Factors related to a negative birth experience - A mixed methods study

Objective: this study aimed to explore factors associated with a negative childbirth experience including descriptions from women themselves. Design: we performed a mixed methods study based on data from the Norwegian cohort of the Bidens study, including a total of 1352 multiparous women. Quantitative information was analysed in addition to thematic analysis of 103 free-text comments provided by women with a prior negative childbirth experience. Key findings: the total prevalence of a negative birth experience was 21.1%. A negative experience was associated with fear of birth (AOR: 5.00 95% CI 3.40-7.23) and a history of abuse (AOR 1.34 95% CI 1.01-1.79) in multivariate analysis. Women who indicated they were para 2 were less likely or report a negative childbirth (AOR 0.66 95% CI 0.46-0.94). Three major themes were identified: 'complications for mother, child or both', 'not being seen or heard'; and 'experience of pain and loss of control'. The majority of respondents reported experiences of unexpected and dramatic complications during childbirth. Further, several of the respondents felt a lack of support, that they had not been treated with respect or included in decisions regarding their birth. A minority described pain and loss of control as the main reason for their negative birth experience. Conclusions and implications for practice: comments by the women show that they were unprepared for complications and inadequate care during birth. The feeling of not being seen or heard during childbirth contributed to a negative experience. Midwives can use the information gained from this study to prevent negative birth experiences.