References
Primiparous women's narratives of confidence in the perinatal period

Abstract
Background
Pregnancy and childbirth are described as transitional phases or existential thresholds that childbearing women have to cross.
Aim
To gather insights into the personal experiences of women in pregnancy, labour and the days immediately after birth.
Methods
We conducted a qualitative study in the postpartum ward at Westmead Hospital. We invited 16 primiparous women who had given birth to a single baby to participate in our study. After the participants signed the consent form, we conducted individual, in-depth interviews. We analysed the data using thematic analysis.
Findings
Confidence was an overarching theme that contributed to the women's experiences of pregnancy, labour and the immediate days after birth. The experiences encompassed two main categories: positive experiences that aided in building confidence, and negative experiences that adversely affected women's confidence. The themes relating to positive experiences, including effective interpersonal relationships, knowledge promotion and positive self-concept, made the women feel more confident. The themes relating to negative experiences, including lack of control and feeling unprepared, made the women feel less confident in their mothering capabilities.
Conclusion
Confidence was the overarching theme in this study and knowledge was shown to be the fundamental feature of confidence.
Pregnancy and childbirth are described as transitional phases or existential thresholds that childbearing women have to cross. These events are multifaceted experiences with many dimensions, unique for each woman, and still strongly influenced by their social context (Nilsson et al, 2018). Women's expectations and experiences of pregnancy and birth are both positive and negative in nature, involving feelings of happiness and belief in a good outcome but also worries, anxiety and fears (Dencker et al, 2018).
Many women feel empowered, strong and competent, as they encounter the challenges of labour and birth, and experience a sense of joy and accomplishment (Callister, 2004; Khajehei and Doherty, 2018). Enhanced maternal-child attachment has also been shown to be associated with a positive pregnancy and childbirth experience (Mutlu et al, 2015). In contrast, other women report negative birth experiences that can be disempowering and have adverse effects on a woman's self-esteem, confidence, self-efficacy and mental health (Khajehei and Doherty, 2017). These women describe themselves as failures and express feelings of anger, frustration, guilt, loss of control, incompetence and inadequacy (Hildingsson, 2015). Negative or traumatic perinatal experiences can also lead to subsequent fear of pregnancy and childbirth, untoward outcomes in their future pregnancies (Ryding et al, 2015) and an increase in the likelihood of not having another baby (Shorey et al, 2018).
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