Utilisation of childbirth education techniques: how does the concept of ‘differentiation of self’ impact this?

Objective: The utility of childbirth education (CBE) techniques during labour is largely unknown. We considered whether ‘differentiation of self’ (DoS), a Bowen theory concept describing a person's capacity to act according to goals and principles, even when experiencing physiological, emotional, and relational stressors, impacted this. The aim was to explore women's perspectives on the utilisation of non pharmacological CBE strategies that support physiological birth, and whether DoS influences use. Methods: Semi structured interviews with participants of varying levels of reported DoS enrolled in an Australian RCT of a comprehensive CBE program. Results: Thematic analysis identified pressure points during childbirth, to which women responded through promoters of CBE (‘Trust in self’, ‘Enlisting support of others’, ‘I clawed it back’) or preventers (‘Impeding issues derailed me’, ‘Conversations with me were incomplete’, ‘I lost my way’). As pressure points intensified, it became increasingly difficult to utilise techniques. The overarching theme, up to a point, describes the use of CBE and the interaction between level of DoS and stressors faced. Conclusion: Women utilise CBE techniques to differing degrees, which is impacted by support available, and stressors associated with birth culture and practices. This has practise implications for supporting physiological birth. The application of CBE techniques is mediated by pressures women encounter. DoS indicates promotion of CBE strategies up to a point, but with sufficient challenges, continued use becomes increasingly difficult.