Control in childbirth: a concept analysis and synthesis.
OBJECTIVE
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.


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


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.


CONCLUSIONS
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.
University of Colorado College of Nursing, Denver, Colorado, USA. shaunette.meyer@ucdenver.edu
Shaunette
S
Meyer
D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D016247:Information Storage and Retrieval; D011247:Pregnancy