First-time mothers’ expectations of the unknown territory of childbirth: uncertainties, coping strategies and ‘going with the flow’

Objective. To explore first-time mothers’ expectations of labour and birth, coping strategies they adopt during pregnancy towards childbirth and coping strategies they expect to use during labour and birth.Design. A qualitative Straussian grounded theory methodology was adopted, with data collected through semi-structured interviews in the third trimester of pregnancy. Ethical approval was gained. Data analysis included the processes of coding and conceptualising data, with constant comparison between data, literature and memos. Setting. Three National Health Service (NHS) Trusts in England offering the choice of various birth settings including home, Freestanding Midwifery Unit (FMU) and Obstetric Unit (OU).Participants. Fourteen first-time pregnant women in good general health with a straightforward pregnancy (single fetus) and anticipating a normal birth.Findings. Three themes were identified in regard to women’s expectations of childbirth and coping strategies: a) the unknown territory of labour and birth; b) waiting for the unknown: coping strategies; c) going with the flow. First-time mothers acknowledged labour and birth was an unknown territory, irrespective of the planned place of birth. While waiting for the unknown, the women put in place a number of coping strategies during pregnancy: preparing; avoiding; thinking about childbirth as a shared experience among women; relying on maternal instinct; relying on pharmacological pain relief; considering birth partner(s) as voice of reason. Overall, women were flexible in regard to their birth plan and open to change if needed, referring to this open-minded state as ‘going with the flow’.Key conclusions and implications for practice. Women and their families may appreciate receiving accurate and realistic information from caregivers starting in pregnancy and continuing during labour and birth to alleviate the state of uncertainty typical of the childbearing event. The midwife should address the woman’s uncertainties and help her ‘go with the flow’ in the labour continuum. The birth plan should also be revised by the midwife and woman together if they can no longer adhere to the original one