Landmark Childbirth Interventions Survey Shows Mothers Hi-tech, but Happy

Have you ever wondered if other women's experiences during childbirth and the postpartum period were similar to yours? Most likely you have, because the majority of women are fascinated by birth stories, including their own. If things about your birth experience upset or surprised you, if they were different from what you were led to believe might happen during labor and delivery, you've probably wondered why they occurred and what, if anything, could have been done to prevent it.

The national Maternity Center Association recently issued the first comprehensive survey of American women's childbearing experiences, gathering data that had never been collected before at the national level. Called "Listening to Mothers," the landmark survey provides healthcare providers, pregnant and parenting women, and the general public with a more complete understanding of the childbearing experience as it is experienced in America today.

For the study, which was conducted by Harris Interactive and the Maternity Center Association, a national not-for-profit health organization dedicated to the needs and interests of childbearing women and their families, nearly 1,600 women, who had given birth within the previous 24 months, were surveyed. The survey, which is one component of MCA's Maternity Wise program to promote evidence-based maternity care, was the first national tally of women's pregnancy, labor, and postpartum experiences, and, as such, has far-reaching implications. "Although more than four million women give birth in the United States every year, this is the first time that women from across the country have systematically described their childbearing experiences," explains Maureen Corry, MCA executive director.

High Labor Intervention Rates

The survey found that technology-intensive labor was the norm, with a majority of women reporting having had the following interventions while giving birth: electronic fetal monitoring (93 percent), intravenous drip (86 percent), epidural analgesia (63 percent), artificial rupture of membranes surrounding the baby (55 percent), bladder catheter for drainage of urine (52 percent), and stitching to repair an episiotomy or tear (52 percent). Almost half of the women reported that their caregiver had tried to induce labor, most commonly through the use of oxytocin. Dr. Eugene Declercq, chair of the National Advisory Council, lead author of the report, and professor of maternal and child health at the Boston University School of Public Health, says: "Given that childbearing women are, for the most part, a well and healthy population, these high rates of intervention are of great concern. Mothers and others responsible for the health and well-being of mothers and babies need to repeatedly ask: 'Is a decision to use a specific intervention supported by the best evidence?'"

The survey did find high levels of satisfaction with care during the labor and birth process, however. Ninety-four percent of the mothers surveyed felt that they understood what was happening, 93 percent felt comfortable asking questions, and 89 percent felt they had an active voice in decision-making.

Almost two-thirds of the women used epidural analgesia, including 59 percent who had a vaginal birth, and the majority rated it as "very effective" in relieving pain. Drug-free methods rated either "very" or "somewhat" helpful included: application of ice or heat (82 percent), hands-on techniques (81 percent), position changes (79 percent), and environmental changes (76 percent). The use of breathing techniques was used by 61 percent of women—with 70 percent finding them somewhat helpful, and the remainder finding them of little or no help. Immersion in a tub was rated "very helpful" by almost half of the women who used it; but both immersion and showering, which was also found helpful, were used by only 8 percent of the women surveyed. Once contractions were well established, 71 percent of women were not permitted to walk around.