The Impact of Prebirth Education on Childbirth Decision Making

Bessie Mae McCants, Walden University


Medically unnecessary Cesarean (C-section) delivery rates have increased 34% over the past 10 years in Michigan, a rate that far exceeds The World Health Organization's (WHO) recommendations. There is little research to explain why women are requesting C-sections when medically unnecessary. One concern is that women may not be receiving enough information about the risks and benefits of different birthing options. The purpose of this study was to understand the attitudes and preferences of women toward childbirth decision making after reading a prebirth educational brochure. In-depth telephone interviews were used to audio-record the narratives of 16 women between the ages of 19 to 50 who lived in the Detroit Michigan area, including 8 who had and 8 who had not experienced childbirth. A phenomenological inquiry was used to gain insight into the meaning ascribed to women's preferences and attitudes toward C-sections and natural childbirth before and after reading a prebirth educational brochure. Interviews, observation, reflective journaling, and thematic content analysis were incorporated with the participants. Data were analyzed using Moustakas' method of content analysis resulting from seeking invariant material, reduction, unitizing, and clustering based on textural or structural description, generating 3 main themes of attitude formation, childbirth decision making, and prebirth education. Results indicated that preferences and attitudes toward decisions about childbirth changed after reading prebirth information. These findings suggest that informing women of the risks and benefits of C-sections and natural childbirth may improve childbirth health care and increase women's understanding about the childbirth experience.