A qualitative study of hospital birth perceptions: The helix of priority needs.

Objective: To understand which needs are considered priorities in the hospital birth experience from the perspectives of postpartum women.

Design: This qualitative prospective study used a phenomenological approach. Data were collected through participant observations and semi-structured interviews recorded at eight weeks and eight months after childbirth. The data were analysed using a thematic approach.

Participants: The study cohort consisted of 43 participants at eight weeks after childbirth and 33 participants eight months after childbirth.

Setting: Donostia University Hospital, San Sebastián, Spain, in 2016-2017.

Findings: Through the analysis, the following four main themes emerged, each in different categories: (a) Professional care: symbiosis between the woman and the professional: (a.1) professional treatment and its characteristics, (a.2) professional competence, and (a.3) professional information and listening: pillars in the support relationship. (b) Control and hospital safety: (b.1) hospital environment: external control. (c) Presence of the partner: (c.1) support, guidance, and participation. (d) Perception of observed feelings: (d.1) fear of complications or separation from the child, (d.2) fear of internal lack of control, and (d.3) fear of an instrumental delivery and/or caesarean section.

Conclusions And Implications For Practise: The core of the hospital birth experience is constituted by the need to establish a supportive relationship based on mutual trust, exchange information that offers internal and external control and the security necessary to overcome feelings of fear, and obtain support and guidance from an involved partner.