Thoughts, emotions and experiences in two different generations of women undergoing cesarean section

Sammanfattning: Background: Giving birth is a major life event and the memories of the birth are often something that women carry with them for the rest of their lives. There can be a lot of emotions and fears tied to childbirth. Some women wish to avoid a vaginal delivery, while others are taken by surprise by how an emergency caesarean section affects them. Over the last two decades in Sweden, caesarean sections have has become a common maternal request. The overall aim of this thesis is to study the attitudes toward and the experiences of caesarean section among healthy first- time mothers. Methods: Both paper I and II in this thesis conducted using a qualitative method with content analysis. In the first study, 12 healthy first-time mothers requesting a caesarean section were interviewed in gestational weeks 26-36. In the second paper, 22 women who underwent caesarean section during the 1970s and 1980s interviewed. Results: The overarching theme that emerged from our first study was that the wish to have a planned caesarean section in healthy women with normal pregnancy is deeply rooted: a feeling that is described as going beyond the fear of childbirth. Four underlining themes - or categories of motivation - emerged through the analysis of the content found in the interviews. Those categories were as follows: Seeing no other option other than a caesarean section; Wishing for control and safety; Managing one’s own opinions and reactions and those of others; Previous experience of health care. The overarching theme in study II formulated to describe the women´s experience of having undergone a caesarean section 30 and 40 years ago is described as “a surprising life event”. Four categories were identified, including: vaginal birth; the norm, a total loss of control, acceptance, and contact with the child. Conclusions: Attitudes and expectations related to caesarean section have changed over time. In modern medicine, women and their partners are more involved in the process leading up to caesarean section. Some women argue that it is their right to decide the way in which they will give birth. Conversely, women giving birth 30 to 40 years ago were not prepared for anything else other than a normal vaginal delivery.