Interventions during labor and birth in the United States: A qualitative analysis of women's experiences

• U.S. women's understandings of and experiences with interventions during labor and birth are explored.
• Women struggle to balance concerns about risk with control during birth.
• Women are confused about the proper place of interventions
• The alignment of women's expectations regarding intervention use with care provider's philosophy and management of birth affects patient satisfaction.

ObjectiveTo explore and describe hospital-birthing women's understandings of and experiences with interventions during labor and birth.MethodsQualitative data was collected as part of a larger ethnographic study of childbirth in the United States. The grounded theory method was employed to analyze interviews with 59 women from three states who had recently given birth in hospitals with physicians or certified nurse-midwives in attendance.ResultsFour themes emerged from the data. The themes safety/risk and provider match, described women's expectations regarding intervention and their interactions with providers. A third theme addressed how women experienced interventions and their perceptions of control over decision-making. A final theme characterized women's satisfaction with maternity care.ConclusionsWomen who received interventions expressed varying levels of comfort or apprehension associated with both expectations of maternity care and provider match. Women whose expectations matched those of the provider reported more positive experiences. Regardless of provider match, women expressed ambivalence about the use of interventions and confusion over their appropriate place. Women's ability to make sense of interventions was related to how well they navigated a complicated and bureaucratic maternity system. Increasing attention needs to be paid to the impact of these factors on women's perceptions of care during pregnancy and childbirth.