Mia Vilhelmsen - Institutionen för hälsovetenskaper

Title: Women’s experiences of childbirth and postnatal care in a follow-up cohort within a randomized controlled trial in Sweden

Main Supervisor: Christine Rubertsson, RNM, Professor

Reviewers: Rikke Damkjær Maimburg RM, Professor, Arhus University and Caroline Bäckström RNM, Ass Prof, University of Borås

Abstract

Background

There is a knowledge gap concerning women’s birth-related experiences and quality of care. Through the perspectives of women can a more complete understanding of maternal healthcare quality be achieved. The aim of this doctoral thesis is to contribute to the understanding of women's experiences during childbirth and the postnatal period.

Research questions

1. What are women’s experiences of the second stage of labour in their first

vaginal birth?

2. What is the association between the initial postnatal care and women’s birth

experiences?

3. Which factors contribute to Swedish women’s satisfaction and positive

experience of a routine postpartum follow-up visit to the midwife?

4. Which factors related to pregnancy, childbirth and the postnatal period are associated with women’s self-rated overall health one year after they have given birth?

Preliminary results

1. A qualitative content analysis of 865 free-text questionnaire answers resulted in three categories. Women described their physical and emotional sensations during the second stage of labour. Women’s relationship with the midwives was a major contributor to a positive experience but could also give self-blame and showed a negative impact. When women were given instructions, it could lead to feelings of blame instead of accomplishment.
2. A positive birth experience was reported by 69 % of participating women. A majority received skin-to-skin care (78 %) and breastfed within two hours (72 %). The most common type of anaesthesia for vaginal examination was Xylocain spray (68 %) and pudendal nerve block (49 %). Six explanatory variables concerning women’s experiences of initial postnatal care all showed significant associations with the birth experience in logistic regression analysis without adjustment for confounders.

Significance

By informing midwives, doctors and decision-makers about how the maternal healthcare is experienced, this thesis provides opportunity to improve the care of women and their families, and to allocate resources more effectively.

Published studies

Vilhelmsen, M., Edqvist, M., Rubertsson, C., & Ängeby, K. (2025). Women experiencing the second stage of labour for the first time: A qualitative free-text analysis within the Oneplus trial. Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives, 44. https://doi.org/10.1016/J.SRHC.2025.101083