Childbirth expectations: an Australian study of young childless women

Abstract

Objective: We investigate young childless Australian women’s stated preferences for future delivery mode and birth attendant and explore correlates of, and explanations for, these preferences. Background: In the context of debate about the causes of rising caesarean rates, we explore broad social assumptions about, and attitudes to, childbirth mode by focusing on the stated birthing preferences and attitudes of young childless women. Methods: A total of 334 single, childless, Australian women, aged 18–25, recruited through a university subject pool and via Facebook, responded to an online survey. Measures included their expected preferences for delivery mode (caesarean or vaginal) and for birth attendant (obstetrician or midwife), stated reasons for those preferences, and standard measures of childbirth self-efficacy, childbirth fear, general anxiety and depression, and life satisfaction. Results: Most women expected that they would prefer a vaginal birth and obstetrician-led care. Multiple regression showed preference for caesarean birth to be associated with low childbirth self-efficacy, and preference for an obstetrician with childbirth fear and general anxiety. Women referenced fear of childbirth as a reason for caesarean birth and ‘naturalness’ for vaginal birth; and technical expertise for obstetrician-led care and emotional support as a reason for midwife care. Conclusion: Young childless women already hold attitudes to childbirth, and at least some report high fear and low self-efficacy. These findings amongst women who have not experienced pregnancy or childbirth suggest that social and cultural attitudes play a major role in women’s approach to childbirth.

Keywords:

• Caesarean
• childbirth
• psychosocial factors
• qualitative methods
• quantitative methods