The Changing World of Childbirth 
Audra Flowers, SN-BSN
Lakeview College of Nursing

The Changing World of Childbirth: An Interview
	Mrs. Sandra F. is a 71 year old woman who lives at home in Mattoon IL with her husband of 56 years; they have three children together. Mrs. F. was kind enough to consent to a interview conducted by her granddaughter at her house on January 12, 2013 about her delivery experience. She was sitting comfortable on her couch covered with a blanket. She recalled the event and began by stating that “it was a long time ago, but she remembers it well” (S.F., personal communication, January 12, 2013). 
Patient’s Birth History
	Mrs. F. delivered her first baby in 1960 at the age of 18 (S.F., personal communication, January 12, 2013). She then had two other deliveries in 1961 and 1963, and a miscarriage previously at six weeks in 1959 (S.F., personal communication, January 12, 2013).  Her history reveals that she is para four gravida three.  
Demographics
	For the purposes of this interview the focus will be placed on her first delivery in 1960 at Mattoon Memorial Hospital in Mattoon IL (S.F., personal communication, January 12, 2013). She describes the facility as a community hospital that did not focus on one particular scope of care (S.F., personal communication, January 12, 2013). The hospital had a separate labor room where the deliveries were conducted by a doctor and two nurses, but no visitors were allowed (S.F., personal communication, January 12, 2013). The recovery room consisted of a private room, but the baby was kept apart from the mother in the nursery (S.F., personal communication, January 12, 2013).   
Medical Interventions
	In the 1960s, Lamaze classes and lactation consultants were not offered to expecting mothers, and Mrs. F. did not receive any form of patient education prior to her delivery (S.F., personal communication, January 12, 2013). Mrs. F. was prepped for delivery by having her perianal area shaved and administered an enema (S.F., personal communication, January 12, 2013). Mrs. F. was then taken to the delivery room and laid on a narrow operating table in the lithotomy position (S.F., personal communication, January 12, 2013). During the delivery, the doctor performed an episiotomy, without Mrs. F’s consent or knowledge of the procedure, and then stitched her up with sutures after the baby was delivered (S.F., personal communication, January 12, 2013). The baby was assisted out of the birth canal with forceps, also without any consent from Mrs. F. (S.F., personal communication, January 12, 2013).  Failing to obtaining consent is a common practice by doctors; sometimes even unintentionally (Goer, 2010). It is important to be knowledgeable about your rights and what is happening during the delivery process so that informed decisions can be made. After Mrs. F.’s delivery, she was treated with what she referred to as a “sits bath” which consisted of a heating lamp and sterile water to help heal her episiotomy stiches (S.F., personal communication, January 12, 2013).
Pain Coping Techniques and Medications for Labor
	Mrs. F. did not have the option of an episiotomy because her doctor did not believe in such things; the only method of pain relief that she used was warm showers (S.F., personal communication, January 12, 2013). 

Patient’s Impression of the Nursing Staff
	Mrs. F. felt comfortable with the doctor, and describes the nurse as “very helpful” (S.F., personal communication, January 12, 2013). Mrs. F. also shares a story about how the doctor and the nurse placed bets about when the baby would arrive … the nurse won (S.F., personal communication, January 12, 2013). 
Length of Stay in Facility
	The delivery took two hours, and then Mrs. F. had to stay in the hospital for three days after delivery (S.F., personal communication, January 12, 2013). 
Emotional Response to Birth
	The look on Mrs. F.’s face during the interview showed how happy she was to have participated in such a wonderful experience. She made it known that she loved being a mother by smiling and recalling many different stories about her pregnancy and her children’s childhood. When asked what the best part of her birth experience was, she laughed and said “hearing the baby’s cry” (S.F., personal communication, January 12, 2013). Mrs. F. was also very adamant that the worst part of the whole experience was the pain during the delivery (S.F., personal communication, January 12, 2013). 
Discharge Instructions
	The doctor advised her to not hold the baby too much while it was little because it could become sore; she was to only handle the baby during feeding, changing, and when it cried (S.F., personal communication, January 12, 2013). The doctor advised Mrs. F. to stay at home for the first 4 weeks as much as possible to prevent the baby from getting sick (S.F., personal communication, January 12, 2013). In reality, the baby should be held often to promote bonding and immunity development (Kyle, 2009). The doctor also recommended that she buy a girdle, and wear it daily (S.F., personal communication, January 12, 2013). She was not given any form of lactation support for breastfeeding or any other advice from the doctor (S.F., personal communication, January 12, 2013).  Mrs. F. did not receive the proper guidance to care for her newborn (S.F., personal communication, January 12, 2013). 
Impression of the Birthing Process
	Mrs. F. was very informative about the delivery. She shared all of the information that she could remember about the process. During that time, women were not given choices regarding the care they were receiving, so she was very fortunate to have a pleasant experience   (S.F., personal communication, January 12, 2013). 
Conclusion
	Mrs. F. had a pleasant experience with her labor. She did not encounter any complications during her delivery, and was not at risk for developing postpartum depression. This is not typical for all birth experiences; some women are susceptible to mood swings, irritability, or crying episodes (Kyle, 2009). Risk factors can be identified to reduce the occurrences of these symptoms. “Subjective distress in labor and obstetrical emergencies were the most important risk factors … Infant complications, low support during labor and delivery, psychological difficulties in pregnancy, previous traumatic experiences, and obstetrical emergencies were other risk factors” (Andersen, 2012. p.2). Interviewing women who have experienced labor promotes changes to be made during delivery so that it can be a positive memory for every woman who experiences it. 
References
Andersen, L. B., Melvaer, L. B., Videbech, P., Lamont, R. F., & Joergensen, J. S. (2012). Risk 	factors 	for developing post-traumatic stress disorder following childbirth: A systematic 	review. Acta Obstetricia Et Gynecologica Scandinavica, 91(11), 1261-1272. 	doi:10.1111/j.1600-0412.2012.01476.x
Goer, H. (2010). Cruelty in maternity wards: fifty years later. hencigoer.com. DONA 	International. 	Retrieved from hencigoer.com/downloads/cruelty_maternity
Kyle, T. & Ricci, S.S. (2009). Maternity and Pediatric Nursing. Philadelphia. Lippincott 	Williams & Wilkins.