 min. However, I am really happy that I managed to push the baby out without a ventouse/surgery. I mean, I didn’t push for so long “for nothing”’. Reija (primipara, moderate FOC)	‘It did not conform to expectations. The tearing nature of the pain surprised me. I had to have an absurd amount of pain-relieving analgesia, the pushing stage was long, and they had to perform an episiotomy. I had expected a calmer and more controllable experience regarding the pain. I did not experience the event as very natural because of the medical induction and pain relief. At first, I was very upset about the experience, but now I am proud of surviving a difficult birth’. Senja (primipara, moderate FOC)

Table 5. Examples of quotes.

		Quotes
Category and subcategories		Success	Failure
Support
	Staff	‘At first I thought that this child is our first and last child, but now I think that I would survive it another time with the help of wonderful midwives < 3 I am a little bit disappointed at the fact that because of the fatigue, the pain, and the medications, I don’t remember some parts of the birth, and the obstetric record that I received was not as detailed as I had hoped for’. Jenna (primipara, moderate FOC)	‘The childbirth was a hard experience for me, especially the second stage of it, for I was not listened to but commanded, and I felt powerless and inferior. Another hard experience is that the contractions had lasted four days before our firstborn was born. Further, the midwives did not say they were going to do an episiotomy to me. I realised for myself when they were talking among themselves about the local anaesthesia’. Elina (primipara, moderate FOC)
	Spouse or support person	‘The cervix didn’t open. I was stressed out without my husband. The lovely midwife listened to me, and I finally was admitted to the delivery room where my husband was able to join me. … I relaxed due to the presence of my husband, and the labour began’. Noora, (primipara, severe FOC)	‘The time after it (because of COVID) was extremely traumatising, because the father was kicked out and I was left alone for several days. I did not receive mental support. The only thought concerning my stay at the hospital was that I felt like a hostage in a small room’. Sara (primipara, moderate FOC)

Table 6. Frequencies of the expressions of success and failure according to Parity.

Category	Primiparae		Multiparae
	Success (n)	Failure (n)	Success (n)	Failure (n)
Physical factors	14	8	6	1
Mental factors	19	17	21	2
Tolerance for pain	5	2	3	-
Previous experience	N/A	N/A	23	5
Total (n) in ‘Personal factors’	38	27	53	8
Duration	8	10	5	3
Pain	1	5	3	1
Pain relief	12	10	10	4
Complications	-	13	2	1
Mode of birth	55	12	40	2
Medical procedures	10	10	7	-
Total (n) in ‘Course of childbirth’	86	60	67	11
Staff	36	19	-	2
Spouse or support person	10	5	15	1
Total (n) in ‘Support’	46	24	15	3
Total (n)	170	111	135	22

*N/A = not applicable.

Figure 2. Number of expressions of failure by parity.

Data availability statement

Data is freely available at https://jyx.jyu.fi/handle/123456789/81710