Adding Comments

We invite Member's comments on any Journal issue or any individual Journal Article. You will find the space for comments at the bottom of each Journal and Article page. You can also send comments directly to the editor at: Members can also be notified of all new comments posted by updating their Notification Settings.

Birth literature reveals many perspectives about “good birth,”  and  an investigation into a good birth is necessary because women and children are entitled to the experience that most supports their health as well as their psychological wellbeing and fulfillment. There exists a culture within maternity services of professionals working with apparently conflicting agendas, which may contribute to service user input being excluded.

Publication Date: 
Page Count: 
Starting Page: 
Price: $10.00

Abstract: Birth literature reveals many perspectives about “good birth,”  and  an investigation into a good birth is necessary because women and children are entitled to the experience that most supports their health as well as their psychological wellbeing and fulfillment. There exists a culture within maternity services of professionals working with apparently conflicting agendas, which may contribute to service user input being excluded. The objective of this study was to understand the viewpoints about “good birth” using a Q methodology approach. Seventeen participants, comprised of mothers, midwives, and obstetricians, completed online Q-sorts. Factor analysis revealed three factors, which were interpreted and named: 1) The quality of the relationship between the  mother  and  her midwife or obstetrician and the importance of a safe outcome, 2) Personal and professional practice balanced with client-centered work and empowerment, and 3) Risk and expectations management as a way of valuing patient experience. Clinical implications for birthing professionals and psychologists are explored in the discussion. Research needs to highlight the variety of understandings of what constitutes a good birth, in order to increase collaborative working in maternity services.


Anderson, T. (2004). The misleading myth of choice: The continuing oppression of women in childbirth. In M. Kirkham (Ed.) Informed choice in maternity care (pp. 257-263). Houndmills, Basingstoke:  Palgrave MacMillan.
Ayers, S., Eagle, A., & Waring, H. (2006). The effects of childbirth related PTSD on women and their relationship: A qualititative study. Psychology, Health and Medicine, 11(4), 389-98.
Bailham, D., & Joseph, S. (2003). Post-traumatic stress following childbirth: A review of the emerging literature and directions for research and practice. Psychology, Health & Medicine, 8, 159-168.
Beck, C.T., Gable, R.K., Sakala, C., & Declerq, E.R. (2011). Posttraumatic stress disorder in new mothers: Results from a two-stage US national survey. Birth, 38, 216-227.
Braun, V., & Clarke, V. (2006) Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101.
Bria, M., Baaban, A., & Dumitrascu, D.L. (2012). Systematic review of birthour risk factors among European healthcare professionals. Cognition, Brain Behaviour, 16, 423-452.
Brown, S. (1980). Political subjectivity:  Applications of Q-methodology in Political Science.
New Haven, CT:  Yale University Press.
Creedy, D.K., Sochet, I.M., & Horsfall, J. (2000). Childbirth and the development of acute trauma symptoms: Incidence and contributing factors. Birth, 27, 104-111.
Davis, B. M. (2008). How authoritative texts reinforce the medical model of birth. British Journal of Midwifery, 16(4), 212-217.
Davis-Floyd, R. (1992). Birth as an American rite of passage. Berkely: University of California Press.
Department of Health. (1993). Changing Childbirth. London:  HMSO.
Dunphy, B., Dunphy, S., Cantwell, R., & Bourke, S. (2010). Evidence based-practice and affect: The impact of physician attitudes on outcomes associated with clinical reasoning and decision-making. Australian Journal  of  Educational  and Developmental Psychology, 10, 56-64.
Eaton, E. (2013). The relationship between control and birth satisfaction: A literature review. Unpublished Doctoral dissertation. Staffordshire and Keele Universities: Stoke on Trent.
Feldman, P., Cymbalist, R., Vedam, S., & Kotaska, A. (2010). Roundtable discussion: “No one can condemn you to a c-section!” Birth, 37, 245-251.
Francis, R.F. (2013). Independent inquiry into care provided by Mid Staffordshire NHS Foundation Trust, January 2005-March 2009. London:  The House of Commons.
Freeman, L. M., & Griew, K. (2007). Enhancing the midwife-woman relationship through shared decision making and  clinical guidelines. Women and birth: Journal of the Australian College of Midwives, 20, 11-15.
Freedman, T.G. (2002). ‘The doctor knows best’ revisited: Physician perspectives. Psycho- Oncology, 11, 327-335.
Goer, H. (2002). The assault on normal birth: The OB disinformation campaign. Midwifery Today, 63. Retrieved April 29, 2013 from  articles/disinformation.asp
Gould, D. (2000). Normal labour: A concept analysis. Journal of Advanced Nursing, 31(2), 418-427.
Gottval, K., & Waldenström, U. (2002). Does a traumatic birth experience have an impact on future reproduction? British Journal of Obstetrics and Gynaecology, 109, 254-260.
Green, J.M., & Baston, H.A. (2003). Feeling in control during labor: Concepts, correlates and consequences. Birth, 30, 236-247.

Hastie, N., Porch, S., & Brown, L. (1995). Doing it ourselves: Promoting women’s health as feminist action. In G. Griffin (Ed.), Feminist activism in the 1990s. Taylor and Francis: Portsmouth.
Hodnett, E.D. (2002). Pain and women’s satisfaction with the experience of childbirth: A systematic review. American Journal of Obstetrics and Gynaecology, 186, S160-S172.
Hodnett, E.D., & Abel, S.M. (1986). Person-environment interaction as a determinant of labour length variables. Health Care for Women International, 7, 341-356.
Hooks, B. (2000). Feminism is for everybody: Passionate politics. Pluto Press:  London.
Houghton, G., Bedwell, C., Forsey, M., Baker, L.,  &  Lavender,  T.  (2008).  Factors influencing choice in birth place- an exploration of the views of women, their partners and professionals. Evidence Based Midwifery, 6(2), 59-64.
Howarth, A.M., Swain, N.R., & Treharne, G.J. (2012). First-time mothers’ perspectives on relationships with and between midwives and doctors qualitative study of giving birth in New Zealand. Midwifery, 28, 489-494.
Jeffares, S. Dickinson, H., & Hughes, G. (2012). iPOETQ (version 1.1). Retrieved August 13, 2012 from:
Jordan, B. (1997). Authoritative knowledge and its construction. In: R. Davis-Floyd & C.F. Sargent (Eds.), Childbirth and Authoritative Knowledge: Cross Cultural Perspectives. Berkely:  University of California Press.
Klein, M.C., Kaczorowski, J., Hall, W.A., Fraser, W., Liston, R.M, Eftekhary, S. …, & Chamberlaine, A. (2009). The  attitudes  of  Canadian  maternity  care  practitioners towards labour and birth: Many differences but important similarities. Journal of Obstetrics and Gynaecology Canada, 31, 827-840.
Kitzinger, S. (2005). The politics of birth. Elsevier: Edinburgh.
Lavender, T., Walkinshaw, S.A., & Walton, I. (1999). A prospective study of women’s views of factors contributing to a positive birth experience. Midwifery, 15, 40-46.
Leeds, L., & Hargreaves, I. (2008). The psychological consequences of childbirth. Journal of Reproductive and Infant Psychology, 26, 108-122.
Lerman, S. F., Shahar, G., Czarkowski, K. A., Kurshan, N., Magriples, U., Mayes, L.C., & Epperson, C.N. (2007). Predictors of satisfaction with obstetric care in high-risk pregnancy: The importance of patient-provider relationship. Journal of Clinical Psychology in Medical Settings,14, 330-334.
Marvel, M.K., Epstein, R.M., Flowers, K., & Beckman, H.B. (1999). Soliciting the patient’s agenda. Have we improved? Journal of the American Medical Association, 281, 283- 287.
Menezes, M.A., Hodgson, J.M., Sahhar M., & Metcalfe, S.A. (2013). “Taking its toll”: The challenges of working in fetal medicine. Birth, 40, 52-60.
Nursing and Midwifery Council. (2008). The code: Standards of conduct, performance and ethics for nurses and midwives. London:  NMC.
National Collaborating Center for Women and Children’s Health. (2008). Antenatal care: Routine care for the healthy pregnant woman. National Institute for Health and Clinical Excellence. London:  RCOG Press.
Obando, A. E. (2003, January 1). Feeling human rights: a holistic-feminist  perspective. (Human rights: Unfinished  business). The Free Library. (2003). Retrieved April 29, 2013 from: holistic- feminist+perspective.+(Human+rights%3A...-a0105915317
Pittrof, R., Campbell, O.M.R., & Fillipi, V.G.A. (2002). What is quality in maternity care? An international perspective. Acta Obstetrica et Gynecologica Scandinavica, 81, 277.
Pratt,  M.G.,  Rockmann,  K.W.,  &  Kaufmann,  J.B.   (2006).   Constructing   professional identity: The role of work and identity learning cycles in the customization of identity among medical residents. Academy of Management Journal, 49, 235-262.

Reime, B., Klein, M.C., Kelly, A., Duxbury, N., Saxell, L., Liston, R., & Wong, V. (2004). Do maternity care provider groups have different attitudes towards birth? British Journal of Obstetrics and Gynaecology, 111, 1388-1393.
Remer, M. (2008). Satisfaction with birth. International Journal of Childbirth Education, 23, 13-16.
Ryding, E.L., Wijma, B., & Wijma, K. (1997). Posttraumatic stress  reactions  after emergency cesarean section. Acta Obstetrica et Gynecololgica Scandinavica, 76, 856– 861.
Schmolck, P. (2002). PQ Method 2.11. Retrieved, January 25th, 2012 from
Simkin, P. (2006). What makes a good birth and why does it matter? International Journal of Childbirth Education, 21, 4-6.
Sinclair, M. (2007). Campaign for a normal birth. Midwives, 10(11), 524.
Smith, A.C., & Kleinman, S. (1989). Managing Emotions in Medical School: Students’ Contacts with the Living and the Dead. Social Psychology Quarterly, 52, 56-69.
Surtees, R. (2010). “Everybody expects the perfect baby… and perfect labour… and so you have to protect yourself”: Discourses of defence in  midwifery  practice  in Aotearoa/New Zealand. Nursing Inquiry, 17, 81-91.
Thomson, G.M., & Downe, S. (2010). Changing the future to change the past: Women’s experience of a positive birth following a traumatic birth experience. Journal of Reproductive and Infant Psychology, 28, 102-112.
The Inter-Agency Group for Safe Motherhood. (1987). Preventing the tragedy of maternal deaths. Report on the International Safe Motherhood Conference: Nairobi.
Tyler, S.T. (2012). Commissioning maternity services: A resource pack to support clinical commissioning groups. NHS Commissioning Board.
VandeVusse, L. (1999). Decision making between women and their caregivers  during labour ranged from being unilateral to  joint  and  was  associated  with  various emotions. Birth, 26, 43-52.
Walsh, D.J. (2010). Childbirth embodiment: problematic aspects of  current understandings. Sociology of Health and Illness, 32, 486-501.
Watts, S., & Stenner, P. (2012). Doing Q methodological research: Theory, method and interpretation. SAGE:   London.
Wildner, K. (2004). How our beliefs (as birth professionals) shape birth. International Journal of Childbirth Education, 19, 10-11.

JOURNAL OF PRENATAL AND PERINATAL PSYCHOLOGY AND HEALTH publishes research and clinical articles from the cutting edge of the science of prenatal and perinatal psychology and health. The journal, published quarterly since 1986, is dedicated to the in-depth exploration human reproduction and pregnancy and the mental and emotional development of the unborn and newborn child.

Join APPPAH for unlimited access to all journals.