- Melbourne Graduate School of Education - Theses
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ItemChildbirth and childbirth education: a study of critical factors in psychological adaptation among primigravidaeAstbury, Jill Anne ( 1978)Factors which facilitate or retard psychological adaptation in the stressful period of childbearing have been the focus of a continuing theoretical controversy, begun by Grantly Dick-Read (1944) and Helene Deutsch (1945). Their disagreement centred on the effectiveness of ante-natal education in reducing maternal anxiety through the provision of information about the reproductive process, as well as the advisability of attempting to reduce anxiety. For Dick-Read and subsequent childbirth educators, anxiety in pregnancy was predictive of physical and psychological maladjustment. Consequently, the elimination of anxiety and the production of self-esteem have been fundamental aims for ante-natal education programs. Deutsch argued that Dick-Read had ignored important primal anxieties which neither could nor should be removed through ante-natal education, because of the crucial role they played in preparing women for the stresses of labour. The theoretical disagreement between these two writers provided a context within which subsequent empirical research findings were evaluated, and informed the experimental hypotheses of the present study. Ninety primigravidae, of whom 45 attended ante-natal education classes and 45 did not, took part in the investigation carried out between May 1976 and May 1977. Subjects were tested late in pregnancy, during labour and early in the post partum, on a variety of questionnaire measures concerning attitudes towards various aspects of reproduction, state and trait anxiety, and attitudes towards self and significant others. Subjects were also interviewed individually about their labour experience in the early post partum. During labour, subjects were randomly assigned to a no treatment group, a group which listened to popular music, and one which listened to a tape giving information on coping with labour. Only state anxiety level was ascertained during labour. Contrary to prediction, women who had attended ante-natal education classes did not have significantly lower levels of state or trait anxiety on any of the testing occasions than did untrained women. Similarly, there was no significant difference in state anxiety depending on an interaction between group membership and treatment level during labour. There were no significant differences favouring trained women over untrained women on any of the obstetrical indices of labour. Of the significant results which were obtained, most favoured untrained women. Thus, in the post partum, untrained women perceived greater congruence between current self-concepts and those relating to 'doctors', 'pleasant and good things', 'nurses', 'childbirth' and 'the ideal mother', contrary to prediction. There were also highly significant changes in state and trait anxiety over the testing occasions regardless of group membership. It was concluded that the significant changes in state and trait anxiety supported the notion of childbearing as a crisis which ante-natal education did little to ameliorate. The possibility that anxiety played a useful role in preparing women for labour was considered. Ways of improving antenatal education, based on the findings of the current study and those from the research literature on coping with stress, were discussed.