The Subjective Experience of Pregnancy and the Ex-pectations of Childbirth on a Medicalized World: a Qualitative Study

Background: To become a mother represents, for many women, a challenging existential process. Women have to deal with countless changes and adaptations, which can be experienced as sources of imbalance but also as moments of personal enrichment.  Currently, this process is influenced by the medicalization of pregnancy and childbirth, which may have positive or negative consequences to the individual experiences of pregnancy and childbirth. Goals: This study aimed to deepen the understanding of the experience of pregnancy and expectations regarding childbirth in a group of women, in a context where pregnancy and childbirth are increasingly medicalized processes. Methods: In this qualitative study, we used semi-structured interviews to collect data regarding the experience of pregnancy and regarding expectations about childbirth in a sample of women (n = 37), recruited in health care centres or obstetric clinics by research assistants. The individual interviews took place at their homes. Data resulting from these interviews, focusing on the relationship with the health team, the partner and the unborn baby, and on the moment of childbirth, were analysed using ALCESTE software. Two senior researchers, psychologists, conducted the content analysis. Investigator triangulation was achieved through independent content analysis by each researcher and subsequent discussion and consensual interpretation. Results: Thirty-seven pregnant women were interviewed. Four classes emerged from the analysis: "Expectations about childbirth and baby health" , “Significant relational experiences of the past” , "Mother-baby relationship process" and “Health care in pregnancy" . Results emphasize the desire of future mothers to have a quick childbirth, without stress and with minimal suffering and anxiety. Despite these worries, women described a positive subjective experience of pregnancy and a feeling of security related to the knowledge they attribute to health professionals.  Discussion: “Medicalization” seems to be perceived as positive and securing, with no mention to a sense of disempowerment or loss of control. Therefore, the existence of spaces for sharing disturbing experiences and expectations of childbirth is prophylactic, contributing to the creation of conditions that foster positive expectations and mitigate fears related to childbirth.