Reclaiming power and peace. Protective factors for positive birth: A qualitative exploration.

Birth is often evaluated through clinical outcome measures with less attention given to the lived experience of the birthing person, with feelings around birth given a low priority. Yet, the psychological consequences of traumatic birth are well documented, and growing evidence suggests that positive perceptions of birth have a protective effect on postnatal mental health. Aim: This study asks; what factors influence peoples’ perception of the experience of birth in a positive way? Method: Using Qualitative Descriptive methodology, face-to-face semi-structured interviews were conducted with participants who self-identified as having had a positive birth experience. Reflexive thematic analysis was used to explore and interpret the data. Findings: Four interconnected themes were generated. I don’t love that for me; Owning the journey – power and peace; Preparation is key – event level planning; and The space I create. Participants described consciously rejecting dominant negative birth narratives. By increasing their knowledge of birth and their own bodies they became more active participants in the process, allowing for informed decision-making and genuine consent. This knowledge-building helped to reduce fear and planning for the birth event with physical and mental tools was identified as key to a positive experience. Birth space was expressed as another critical element, encompassing not just the external environment, but more importantly, the internal environment shaped by a network of trusting, respectful relationships with attendants and providers. Discussion: The findings support an argument that consciousness plays a central role in shaping birth experience and resonate with the established theory of altered states known as Set and Setting. When viewed through this lens, elements such as preparation, positive mindset, and the presence of supportive, trusting relationships come together as mutually reinforcing influences. Framing these factors in terms of set (internal state) and setting (external environment) offers a compelling explanation for how a positive birth experience may be cultivated. Key message: There is much we can do to bolster belief in self and belief in birth, both of which positively influence how the experience is perceived, regardless of the type of birth. Considering birth using a Set and Setting framework could change how we approach birth preparation, providing a clear path to navigate towards supporting the perception of birth as positive. This framework offers an additional tool for both consumers and providers to reflect on, and use to challenge current practice realities, fostering environments that centre agency, trust and a deep sense of safety.

Name thesis:degree_name

Master of Midwifery

Level thesis:degree_level

Masters

Grantor

Otago Polytechnic

Year dc:date.issued

2025

Author dc:creator

• Krakosky, Anna

• positive birth experience
• protective factors
• birthing consciousness
• set and setting theory
• self-efficacy
• birth belief
• mindset
• positive thinking

Statement dc:rights

• CC BY-NC-ND Attribution-NonCommercial-NoDerivs 4.0 International

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/10652/7064

OAI identifier oai:identifier

oai:null:10652/7064