Navigating the depths of primiparous’s birth perceptions: understanding vaginal birth through metaphors

Vaginal birth is a unique and transformative experience for women, encompassing both physical and emotional dimensions. Understanding how primiparous perceive this process is essential for improving childbirth education and maternal health outcomes. The aim of this study is to reveal the basic feelings, expectations, and cognitive representations of women about birth by examining their metaphorical perceptions of vaginal birth. This qualitative study adopted a phenomenological approach. Data were collected online from 68 primiparous between July 2019 and March 2020 using a structured questionnaire consisting of ten questions. Participants were asked to complete the sentence “Vaginal birth is like … because …” to express their metaphorical perceptions. Eleven participants who did not provide metaphors were excluded, and analysis was completed with 57 responses. Data were analyzed using content analysis, and inter-rater reliability was established. Participants produced 57 metaphors, which were grouped into seven subcategories: Miraculous/sacred event, renewal/innovation, mixed feelings, situation to overcome, pain/discomfort, waiting/reunion, and other. Vaginal birth was most frequently described as a “miraculous/sacred event” (26.3%), followed by “mixed feelings” and “waiting/reunion” (15.8%). Women who received prenatal care and those at more advanced gestational weeks expressed more positive perceptions (p < 0.05). Primiparous women largely perceive vaginal birth as a positive and meaningful experience symbolizing renewal and sacredness. Health professionals, particularly midwives and nurses, play a crucial role in reinforcing these positive perceptions through education and emotional support during prenatal care.