Too Posh to Push or Too Smart to Cope? A Survey of Women’s Preferences and Beliefs Related to Childbirth Across Generations & Reproductive Life Stages
Abstract Number: F 25
Abstract Type: Original Research
Introduction: Increasing use of medical interventions during childbirth has led to increasing concern over and criticism of women’s choices. This survey explored women’s beliefs/preferences regarding epidural pain relief and preferred delivery mode across generations and reproductive life stages as well as factors contributing to decision-making.
Methods: Following REB approval, 3 groups of women were recruited. Groups were: 1) young adult currently non-pregnant women, ages 18-25, recruited from the University of Toronto campus, 2) adult currently pregnant women receiving antenatal care at a clinic at Sunnybrook Health Sciences Ctr(SBHSC); and,3) older(>50years) non-pregnant women providing non-professional birth support to laboring women at SBHSC. Respondents self-completed a survey consisting of closed and open-ended questions related to demographics, past birth experiences, preferences/beliefs related to epidural analgesia and preferred delivery mode and factors contributing to these choices. Women’s beliefs were examined using responses to fixed statements with 5-point Likert scales (strongly disagree to strongly agree). Analyses included appropriate use of quantitative and qualitative methods.
Results: 281 women participated(Group 1 n=120; Group 2, n=104, Group 3, n=57). Over 70% of each group had or were completing a post-secondary degree. Most (>80%) women in all groups agreed or strongly agreed with the statement, “All women should have the right to an epidural in labor.” If given the choice, 32% of Group 1 (young, non-pregnant), 52% of currently pregnant (Group 2) and 64% of older women would opt for epidural pain relief. More than 70% of Group 3 and 30% of Group 2 respondents had had a previous labor epidural. Most women in each group (51-61%) disagreed or strongly disagreed with the statement, “Women who receive an epidural during childbirth miss out on the natural birthing experience”. The majority of women in Groups 2 (64%) and 3 (71%) also disagreed or strongly disagreed with the statement, “I would be disappointed if I got an epidural,” whereas 37% of young non-pregnant women disagreed and 32% were neutral. Six percent of young group 1, 10% of Group 2 women and 12.5% of older support women reported elective caesarean delivery as their preferred delivery mode. Opinions of most older support women came from their own experiences whereas younger women(both groups 1 and 2) cited friends and family as major influences in decision-making. These outweighed the advice of medical providers for all groups.
Conclusions: Highly educated women, regardless of age and reproductive life stage, value both epidural pain relief during childbirth and a woman's right to choose it. A small but significant number of women also see elective primary cesarean section as a preferred delivery option. These findings suggest a shift in women's perspectives toward use of medical interventions during childbirth that spans generations.