title: Women's birth expectations, are they fulfilled? Findings from a longitudinal Swedish cohort study.
abstract: BACKGROUND
  The importance of women's expectations on the experience of birth has shown contradictory results regarding fulfilment. The aim of this study was to describe pregnant women's expectations of birth and to investigate if these expectations were fulfilled. An additional aim was to determine if unfulfilled expectations were related to the mode of birth, use of epidural and the birth experience.
  
  
  METHODS
  This research investigated a prospective regional cohort study of 1042 Swedish-speaking women who completed a questionnaire about birth expectations in late pregnancy and were followed up with two months after birth. Five areas were under study: support from partner, support from midwife, control, participation in decision making and the midwife's presence during labour and birth. An index combining expectations and experiences was created.
  
  
  RESULTS
  Certain background characteristics were associated with expectations as well as experiences. Statistically significant differences were shown between expectations and experiences in support from midwife (mean 3.41 vs 3.32), support from partner (mean 3.70 vs 3.77), and midwife's presence (mean 3.00 vs 3.39). Experiences 'worse than expected' regarding decision making and control were associated with modes of birth other than vaginal and four out of five areas were associated with a less positive birth experience.
  
  
  CONCLUSIONS
  Some women had high birth expectations of which some were fulfilled. An expectation on support from the midwife was less likely to be achieved, while support from partner and the midwives' presence were fulfilled. If the woman's expectations were not fulfilled, e.g. became 'worse than expected' this was associated with a less positive overall birth experience as well as with instrumental or surgical mode of birth.
authors.affiliation: Mid Sweden University, Department of Nursing, 851 70 Sundsvall, Sweden; Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, 751 85 Uppsala, Sweden; Karolinska Institutet, Department of Women's and Children's Health, Division of Reproductive and Perinatal Healthcare, 17177 Stockholm, Sweden. Electronic address: Ingegerd.hildingsson@miun.se.
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Hildingsson
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008016:Life Change Events; D008880:Midwifery; D009035:Mothers / Q000523:psychology*; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D036801:Parturition / Q000523:psychology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012944:Social Support; D013548:Sweden
keywords: Birth; Expectations; Experiences; Longituinal survey; Pregnancy