Reproducing fear: the effect of birth stories on nulligravid women’s birth preferences

Objective Preference for caesarean birth is associated with higher fear and lower self-efficacy for vaginal birth. Vicarious experience is a strong factor influencing self-efficacy in nulligravid women, and is increasingly accessible via digital and general media. This study assessed the effect of exposure to different birth stories on nulligravid women’s childbirth preferences and the factors mediating these effects. Methods Nulligravid women (N = 426) were randomly allocated to one of four conditions exposing them to written birth stories. Stories varied by type of birth (vaginal/caesarean) and storyteller evaluation (positive/negative) in a 2 × 2 design. Childbirth preference, fear of labour and vaginal birth, and self-efficacy for vaginal birth were measured before and after exposure via a two-way between groups analysis of covariance. Hierarchical regression models were used to determine the mediating effects of change in childbirth fear and childbirth self-efficacy. Results Variations in type of birth and storyteller evaluation significantly influenced childbirth preferences (F (1, 421) = 44.78, p < 0.001). The effect of vaginal birth stories on preference was significantly mediated by fear of labour and vaginal birth and self-efficacy. Effects of exposure to caesarean birth stories were not explained by changes in fear or self-efficacy. Conclusions Childbirth preferences in nulligravid women can be significantly influenced by vicarious experiences. For stories about vaginal birth, the influence of birth stories on women’s fear and self-efficacy expectancy are partly responsible for this influence. The findings highlight the importance of monitoring bias in vicarious experiences, and may inform novel strategies to promote healthy childbirth.

A PHENOMENOLOGICAL ANALYSIS OF RURAL WOMEN'S CHILDBIRTH PREFERENCES

Women’s agency and reproductive control have direct bearing on the outcome of their pregnancy as well as their future childbearing experiences. The present study is mainly concerned with the process of knowledge construction with regards to decision-making, in the context of childbirth planning. The study drew on cultural discourses to understand the societal and familial context which reinforces traditional home birthing. The study used anthropological approach and mainly relied on in-depth and narrative interviews that were conducted with 60 married women of childbearing age who went through the process of childbirth. Phenomenological ethnography is the methodology that used in-depth face to face interviews to collect narratives of experiential knowledge of the pregnancies and agency. Field findings indicate that significant determinants for these childbearing women included the desire for a natural childbirth experience, apprehensions regarding obstetric interventions by medical doctors, provision of emotional support, comfort and assistance provided by female relatives and traditional birth attendants and also the influence of their husbands who prefer their partners giving birth at home. In addition, another prominent finding of this study is the role of authoritative knowledge and shared experiences of older women that may deprive many young women from accessing maternal care survives at hospitals. The study concludes to enable rural women to make well informed decisions about their babies and bodies to improve the utilization of reproductive health care services in Pakistan.

A PHENOMENOLOGICAL ANALYSIS OF RURAL WOMEN'S CHILDBIRTH PREFERENCES

Women’s agency and reproductive control have direct bearing on the outcome of their pregnancy as well as their future childbearing experiences. The present study is mainly concerned with the process of knowledge construction with regards to decision-making, in the context of childbirth planning. The study drew on cultural discourses to understand the societal and familial context which reinforces traditional home birthing. The study used anthropological approach and mainly relied on in-depth and narrative interviews that were conducted with 60 married women of childbearing age who went through the process of childbirth. Phenomenological ethnography is the methodology that used in-depth face to face interviews to collect narratives of experiential knowledge of the pregnancies and agency. Field findings indicate that significant determinants for these childbearing women included the desire for a natural childbirth experience, apprehensions regarding obstetric interventions by medical doctors, provision of emotional support, comfort and assistance provided by female relatives and traditional birth attendants and also the influence of their husbands who prefer their partners giving birth at home. In addition, another prominent finding of this study is the role of authoritative knowledge and shared experiences of older women that may deprive many young women from accessing maternal care survives at hospitals. The study concludes to enable rural women to make well informed decisions about their babies and bodies to improve the utilization of reproductive health care services in Pakistan.

Privilege in the Delivery Room? Race, Class, and the Realization of Natural Birth Preferences, 2002–2013

We expand prior research on the sociology of birth by testing race and class effects on women’s capacity to realize their childbirth preferences in hospital settings. Drawing on data from the U.S. Listening to Mothers survey, we use Poisson regression and logistic regression to examine the extent to which women’s preferences are associated with actual experiences of medical intervention during perinatal care. We find that 1) less privileged women were significantly less likely to have certain interventions and had fewer interventions overall; but 2) less privileged women with natural birth preferences were significantly more likely to have certain medical interventions, compared to their race/class privileged counterparts. Thus, less privileged women simultaneously receive less and more childbirth interventions—both of which appear to be out of sync with their birthing preferences. Our results support previous research which has found race and social class inequities in medical treatment, which we interpret here as “privilege in the delivery room.”

Childbirth Education Prior to Pregnancy? Survey Findings of Childbirth Preferences and Attitudes Among Young Women

ABSTRACTThe childbirth preferences and attitudes of young women prior to pregnancy (N = 758) were explored in a cross-sectional survey. Sources of influential childbirth information and self-reported childbirth learning needs were described. Young women’s attitudes about childbirth, including the degree of confidence in coping with a vaginal birth, whether birth is considered a natural event, and expectations of labor pain were associated with their mode of birth preference. Conversations with friends and family were the most influential source of childbirth information. Gaps in knowledge about pregnancy and birth were identified. An improved understanding of women’s preferences and attitudinal profiles can inform the structure and content of educational strategies that aim to help the next generation of maternity care consumers participate in informed decision making.