Women Experience On Birth Environment

Published Date: 02 Nov 2017

Abstract

Introduction

Literature review

Birth environment

Brief history of Birth environment

Ideal birth environment

The world as experienced by women

Existential Phenomenology

Steps involved in existential phenomenology

Methodology

Area of study

Data collection

Data analysis

Data Presentation and interpretation

conclusions

Women Experience on Birth Environment: A phenomenological study

ABSTRACT

Since the aim of phenomenology is to examine and clarify human experiences or situation, events as they continue to occur in the course of our daily life therefore it’s an interesting tool to be used in understanding any kind of human experience, situation or event. Birth is the process of bearing child or offspring (3) and birth occur in environment. Birth occurs in a unique environment with unique qualities

The main aim of this research is to investigate the experience of women on birth environment focusing on psychological and physical effect of the environment and also identify a perfect environment for birth. The research is made based on both qualitative and phenomenological research method.

The research will focus on the effect of environment on mothers during birth and also identifying a perfect birth environment using mother’s opinion. Two different environments are selected and used as a research area namely: hospitals/Maternity and homes. The research aid to understand the physical and psychological effects environment have on women and also a perfect birth environment using the eleven essential elements.

INTRODUCTION

A central focus of phenomenology is the way people exist in relation to their world. In Being and Time, Heidegger (1962) argued that, in conventional philosophy and psychology, the relationship between person and world has been reduced to either an idealist or realist perspective (11). In an idealist view, the world is a function of a person who acts on the world through consciousness and, therefore, actively knows and shapes his or her world. In contrast, a realist view sees the person as a function of the world in that the world acts on the person and he or she reacts. Heidegger claimed that both perspectives are out of touch with the nature of human life because they assume a separation and directional relationship between person and world that does not exist in the world of actual lived experience (11).

Since birth is an event or experience which occurs in an environment therefore a phenomenological study could be made on both birth and its environment, but this paper deals mainly with the environment. Birth is one of the most important if not the most important thing that occurs in human’s life, which is the act of bearing an offspring which occurs in a particular environment with a unique character. Therefor the way humans behave, relate and even experience it, is different from all other environment: to some the environment is scary while to others it’s an environment that produces happiness.

Phenomenology deals with the study of human experience which we experience with both our body and mind. The goal of phenomenology is not to interpret or explaining human experience rather it’s a style of thinking which studies "essence" or the Perception of physical Phenomena and Human behavior. It tends to describe life behavior and events rather than explaining them (10). Therefore this study is going to use existential phenomenology to identify how women experience and relate to birth environment.

Existential phenomenology describes subjective human experience as it reflects people's values, purposes, ideals, intentions, emotions, and relationships. Existential phenomenology concerns itself with the experiences and actions of the individual, rather than conformity or behavior. The individual is seen as an active and creative subject, rather than an object in nature: in other words, the existential person is not merely passive or reactive, subject to environmental influences, but also a purposeful being who has inner experiences and can interpret the meaning of his or her existence and relationships with others in a social world. (13).

Methodology

This section of the paper presents us with the method adopted for this study. The methodology used for this study is phenomenological method and qualitative research method. At the beginning of this research two of the main birth environments were used for this research, so as to find out how women experience them

Birth environment

There are two main environment of birth namely:

Homes and

Hospital/maternities

The home birth is the first and oldest birth environment and still bee practice by few people today. Before 1940 women give birth at home under the super vision of midwives, Midwives are women who have experience about child birth. When the woman is given birth her family and friends will be around to support her to ease the pain during labor. Some will be around to be helping her till she is strong enough to take her house hold duties. (12)

The second environment which the hospitals/maternities it’s the most used environment for birth. In the hospitals/maternities there is a special room, department or ward that is dedicated to birth only unlike the home birth. The hospitals are more comfortable and safer environment because they provide adequate care for the birthing women.

2.1 History of birth environment

The history of birth environment goes back to when man started giving birth, therefore it’s difficult to talk about the whole history but here are some brief histories of the birth environment from 1800 till date:

Till late 1800s: home

1890-1940: transition from home to hospital

1940s to 1970s: mothers alone, drugged, without humane care

1960s and 1970s: "family-centered maternity care," natural birth; also midwifery and home birth

1980s: "ABC" rooms, EFM, epidurals, C/S

1990s: Drop in C/S; more VBACs till 1997

1997-2007: birth rooms geared for induction, epidurals, more ORs for 30+% C/ (12)

2.1.2 Ideal birth environment

For women to give birth comfortably the environment has to be psychologically safe for them and physically safe for them as describe in a survey made by Newburn M. and Singh D. 2003 in UK, they have been able to identify the following qualities of an ideal birth environment:

• Control over the temperature,

• A pleasant place to walk,

• Sufficient pillows, floor mats and bean bags,

• A homely, non-clinical, room,

• Not being overheard by others,

• Control over who came into the room, and

• A place to get snacks and drinks. (8)

2.3 Existential phenomenology

Phenomenology is a philosophical approach most attribute to Husserl although Descartes inspired his project (10). Husserl attempts to describe consciousness by focusing on phenomena, or how reality appears to consciousness, and "bracketing" all other possible philosophical or theoretical topics (10). In other words he tries to describe reality from scratch, as it appears to consciousness, from what he refers to as "the natural standpoint" (10). Or in other word Phenomenology is the exploration and Description of Phenomena refer to things or experiences as human Experience them. Any object, event situation or Experience that a person sees, touch, Fell smell or Understands can be a topic of Phenomenology. Since phenomenology deals with human experiences then it’s going to be used in this study to explore the birth environment

As described in the first part of this paper what phenomenology its nature and the three different methods or types used in the study of phenomenology. In this part am going to concentrate on mainly on Heidegger existential phenomenology.

Existential phenomenology

This is a psychology approach inspired by the philosophical tradition developed by thinkers such as the existential dimension deepens our understanding of persons living in their everyday circumstances through in-depth reflection on the psychological meanings expressed in both experience and action. The phenomenological dimension encourages openness toward psychological reality by identifying and putting aside theoretical and ideological prejudgments. s, Kierkegaard, Heidegger etc. Existential-phenomenology seeks to develop an in-depth understanding of human existence. It challenges traditions that study the person in a reductionist manner or promote dualistic modes of thinking (e.g., mind vs. body or freedom vs. determinism). Our program distinguishes itself both by using this philosophical tradition as a foundation for psychology and psychotherapy, and as a source of insight about specific human experiences. (14). the existential dimension deepens our understanding of persons living in their everyday circumstances through in-depth reflection on the psychological meanings expressed in both experience and action. The phenomenological dimension encourages openness toward psychological reality by identifying and putting aside theoretical and ideological prejudgments (14). Since existential phenomenology deals with human experience and birth is an experience that is experience by women in a unique environment basically (maternities, Hospital or homes), therefore this paper will study their experiences of birth environment.

World as experience by women

For McGuire 2006 women are bound in a world of Subjectivity; i.e. she found her self-bound to a world of feeling, intuition and relationship and empathy, so for McGuire Female’s experience of the world is always different from the way male experienced. Therefore some women’s way of being-in-the-world are synonymous with a phenomenological methodology, as drawn from Husserl and explicated by Gendlin (1962), particularly:

(a) The acceptance of inner experiencing as real;

(b) The acceptance of direct reference to felt experiencing as a ground for determining truth or

Falsity;

(c) The demand that concepts be grounded in concrete experiencing, rather than abstraction. (7)

Our next discussion goes through some of the simple characteristics of the "feminine "as described in Utopian literature and show how concepts from existential/phenomenology confirms these ways of being as basic for human beings namely:

3.1 Feeling and intuition are basic existents.

For utopian writer’s Bryant, 1971 women experience herself as at one with the world, a process, not static roles or units. She trusts her intuitive sensing of others and relates through empathy (1). The first thing existential philosophy did was simply to point to the existence of feeling and intuition as a sub-stratum of human being, a source of knowing (7). The existence of feeling can be proven through direct reference to felt experiencing. If you were to pause for a moment now, and turn your attention inward to your sense of yourself as existing, you could verify the existence of felt meaning through this direct reference.

3.2 The body is a source of knowledge about the world

Gearhart, 1979 believe woman experiences herself as located in her body, and through it, as co-extensive with nature, with the human community. She trusts in her "feelings" to guide decisions (6).

3.3 The body is inherently relational

Woman experiences herself as a part of other people. She lives in a world of empathy, concern with relational climate (1). Heidegger says there is no "human being" as a separate or separable entity; there is only "being-in-the-world," the human being as implicitly and by nature an interaction.

3.3 Experiencing is a Source of Knowledge

Woman turns her thinking toward her inner experiencing, and she finds their feelings and

Intuitions, not as in traps chic, subjective contents, but as a nexus of interaction between herself and world, For Heidegger feelings are always at, or toward, or in relationship to other people and other things (Heidegger, 1962).

For this paper the four characteristics discussed above are the most important one in this study.

Data Presentation and Analysis

This section of the paper presents us with women experiences of birth environment (homes and hospitals/ maternity), this study will use 7-10 question that was used in a questionnaire to women from different surveys that was made by various researchers regarding their experience of hospital/maternity (birth environment), including a national survey made by Newburn M. and Singh D. 2003 in UK Creating a Better Birth Environment: Women’s views about the design and facilities in maternity units, The Birth Environment: How the place and people influence outcomes by Simki P. PT.2007 for WHONN etc. In this paper ten women experience was used in hospital birth and five for homes as a birth environment.

4.1 Hospital as birth environment

The following are some of the questions and responses from different women for hospital/maternity:

Q1. Why do prefer giving birth in hospitals than homes?

Q2. What do you think of hospital/maternity as a birth environment?

Q3. How do you feel about this environment?

Q4. What are the main characteristics of hospital/ maternity in respect of birth environment?

Q5. What are the aesthetics qualities of the environment?

Q6. What is the atmospheric condition of the place?

Q7. How do you rate the environment?

Q8. Does the color use help in any way?

Q9. Which color would you prefer?

N0

Respondents

Q1

Q2

Q3

Q4

1

Mrs. A

Relaxing

Ok

Ok

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

2

Mrs. B

Relaxing

Perfect

Very nice

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

3

Mrs. C

Safer

Welcoming

Ok

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

4

Mrs. D

Safer

Peaceful

Ok

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

5

Mrs. E

Less Stressful

Perfect

Ok

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

6

Mrs. F

Confortable

Ok

Ok

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

7

Mrs. G

Relaxing

Ok

Safe

Physically Pleasant, Warm, Relaxing, safe and, welcoming

8

Mrs. H

Controllable

Scarred

Ok

Physically Pleasant, Warm, Relaxing, scarred, aesthetically ok and, welcoming

9

Mrs. I

Less stressful

Scarred

Relaxed

Physically Pleasant, Warm, Relaxing, scarred, aesthetically ok and, welcoming

10

Mrs. J

More hygienic

perfect

Safe

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

Fig1. Women response to birth environment

N0

Respondent

Q5

Q6

Q7

Q8

Q9

1

Mrs. A

Ok

Warm

Very good

No

Yellow

2

Mrs. B

Perfect

Ok

Excellent

Yes

Green

3

Mrs. C

Scarred

Perfect

Perfect

No

White

4

Mrs. D

Ok

Warm

Ok

No

Yellow

5

Mrs. E

Aesthetically ok

Warm

Ok

No

White

6

Mrs. F

Nice

Ok

Good

No

Green

7

Mrs. G

Nice

Perfect

High

Yes

Green

8

Mrs. H

Good

Warm

Very high

Don’t know

Blue

9

Mrs. I

Ok

Warm

High

Don’t know

Green

10

Mrs. J

Perfect

Warm

Low

Yes

Blue

Fig2. Women response to hospital/maternity birth environment

The following are the responses of women that use hospitals as a birth environment most of them think that the hospital environment is a better birth environment and most responded well.

4.1. 2. Homes as a Birth Environment

The following are some of the questions asked to the women that prefer giving birth at home and their responses, most of the question asked to them are similar to the ones that prefer hospitals/maternity than homes:

Q1. Why do prefer giving birth at homes than hospitals?

Q2. What do you think of homes as a birth environment?

Q3. How do you feel giving birth at home?

Q4. What are the main characteristics of home in respect of birth environment?

Q5. What are the aesthetics qualities of the environment?

Q6. What is the atmospheric condition of the place?

Q7. How do you rate the environment?

N0

Respondent

Q1

Q2

Q3

Q4

1

Mrs. 1

Safe

Ok

Safe

Safe, relaxing, Natural environment

2

Mrs. 2

Can’t afford

Happiness

Relaxed

Confortable, safe, Relaxing

3

Mrs. 3

Presents of relatives

Ok

Happy

Safe, Relaxing, Natural environment

4

Mrs. 4

Tradition

Safe

Happy

Safe, Relaxing

5

Mrs. 5

Presents of love ones

Ok

Harmless

Comforting, Relaxing and safe

Fig1. Women response to homes as birth environment

N0

Respondent

Q5

Q6

Q7

1

Mrs. 1

Ok

Not hygienic enough

Ok

2

Mrs. 2

Ok

Not hygienic enough

Low

3

Mrs. 3

Non

Not hygienic enough

Low

4

Mrs. 4

Non

ok

Ok

5

Mrs. 5

Non

Ok

High

Fig1. Women response to homes as birth environment

The following are the response of women that give birth at home seven questions were asked to five women and each of them responded well.

ESSENTIAL THEMES IN BOTH ENVIRONMENTS

Questions

Hospitals/maternity

1-10

Homes as birth environment

Essential themes

Q1

Relaxing, Relaxing, safer, safer, less stressful, confortable, relaxing, controllable, less stressful, more hygienic.

Safe, Can’t afford,

Presents of relatives, Tradition, Presents of love ones

Safer

Relaxing

Presence of relatives

Q2

Ok, Perfect, Welcoming

Peaceful, Perfect, Ok, Ok

Scarred, Scarred, perfect

Ok, Happiness, Ok, Safe

Ok

Perfect

Scared

Joy

Q3

Ok, Very nice, Ok, Ok, Happy, Happy, Safe, Ok, Relaxed, joy

Safe, Relaxed, Happy

Happy , Harmless

Happiness

Q4

Physically Pleasant, Warm, Relaxing, safe, aesthetically ok and, welcoming

Safe, relaxing, Natural environment, Natural environment

Physically pleasant

Natural environment

Aesthetically good

Q5

Ok, Perfect, Scarred, Ok, Aesthetically ok, Nice ,Nice, Good, Ok , Perfect

Ok, Ok, Non, Non, Non

Nice

Q6

Warm, Ok, Perfect, Warm, Warm, Ok, Perfect, Warm, Warm, Warm

Not hygienic enough , Not, hygienic enough, Not hygienic ,enough, ok, Ok

Hygienic

Warm

Q7

Very good, Excellent, Perfect, Ok, Ok, Good, High, Very high, High, Low

Ok , Low, Low, Ok, High

-

Q8

No, Yes, No, No, No, No, Yes, Don’t know, Don’t

-

-

Q9

Yellow, Green , White, Yellow, White, Green, Green , Blue, Green, Blue

-

Green, Yellow and blue

Discussions

This section of the paper is divided into (2) two the first part discusses on the essential themes identified in the first part while the second part uses the essential themes to identify a perfect birth environment.

So the first part examines the findings made in the previous section of the paper by identifying some important themes. Eleven essential themes were identified from the phenomenological analysis of the birth environments namely: Safety, Relaxing, Presence of familiar face , Scared, Happiness, Physically pleasant, Natural environment, aesthetically good or Nice, Hygienic and Warm

4.1 Essential issues

Ten themes reflecting on the essence of the general statement in relation to women experience of birth environment

4.1.1 Safety

This research reveals that women that give birth in hospitals/Maternities feel safer there likewise women that give birth at home feels it’s safer to give birth at home.

4.1.2 Relaxing

For women that give birth at homes feels more relaxed likewise those that give birth in hospitals/Maternity, they feel more relaxed

4.1.3 Presence of Familiar face

The research reveals to us the importance of familiar faces in the birth environment is important so as to help her through the pain, for the women presence of familiar face will ease the pain.

4.1.4 Scared

The current revealed that most women fill scared when going to birth environment especially those that are given birth for the first time.

4.1.5 Happiness

Evidence from many women indicates that both home and hospitals/maternity as birth environment is a place that produces happiness especially when the birth occurred successfully

4.1.6 Physically Pleasant

All Ten (10) women from hospital/maternity all agreed that the environment is physically pleasant.

4.1.7 Natural environment

Almost all women that give uses home as birth environment agreed that they prefer birth environment that looks like natural environment it’s among the reasons why they give birth at home.

4.1.8 Aesthetically Good

The research reveals that most that uses hospital feels that the environment is aesthetically good.

4.1.9 Hygienic

Almost all the women that give birth in hospital feels that its more hygienic to give birth in hospitals than homes.

4.1.10 Warm

The research reveals that all women that uses hospitals as birth environment that the atmospheric condition is warm.

4.1.11 Color

The research also reveals to us that the color used in birth environment affect some women psychologically. The most common color preferred by most women is green, Yellow, white and blue.

The discussion above clearly shows us the experiences of women on different birth environment can be similar while some have different experiences.

The above discussion leads us to the final section of this study which is the identification of a perfect birth environment. In this study the identification will be made by using the essential themes/ or common themes so as to create a perfect birth environment.

4.2 Perfect birth environment

By identifying the women experiences and analyzing them using phenomenology, the research reveals that a perfect birth environment can be created using the some of the essential themes discussed in the previous section of this paper. Therefore based on this study a perfect environment will have the following characteristics:

The environment has to be welcoming not scary

Most women prefer privacy while giving birth

Physically pleasant

Mothers have to feel at home i.e. the environment have to be confortable

The environment has to be hygienic

For most mothers they prefer familiar faces around them while giving birth some prefer their husbands while some prefer their mothers

Warm environment

Relaxing

From the analysis made in the previous section of this paper, it has been identified that for most women if not all for them to have a physically and psychologically safe birth, the environment should have the above mentioned characteristics. When women that give birth at homes were asked: if a birth environment that purses the above mentioned characteristics was to be created for you would you stop giving birth at homes? All of the women replied yes except for one, who claims that it’s a family tradition.

Conclusions

In conclusion the study has clearly reveal to us people may have similar and different experiences on a Particular environment and also may have similar experiences on two different environments, as can be seen clearly from this study. This study also reveals to us that birth environment is not just the labor room or room but it’s a room that produces both happiness and sorrow.

Another important issue that this study reveals to us it’s important for architect when designing a particular environment they should make a close study of that environment by asking the users of that particular environment their own opinion on how they would have preferred it or how they would have wanted that environment to be, just as can be seen in this researcher. The researcher uses both his experience and the experiences of the mothers so as to have better understanding of birth environment.

Finally this research also reveals to us the importance of using phenomenology as a research tool for understanding human experiences, situation or events.