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

Borrelli, Sara E.; Walsh, Denis; Spiby, Helen


Denis Walsh


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.


Borrelli, S. E., Walsh, D., & Spiby, H. (2018). First-time mothers’ expectations of the unknown territory of childbirth: uncertainties, coping strategies and ‘going with the flow’. Midwifery, 63, 39-45.

Journal Article Type Article
Acceptance Date Apr 27, 2018
Online Publication Date May 7, 2018
Publication Date 2018-08
Deposit Date May 8, 2018
Publicly Available Date May 8, 2019
Journal Midwifery
Print ISSN 0266-6138
Electronic ISSN 1532-3099
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 63
Pages 39-45
Keywords childbirth; labour; birth; pregnancy; coping strategies; birth plan
Public URL
Publisher URL
Copyright Statement Copyright information regarding this work can be found at the following address:
Additional Information This article is maintained by: Elsevier; Article Title: First-time mothers’ expectations of the unknown territory of childbirth: Uncertainties, coping strategies and ‘going with the flow’; Journal Title: Midwifery; CrossRef DOI link to publisher maintained version:; Content Type: article; Copyright: © 2018 Elsevier Ltd. All rights reserved.