Introduction
Childbirth remains one of the most memorable and significant events for a woman as well as her family. Females’ experiences regarding birth possess long-term and short-term consequences on their well-being and health for both the infants and themselves. World Health Organization posited that the key outcome for all expectant mothers is to have confidence in their child delivery experience (De Leo et al., 2019). The primary expectation encompasses giving birth to a strong child in a safe, conducive environment with the permanency of care offered by caring, competent maternity care practitioners.
Discussion
Moreover, the World Health Organization has emphasized that several women value physiologically managed labor and birth. Notably, facing physiological child delivery also has a longstanding effect. It demonstrates that the well-being and health of a child and mother at birth mainly determine the future wellness and health of the whole family. In addition, childbirth generates physical impacts on women and their coming pregnancies (De Leo et al., 2019). For example, cesarean birth is linked to a lower rate of urinary inconsistence and pelvic organ displacement. It is also connected with high risks of future pregnancy, fertility, and lasting childhood impacts such as high odds of obesity and asthma.
Pre and post-natal care require evidence-based practice, a move embraced globally as the best strategy for enhancing healthcare outcomes for mothers and infants, using the ideal pieces of evidence to inform practice. Within maternity, evidence-based practice has been labeled as important for lowering the use of inefficient evidence-based information (Verhoeven et al., 2019). However, research continues to provide maternity practitioners with fresh evidence to inform their practice, and the judicious uptake of the best obtainable evidence in clinical contexts is inconsistent (Verhoeven et al., 2019). It creates a substantial challenge for midwives and obstetricians who are all cognizant of their obligation to render evidence-based care.
Midwives and obstetricians explore birth plans in the management of childbirth experiences. Birth plans assume diverse formats such as a list of preferences that expectant mothers can utilize during labor and childbirth or open questions issued to pregnant women to specify their choices (Ahmadpour et al., 2020). Women must comprehend these available practices if they require a birth-positive experience and fewer interventions. It is essential for women to exhaustively comprehend the pragmatic practices if they need a birth with minimal interventions. The situation stems from the fact that most hospitals offer generic pre and post-natal programs. It then limits women to the practices of the particular health facility and does not focus on allowing them to make informed choices during the delivery process. Therefore, the birth plan option was initially aimed as an instrument to empower and educate women as well as inspire shared decision-making (López-Gimeno et al., 2021). The tool also sought to facilitate communication regarding delivery expectations and even cultivate trust between midwives and expectant mothers.
Common aspects of the birth plan encompass requests for ambulatory services such as an ambulance during the onset of labor, drinking desired fluids, and reception of the baby to the abdomen section after birth. The plan also usually comprises a list of items that the mother desires to circumvent such as incessant fetal monitoring, pain medications, epidurals, and episiotomies (Ahmadpour et al., 2020). Most women who prefer birth plans need an unmedicated birth coupled with a few interventions. Against this background, this paper explores choosing of pre and post-natal care by expected mothers and how a midwife compares to an obstetrician in giving a birth plan. The PICO framework was employed to clarify the questions at hand. P: expectant mothers, I: choosing pre and post-natal care, C: midwife and obstetrician, O: birth plan.
Method
Search Strategy
A systematic method of literature examination was utilized to enable a search approach, selection, and constructive assessment of previous studies on the subject at hand. The search strategy was anchored in Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) as well as a couple of articles published by various reputational medical journals. The method outlined a stepwise technique for performing systemic reviews. Moreover, The Peer Review of Electronic Search Strategies was employed to increase the quality and completeness of the electronic literature search. A systematic search was conducted on bibliographic databases such as PubMed, EMBASE.com, The Cochrane Library, Google Scholar, and the Maternity and Infant Care Database.
The search approach encompassed the Boolean terms AND and OR, the key search words comprised measured terms as well as free text terms.
The purpose of the above search approach was to establish relevant publications on the topic at hand guided by PICO criteria. The question framed for this research was “In expected mothers choosing pre and post-natal care, how does a midwife compare to an obstetrician give more options for their birth plan?” Selection criteria were reached to establish which articles fit the onward review process. The eligible publications encompassed original qualitative study materials, literature published between 2017 and 2022 as well as resources printed in English.
Exclusion and Inclusion Criteria
Only articles providing full access and available in peer-reviewed journals were considered for utilization in the research. Moreover, only materials written in English were included in the review process since the investigator could just comprehend the language. All materials detailing pre and post-natal care, birth plan on expectant women’s experiences, or midwives’ and obstetrician preferences in childbirth were all included. Case studies relating to midwifery practices and only concentrating on care during stages of labor were excluded. Materials including expectant women who had a cesarean section or operative vaginal birth were also excluded. Moreover, reviews that involved women, who experienced a preterm birth, had induced labor, or those enhanced with venous oxytocin were also omitted.
Studies were also nominated for inclusion after a two-phase process through Covidence, an online software system that rationalizes the generation of systematic material reviews, comprising Cochrane reviews. During the initial screening phase, every study had the abstract and title examined and was exempted if fail to meet the eligibility standards. Finally, after the vigorous inclusion/ exclusion exercise full-text materials from the selected resources were retrieved for onward usage in the research.
Results
Many obstetricians and midwives believe that expectant mothers with birth plans possess unrealistic expectations coupled with inflexibility in making changes to their plans when necessary. To this effect, obstetricians, and midwives may become irritated since patients walk into the maternity with a list of anticipations yet they might not be prepared physically or emotionally to handle the task of birth. Midwives and obstetricians seem to be confident that expectant mothers who seek maternity services while having birth plans are more at risk of cesarean birth and tend to have an overall worse childbirth experience. It is also recognized that a birth plan provides a better means through which midwives offer their best services to ensure the satisfaction of expectant mothers’ preferences (Ahmadpour et al., 2020). Birth plans assist women to give realistic expectations, trigger them to reason, and have skills in managing labor and how to handle any eventualities that might come with it.
Obstetric interventions come in place to strengthen pre and post-natal outcomes. Positive outcomes of a good childbirth experience encompass self-esteem, enhanced and efficient maternal bonding, and compliance (López-Gimeno et al., 2021). Therefore, a good outcome should make every mother feel satisfied with the provided care coupled with the support received during the prenatal, delivery, and post-natal periods. Midwives have an essential task in the childbirth experience and overall positive outcomes. Expectant mothers who receive care from them show higher self-efficacy and self-esteem (Verhoeven et al., 2019). They also show the empowerment they require to attain a sense of mastery during the later stages of pregnancy, labor, delivery, and child nurturing. Midwives play a critical role in offering information and expanding comprehension as well as keeping channels of communication between the patient and obstetrician.
Discussion
Expectant mothers’ anticipations and experiences of childbirth are fundamental and worth evaluation. The use of a scoring system in childbirth seeks to inform on the extent of satisfaction and quality of rendered services during the entire process of labor and delivery (Afshar et al., 2019). Sound pre and post-natal education to women in terms of building their confidence and ability to cope with their preferences during the whole process of child delivery has been linked depict increased birth satisfaction.
The establishment of a birth plan aided to ameliorate a spiking fear during childbirth. Expectant mothers believe it is critical to think and draft their preferences and believe that their requirements and preferences will be met during delivery (Afshar et al., 2019). However, the medicalization of childbirth in many developing nations has not often resulted in positive experiences among mothers during birth. While midwives have assumed a lead, role aimed at encouraging birth plans in other nations. Midwives have also been active in implementing birth plan activities for Primipara.
Some of the key objectives of birth preparedness, including writing birth plans is to enhance communication and sensitization for expectant mothers for a positive childbirth experience. Responsiveness of a midwife or an obstetrician plays a vital role in mothers’ satisfaction, perhaps recapping the advantages drawn by utilizing birth plan options by this cadre of practitioners during pregnancy (López-Gimeno et al., 2021). In certain scenarios, even if a mother’s documented birth plans are not fulfilled, they still express satisfaction since they find amended discussion of their plans to be advantageous.
Conclusion
It is evident from the review that robust birth planning remains an elemental practice for midwives in many developed countries. Importantly, self-assessed profiles of desires regarding childbirth help to offer profound insights into mothers’ needs from their childbirth experience. Midwives might also come nearer to fulfilling the wishes and needs of childbearing expectant women. Precisely, there are challenges encountered by midwives and obstetricians, especially during labor. Some of these challenges are inescapable particularly when the delivery process is complicated as manifested by maternal suffering, fetal distress, obstructed labor, failure to progress, and malposition. However, the existence of such complications should not negate the role of trying to fulfill a positive and appropriate as well as holistic and effective childbirth. The paper recommends that obstetricians and midwives should use reliable and valid psychometric tools to evaluate mothers’ satisfaction with their childbearing experience.
References
Afshar, Y., Mei, J., Fahey, J., & Gregory, K. D. (2019). Birth plans and childbirth education: what are provider attitudes, beliefs, and practices? The Journal of Perinatal Education, 28(1), 10-18.
Ahmadpour, P., Mosavi, S., Mohammad-Alizadeh-Charandabi, S., Jahanfar, S., & Mirghafourvand, M. (2020). Evaluation of the birth plan implementation: a parallel convergent mixed study. Reproductive Health, 17(1), 1-9.
De Leo, A., Bayes, S., Geraghty, S., & Butt, J. (2019). Midwives’ use of best available evidence in practice: an integrative review. Journal of Clinical Nursing, 28(23), 4225-4235.
López-Gimeno, E., Falguera-Puig, G., Vicente-Hernández, M., Angelet, M., Garreta, G. V., & Seguranyes, G. (2021). Birth plan presentation to hospitals and its relation to obstetric outcomes and selected pain relief methods during childbirth. BMC Pregnancy and Childbirth, 21(1), 1-9.
Verhoeven, C. J., Spence, D., Nyman, V., Otten, R. H., & Healy, M. (2019). How do midwives facilitate women to give birth during physiological second stage of labour? A protocol for a systematic review. Systematic Reviews, 8(1), 1-5.
