| The purpose of this research was to identify recurring themes in the lives of pregnant women with self-efficacy for childbirth, and to propose relationships between these recurring themes and the development of self-efficacy for childbirth. The researcher interviewed 10 pregnant women, all multiparas planning homebirths with licensed midwife practitioners, once in the last trimester and again within 2-3 months after birth. All had uneventful homebirths except for one who delivered preterm in the hospital, and who was dropped from the study at that point. Demographic data was obtained and the CBSEI (Childbirth Self-Efficacy Inventory) (Lowe, 1991a) was administered before the focussed life-history interviews were conducted. Only one woman fell into the high self-efficacy group, but the CBSEI was determined not to have been a valid instrument for use in this sample. The interviews were analyzed using Spradley's ethnographic analysis technique (1979). Three major domains of meaning emerged from the data: "difficult times in life and/or turning points," "deciding to have a homebirth," and "dealing with labor." The researcher performed taxonomic analysis and then theme analysis. The two themes that constituted the relationships among the domains were "Walking with God" and "Family and Home as Central." References to their spiritual beliefs and experiences and to the centrality of home and family occurred in all three domains. Whether they developed their spiritual core early in life under the influence of a stable family which encouraged spiritual development, or later in life after difficult experiences or turning points of a spiritual nature, participants drew from their spiritual core to plan homebirth and to deal with childbirth and other difficult times in their lives. The researcher compared this homebirth sample to other homebirth populations, all of whom espouse the "wholistic" model of birth (Davis-Floyd, 1992). The magico-religious/holistic world view of this homebirth sample constituted the cognitive matrix through which they appraised and integrated self-efficacy information for childbirth. Implications include nursing assessment of spirituality, cultural world view, and childrearing practices, as well as the changes needed in hospital birth environments to meet the psychological/emotional/spiritual needs of women. |
