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Document Type

Article

Abstract

Introduction: We wished to better understand primiparous women’s childbirth experiences in private and public hospitals. Within the context of high caesarean section rates, in both private and public hospitals in Turkey, the experiences of women who delivered vaginally needs to be considered if we aim to decrease the number of caesarean births. We, therefore, conducted a descriptive study of women’s vaginal birth experiences in two hospitals in Istanbul.
Methods: Two hundred and forty primiparous women, from two hospitals (one public, one private), who had vaginal births, were included in this descriptive study. Information was obtained from medical records and through personal interviews with women in the early post-partum period. Birth perceptions, interventions, and supportive practices were investigated.
Results: Women in both the private and public hospitals had high rates of obstetric interventions. Interventions, such as enemas, amniotomies, fundal pressure and episiotomies commonly occurred in both hospitals. Oxytocin induction was twice as common in the private hospital. The most common supportive practice was position and mobility during the first stage. Women seldom received oral nourishment or had skin-to-skin contact with the baby. The women in the private hospital, significantly, more often reported that protection of privacy and encouragement from the midwife and from the gynecologist were greater than expected. Conversely, these women, significantly, more often indicated that their levels of fear and anxiety were greater than expected.
Conclusions: Primiparous women in both hospitals, who delivered vaginally, experienced multiple interventions during the course of labour and birth. The overall context of high caesarean section rates and high interventions in labour in women at full term illustrate the over-medicalisation of birth. These findings point to the need for greater understanding by women, maternity care providers and policy makers about the potential harm of such practices. Midwives are an essential part of the healthcare system, who can improve the quality of care for mothers and babies by providing education, counseling, and support to women and families and through implementing known best practices that promote normal childbearing.

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