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Empowerment or discouragement: women's experience of caring and uncaring encounters during childbirth.

The objective of this study was to explore the essential structure of caring and uncaring encounters with nurse-midwives and other health professionals during labor and delivery as perceived by women who have given birth. The phenomenological perspective of qualitative research theory guided the methodological approach to the study, in which true dialogues were entered into with 10 mothers in Akureyri and Reykjavik, Iceland. The overriding theme of the women's experience of caring and uncaring was "empowerment or discouragement." Within that theme, four major categories were identified: (a) the nurse-midwife perceived as caring--an indispensable companion on the journey through labor and delivery; (b) the woman's perception of the effects of the encounter with the caring nurse-midwife--the sense of being empowered; (c) the nurse-midwife perceived as uncaring--an unfortunate hindrance to a successful birth experience; (d) the woman's perception of the effects of the encounter with the uncaring nurse-midwife--the sense of being discouraged. Findings indicate that the nurse-midwife who satisfies a woman's need for professional caring during the birth experience is likely to be more effective in meeting nursing and midwifery care goals than the nurse-midwife who does not and is perceived as uncaring.