The proposed study has been designed to (1) describe and compare the effects of two types of antenatal childbirth preparation classes on maternal postpartal reactions to unplanned cesarean delivery and vaginal delivery, (2) determine the effects of type of anesthesia, presence of a supportive person at delivery, and maternal fear/anxiety about cesarean birth on the relationship between type of antenatal childbirth preparation classes and maternal postpartal reactions to unplanned cesarean delivery, (3) describe and compare maternal postpartal reactions for women who have unplanned cesarean deliveries, those who have planned cesarean deliveries, and those who have vaginal deliveries, and (4) determine the credibility of Roy's (1984) Adaption Model of Nursing and its utility for research investigating the effects of information on adaptation to cesarean birth. Maternal postpartal reactions to be investigated include pain intensity, physical distress, self-esteem, functional ability, feelings about the baby, changes in the quality of the marital relationship, and perception of the birth experience. One type of antenatal childbirth preparation classes, the experimental treatment, will present comprehensive cesarean birth information, including a pamphlet of procedural, sensory, and coping strategies information and focused discussion about cesarean birth, that is an integral part of the classes. The second type of antenatal preparation for childbirth classes, the control treatment, will be traditional childbirth preparation classes that presents limited information about cesarean birth. The experimental and control treatment groups will each have 50 subjects. Additional subjects include 100 women who attend either the experimental or control treatment childbirth preparation classes and have vaginal deliveries, and 100 women who have planned cesarean deliveries. It is hypothesized that the experimental treatment group will experience more positive reactions, including less intense pain, less distress, greater self-esteem, greater functional ability, more positive feelings about the baby, less negative change in the quality of the marital relationship and more positive perceptions of the birth experience than the control treatment group. It is also hypothesized that the control treatment group will have more negative postpartal reactions than the experimental treatment group, a group who have planned cesarean deliveries, and a group who have vaginal deliveries. Data will be analyzed using multivariate analysis of variance and covariance procedures.
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