PhD Graduates – Fries

Kathleen Simone Fries, PhD
Spring 2007

“African American Women and the Experience of Unplanned Cesarean Delivery: A Phenomenological Study”

The aim of this research was to describe the experience of unplanned cesarean childbirth from the perspective of the African American woman. More than one in four women will experience cesarean birth and approximately half of this group will undergo cesarean delivery that is unplanned. In addition, the incidence for cesarean deliveries in African American women remains consistently higher than rates for all races combined. The increased incidence for cesarean delivery combined with research findings that focus primarily on Caucasian women provided validation for phenomenological research on the topic. The purposive sample for this study included seven African American women who experienced an unplanned cesarean delivery within the past year. Participants who were English speaking, between 19 and 33 years of age and delivered healthy full-term infants were asked to respond to the following interview question, “Please share your thoughts and feelings surrounding your experience of undergoing an unplanned cesarean delivery”. The interviews were audio taped, transcribed, and reviewed for accuracy. Data were analyzed using Colaizzi’s descriptive, phenomenological method where significant statements were extracted and formulated meanings were written for each statement. The formulated meanings were clustered into the following six themes: getting ready for childbirth, encountering difficulties in labor, loss of control, details of their surgical childbirth, initial reactions post-delivery, and reflections on the overall childbirth experience. The metaphor of complicated airline travel emerged from the descriptions provided by the participants. An exhaustive description of preparing for childbirth and then encountering labor difficulties that resulted in unplanned cesarean childbirth was reviewed by several of the participants to confirm that the findings represented their experience. The research findings will be used to inform nursing professionals and will guide the development of anticipatory guidance for expectant women with a greater focus on the possibility of cesarean delivery overall, and on unplanned cesarean delivery in particular. Research implications included the use of other qualitative and quantitative methods to further evaluate the impact of anticipatory guidance on women’s perceptions of unplanned cesarean childbirth, while also utilizing translation research to promote changes in obstetrical practice with an overall focus being a reduction in cesarean childbirth for all races, and a focused commitment to equalizing the incidence of cesarean delivery for African American women as a racial subgroup.