Motherhood and the woman´s encounter with delivery ward staff - a qualitative study with focus on normal and complicated deliveries. Moderskap och vårdrelation. En kvalitativ studie med fokus på normal respektive komplicerad förlossning

Sammanfattning: The purpose of this thesis was to describe the woman´s transition to motherhood during pregnancy and childbirth and the influence of the intersubjective nursing relation in this process. The physical and mental wellbeing of the expectant mother has a direct impact on the health of the unborn and newborn child. In two qualitative studies using a phenomenological approach the objective was to describe women´s experience during childbirth, the encounter with the midwife during childbirth at an Alternative Birth Care centre (Paper I), and the experience of an obstetrically complicated childbirth (Paper II). The essential structure of the phenomenon in the encounter was defined as "presence" if three themes were fulfilled: 1) to be seen as an individual 2) to have a trusting relationship and 3) to be supported and guided on one´s own terms. If any of the mentioned features were lacking the women felt that the midwife was "absently-present" which increased the risk of a negative birthing experience. During an obstetrically complicated childbirth the essential meaning was the desire to be recognised and affirmed as a genuine subject. If this happened the woman felt accepted as a childbearing woman and as a mother-to-be, even if obstetric interventions were necessary and high technology was used. The essence was defined as "confirmation" and included five dimensions: 1) to be seen, 2) trust, 3) a dialogue, 4) control and 5) mothering. If any of the mentioned features were lacking the woman experienced "dis-confirmation" which could lead to negative feelings as stress, insecurity, sense of guilt, disappointment, worse pain management and difficulty in accepting motherhood. Irrespective of race and culture, midwives, obstetricians and other caregivers have a challenge to support the pregnant and birthing woman in the transition to motherhood.