Date of Completion

4-28-2015

Embargo Period

4-25-2015

Keywords

childbirth, cesarean birth, planned cesarean, primipara

Major Advisor

Dr. Cheryl Beck

Associate Advisor

Dr. Regina Cusson

Associate Advisor

Dr. Heather Evans

Field of Study

Nursing

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

The elevated cesarean birth rate continues to be an issue of concern. Many of these births are to first time mothers. Numerous studies have been conducted to examine specific physiological or psychological complications of a cesarean birth. Yet little research has been done to qualitatively explore the overall experience of women having a cesarean birth and none have focused exclusively on first time mothers’ experience of a planned cesarean birth.

The purpose of this narrative analysis of first time mothers’ planned cesarean birth stories was to gain insight into the entire physical and emotional response to the cesarean birth experience, beginning with the preceding factors that influenced the women to have a planned cesarean birth, including the birth itself, and concluding with the recovery and postpartum period. Narrative analysis is a type of qualitative design in which the participants’ story is the object of inquiry. A convenience sample of 11 first time mothers who underwent a planned cesarean birth was interviewed either by email or face to face. The data were analyzed using Reissman’s method of thematic narrative analysis. Each narrative was analyzed as a whole and the results were discussed within the theoretical framework of Roy’s Adaptation Model to produce thematic categories. Similarities were identified and used to create a metastory which revealed seven overarching themes: Decision, not much of a choice; Acceptance of birth method; Emotional roller coaster of birth, Physical recovery, feeling like myself, Emotional recovery, a kaleidoscope of feelings, Expectations, a picture in my mind; Outcomes, ties that bind.

This study reveals valuable clinical implications. Healthcare providers need to work to improve policies to decrease maternal-infant separation during the cesarean birth. Education needs to be provided to the woman and her support person to decrease fears and help create realistic expectations. This study will guide providers to make improvements in providing holistic maternity care specific to first time mothers having a planned cesarean birth. Recommendations are made for clinical practice, education, and research. Increased education and support can lead to a positive experience despite having an alternative birth method.

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