Search

OBJECTIVE: To explore the culture, beliefs, values, customs and practices around the birth process within a free-standing birth centre (FSBC). DESIGN: Ethnography. SETTING: A birth centre situated in the midlands of England. PARTICIPANTS: Women attending the centre, midwives and maternity-care assistants (MCAs) working at the centre. FINDINGS: Women in the study seemed to invoke intuitive nesting-related behaviours in their assessment of the suitability of the birth centre. In addition, the birth centre staff's focus on creating the right ambience for birth may also emanate from nesting concerns. Birth-centre staff assisted women through the 'becoming mother' transition, which is conceptualised as 'matrescent' care. KEY CONCLUSIONS: The birth-centre environment elicited nesting-like behaviours from both women and staff. This formed part of a nurturing orientation that was conceptualised as 'matrescent' (becoming mother) care. 'Matrescence' does not seem to be grounded in clinical skills but is relationally mediated. IMPLICATIONS FOR PRACTICE: Nesting-like behaviours and 'matrescent' care in this context challenge maternity services to review traditional conceptualisations of safety and traditional expressions of clinical intrapartum care. [ABSTRACT FROM AUTHOR]

Background: This study sought to describe patient features before beginning fertility treatment, and to ascertain their perceptions relative to risk of twin pregnancy outcomes associated with such therapy. Methods: Data on readiness for twin pregnancy outcome from in vitro fertilisation (IVF) was gathered from men and women before initiating fertility treatment by anonymous questionnaire. Results: A total of 206 women and 204 men were sampled. Mean (± SD) age for women and men being 35.5 ± 5 and 37.3 ± 7 yrs, respectively. At least one IVF cycle had been attempted by 27.2% of patients and 33.9% of this subgroup had initiated >3 cycles, reflecting an increase in previous foiled cycles over five years. Good agreement was noted between husbands and wives with respect to readiness for twins from IVF (77% agreement; Cohen's K = 0.61 ; 95% CI 0.53 to 0.70). Conclusion: Most patients contemplating IVF already have ideas about particular outcomes even before treatment begins, and suggests that husbands & wives are in general agreement on their readiness for twin pregnancy from IVF. However, fertility patients now may represent a more refractory population and therefore carry a more guarded prognosis. Patient preferences identified before IVF remain important, but further studies comparing pre- and post-treatment perceptions are needed. [ABSTRACT FROM AUTHOR]