1. Midwifery Postgraduate Seminar How pregnant women in Hong Kong Perceive labour pain Irene Lee 24 November 2011

2. Part of PhD study Aim of PhD study to understand how attitudes towards the embodied experience of labour and childbirth are mediated by external norms and authoritative knowledge. Title of the study: An interpretive hermeneutic study of the meaning of labour pain for Hong Kong Chinese women towards the development of an individualized tool for labor pain support

3. Three phases Systematic review and meta- synthesis Longitudinal qualitative study Quantitative study

4. Qualitative study Explore the meaning of labour pain for HK Chinese women, and their expectations, views and experiences of pain relief in labour Through audio taped and transcribed interviews at 4 different points of time –Third trimester of pregnancy –Postnatal day 3 –6-7 weeks after birth –10-12 months after delivery

5. Qualitative study Phenomenological approach 10 women will be included Plan: 5 primigravida, 5 multigravida Result: 1st interview = 10 + 1 2nd interview = 5 + 5 3 rd interview = 5 + 4 4th interview = pending Range of interview duration : 845 to 1949

6. How pregnant women in HK perceive labour pain – initial findings Findings from 3 primigravida Different feelings on labour pain Sex of baby Carry on the family name Antenatal talk on pain relief methods Use of pain relief during labour Views on husband accompany labour

7. Sex of baby (1) Overall no preference on the sex of baby (2 out of 3) 001: No specific preference on the sex of the baby 002: My husband and I do not have any preference on having a boy or girl. Actually, I think …already… it is very lucky to have a baby and that if the baby do not have any problem we will be very satisfy.

8. Sex of baby (2) 004: It does not matter, boy or girl is OK. However, when question rephrase: Do you like to have a son or a daughter? Answer: I like to have a daughter more than a son.

9. Sex of baby (3) Possible Implication In Chinese culture, it is important to have a son as it carries the family name from one generation to another. It is still the condition in Mainland China Knowing the family / husbands preference towards the sex of the baby may add stress to the woman

10. Sex of baby (4) Possible implication The stress can affect the womans feeling of pain during labour. A surprise to the finding that all of them do not have any preference towards the sex of the baby Even if choose, one of the participant choose a girl which is different from China Such situation may be due to one child policy, and the self selected choice.

11. Carry on the family name (1) Overall, all the 3 participants had not think of it. 001: I have not thought of it. I have not think of such issue. 002: Had not thought about it. No pressure from family. 004: Do not have such idea.

12. Carry on the family name (2) Possible Implication: In a modernized city, the traditional Chinese culture changed gradually. Preference a male baby to carry on the family name seems to be absent.

13. Feelings of labour (1) Overall feelings: affected by what they heard from friends (2 out of 3) 001: I am a bit nervous because I always hear from others that it is very painful, but I think it is just a process, it should be fine after the painful process

14. Feelings of labor (2) 002: I am scared and worried. I think it is the pain. I heard about it from my friends, they had experience in delivery, they had different views on the feeling of pain. I think I had poor tolerance on pain, yes, worried about the pain.

15. Use of pain relief (1) All of them had prepared to face the labour pain 001: I have attended all AN talks, so I already know the pain relief methods (Entonox, pethidine, and epidural) 001: …this is our plan, we hope (emphasis) that we do not need to use pain relief methods beyond pethidine.

16. Use of pain relief (2) 002: I have read many books. I am thinking whether I should use epidural.. But I had heard many negative things, the negative (adverse) effect on epidural

17. Use of pain relief (3) 004: I had attended AN talk before, actually I know there are several pain relief methods. But of course, I prefer to choose method which can release all the pain, but I know it is impossible. I think I will use the methods introduced in the AN talk, e.g. Entonox, pethidine.

18. Preferred support– Husband accompany labour (1) All the 3 participants indicated that they would like to have their husband accompany labour

19. Preferred support– Husband accompany labour (2) 001: I think if my husband accompanies me, he can help me and encourage me. I think this is very important. I think he should give his wife more encouragement and support.

20. Preferred support– Husband accompany labour (3) 002: At least I think he (my husband) can give me psychological support… I think this process should go through together, that is not just … one person to strive hard to go through the process. Well, he stay with me by my side and cheer me up, I think, he actually cannot help me much towards my physical condition, but, I think well, just psychological comfort.

21. Preferred support– Husband accompany labour (4) 004 Mostly like is my husband. It is very good that he is there staying with me by me side. Actually there is nothing he can do.

22. Preferred support– Husband accompany labour (5) Possible implication The women think that the husband had nothing to do during their labour, however, the physical existence of the husband during labour had already providing psychological support to the women.

23. Difficulties (1) Interview skill – need probing technique The participants do not have much to say about their feelings. The duration of interview ranges from 845 to 1949. It is likely a cultural issue. Questions may need to be repeated or rephrased again

24. Difficulties (2) Since the interviews are conducted in Cantonese, it need to be translated into English The work for the transcribe and translation done by non-professionals Need to review the transcribe copies for checking as the meaning may be different from the translated words

25. Thank you!