title: Grand multiparae's evolving experiences of birthing and technology in U.S. hospitals.
abstract: OBJECTIVE
  To explore the nature of birthing in United States (U.S.) hospitals from 1973-2007 and to explicate and interpret common, often overlooked, birthing experiences and nursing care.
  
  
  METHODS
  A Heideggerian phenomenological approach utilizing in-depth interviews.
  
  
  METHODS
  Participants' homes in Washington, Idaho, and Oregon.
  
  
  METHODS
  A purposive sample of grand multiparaes (N = 14).
  
  
  METHODS
  Data were collected via open conversational interviews of 60-90 minutes recorded on digital media and completion of a demographic and birth attribute form. Field notes and interpretive commentary were used as additional data sources and were analyzed using an established Heideggerian approach.
  
  
  RESULTS
  The participants came from diverse religious and ethical backgrounds and experienced 116 births (8.29 births per woman, 79% unmedicated), a Cesarean rate of 6%, and a breastfeeding rate of 99% with a mean duration of 12 months. Two overarching patterns emerged: pursuing the "'good birth": a safe passage for baby and being in-and-out of control: body, technology, others. Each pattern subsumed several overlapping themes. The first pattern revealed that women often desire a good birth in the safety of a hospital by navigating their options prior to and during the birth. The second pattern revealed a common, yet often unachievable, desire by all of those involved in the process to control birth.
  
  
  CONCLUSIONS
  Harmonizing an exchange of ideas in a technologically advanced environment prevalent in hospitals today can increase the quality of intrapartum care. Encouraging anchored companions and promoting normal physiological birth will make hospitals places where women can experience a good birth and feel safe.
authors.affiliation: Washington StateUniversity College of Nursing, Spokane, WA 99210, USA. sefleming@wsu.edu
authors.forename: Susan E
authors.initials: SE
authors.lastname: Fleming
authors.forename: Roxanne
authors.initials: R
authors.lastname: Vandermause
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D036861:Delivery, Obstetric / Q000379:methods / Q000451:nursing* / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007061:Idaho; D007407:Interviews as Topic; D008425:Maternal Behavior / Q000523:psychology*; D008875:Middle Aged; D009321:Natural Childbirth / Q000379:methods; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009773:Obstetric Nursing / Q000379:methods; D009922:Oregon; D010298:Parity; D036801:Parturition / Q000523:psychology*; D011247:Pregnancy; D012307:Risk Factors; D014861:Washington