'I felt as though I'd been in jail': Women's experiences of maternity care during labour, delivery and the immediate postpartum

It has been widely recognized, both in the UK and internationally, that there is a need for a multidimensional or holistic approach to maternity care, which incorporates psychological as well as physical aspects, in order to optimize women's experiences both in the intra- and postpartum period. Central to such an approach is the relationship between women and maternity care staff. The aim of this study was to explore the impact of maternity care staff on women's experiences, and feelings associated with the childbirth process. Semi-structured interviews were conducted with 24 primiparous and multiparous women, and transcripts analysed using open and axial coding with triangulation. Three main themes emerged from women's accounts: perceptions of control, staff attitudes and behaviours, and resource issues. Each of these themes was evident throughout the various stages of the childbirth process, in the delivery suite, on the maternity ward, and specifically in relation to breastfeeding. In the women's accounts, feelings of little control were related to inadequate information provision, poor communication, and no opportunity to influence decision making. These, together with the negative attitudes and behaviours of maternity staff, and issues of under-resourcing, were often linked to negative feelings such as fear, anger, disappointment, distress, guilt, and inadequacy. These findings illustrate the importance of maternity care staff recognizing women's psychological and emotional needs during the childbirth process, and the impact that they themselves may have on women's experiences. These issues are discussed with reference to the wider debate on authority and power within the medical relationship, from a feminist viewpoint.