To give birth in late- and post-term pregnancy - women's experiences and perspectives

Abstract: Childbirth is a lifechanging event, and women carry with them the experience throughout life. Around one in five pregnancies reach gestational week 41. When to recommend induction of labour for those extending 41 gestational weeks has been debated. Also, knowledge of women’s experiences and perspectives is limited. Therefore, the overall aim of this thesis was to obtain a deeper understanding of women’s experiences and perspectives of giving birth in late- and post-term pregnancy. Study I is a systematic review aiming to identify and present validated instruments measuring women’s childbirth experiences. In total, 36 instruments were identified representing different aspects of childbirth experiences with varying quality of psychometric properties. Study II compared childbirth experience between women randomised to either induction in gestational week 41+0 to 41+2 or to expectant management until gestational week 42. In total, 656 women responded to the Childbirth Experience Questionnaire version 2, three months after birth. As an exploratory outcome, 1457 women responded to the overall childbirth experience measured on a visual analogue scale within three days after birth. No significant difference was seen between the two randomised groups. Study III is a phenomenological study where twelve women were interviewed about their experience of induction of labour in late- and post-term pregnancy. The essence was described as the induction of labour becoming another journey than the intended one. In Study IV, ten women who wanted to await spontaneous onset in week 41 were interviewed about their experiences and perspectives regarding giving birth in late-term pregnancy. Through reflexive thematic analysis, three main themes were identified: well-being and trust in the own body’s process, not for me right now – if everything is good, and the embodied experience of giving birth. This thesis provides new insights into how induction of labour can be experienced in late- and post-term pregnancy as well as the experience of wanting to await spontaneous onset of labour. The included studies can aid maternity personnel in acquiring a deeper understanding and enable more individualised care in the lifechanging and existential period that giving birth and becoming a parent is.