Women Construct Their Birth Narratives and Process Unplanned Cesarean Births Through Storytelling.

Objective: To examine birth narratives of primiparous women who experienced unplanned cesarean births to improve nursing care.

Design: Descriptive, qualitative.

Setting: The family/newborn units of a large teaching hospital in the Northeast United States.

Participants: Fourteen women who experienced unplanned cesarean births of singleton infants at term.

Methods: We used semistructured interviews to analyze the participants' birth narratives. Within 48 hours of birth, participants answered the prompt: "Tell us your birth story." Four perinatal nurse experts in consultation with a qualitative research expert ordered, analyzed, and coded data into themes and subthemes.

Results: We identified the following four themes: Changing Reality: Transition to Labor, Expectations Meeting Reality: Navigating the Unknown, Transition to Motherhood: The Cesarean Birth Experience, and Accepting the New Reality.

Conclusion: Childbearing women need time immediately after birth to process their experiences. Our findings highlight avenues for changes in clinical care to optimize women's experiences of unplanned cesarean births. Participants wanted clearer communication with the maternity care team, voices in the decision-making process, and inclusion of support persons to optimize their birth experiences. Because negative birth experiences affect maternal and child well-being, it is important to understand women's perceptions and develop strategies to assist them in the construction of their birth narratives.