Women's experiences of the transition phase of physiological labour during freebirth: A qualitative study.

Women who give birth without any medical or midwifery assistance—a practice called freebirth—experience a highly individualised 'peak intensity' during the transition phase of labour, which is not well captured in standard midwifery teaching. In-depth interviews with ten Australian women who had unassisted physiological births revealed three overarching themes: an 'inner world' of intense somatic sensations, an 'outer world' shaped by perceptions of others and feelings of safety, and an 'other world' involving liminal space and a sense of oneness. These findings affirm that the transition phase is a nuanced, personal experience and suggest that current midwifery discourse may not adequately reflect or support women's actual experiences during this critical phase of labour.

Study at a glance

Abstract

There is a poverty of knowledge relating to the transition phase of labour and undisturbed childbirth physiology. This study explored women's experiences of the transition phase of physiological labour during freebirth. Transition within physiological labour is described as a phase occurring as a woman ends the first stage of labour. The woman may display a range of signs and symptoms, including shaking, thirst, nausea, difficulty in communication, irritation, loss of control and inability to cope. The study aimed to explore women's experiences of the transition phase of physiological labour during an intended, unassisted labour and birth, known as freebirth. A qualitative study design, using narrative inquiry was undertaken. Individual in-depth interviews were conducted with women who had experienced physiological births in Australia without the presence of registered health practitioners, doulas or childbirth attendants (n = 10). Reflexive thematic analysis was undertaken to identify themes and patterns. Women experienced a physiological 'peak intensity' of labour that was individualised and nuanced. Three over-arching themes, inner world, outer world and other world, were conceptualised from data analysis. The inner world focussed on the somatic experience of labour. The outer world centred on the women's perceptions of others and feelings of safety. The other world explored experiences of liminal space and oneness. Findings support earlier studies regarding how women experience physiological processes and affirm that women experience the peak intensity of labour in individualised ways which are not reflected or supported in the common midwifery discourse. This study provides evidence about women's experiences of physiological labour and insight into their dynamic inner, outer and other worlds. Further research is recommended into the freebirth experience in Australia from the perspective of childbirth physiology, and how the context of the birth setting, and midwifery practice may influence physiology and experience. It is also recommended that emergent knowledge on the altered states of consciousness and the sexual nature of birth be explored.