Control in childbirth: a concept analysis and synthesis

Abstract

Aim: To report a concept analysis of control in childbirth.

Background: Control has a variety of definitions from a wide range of disciplines. In childbirth, however, the concept is more tenuous and depends on the context. It can be viewed in relationship to a woman's body and labour progression, pain, environment and the ability to request her method of birth.

Data sources: Medline, CINAHL and PsycINFO databases were searched between 1970-2011 using the keywords, 'control', 'childbirth', 'labour' and 'delivery'.

Review methods: Walker and Avant's method of concept analysis was used for this review. In addition, cases were placed before defining attributes as recommended by Risjord.

Results: Four attributes of control were identified: decision-making, access to information, personal security and physical functioning. Antecedents include pregnancy and expectations of the birth. Consequences include childbirth satisfaction, childbirth experience, emotional well-being, fulfilment and the transition into motherhood. A model case, contrary case and borderline case are described.

Conclusion: Clarifying the definition of control in childbirth and defining its attributes can help inform women and maternity providers throughout the world. This analysis provides clarity to a previously tenuous concept and allows practitioners to better understand the critical relationship between control in childbirth and satisfaction with the childbirth experience. It also has the potential to affect perinatal outcomes and subsequently healthcare costs.