College students' knowledge and attitudes about cesarean birth

Factors Associated with Vaginal/Cesarean Birth Attitudes among Medical Students

Background: Polish perinatal care is facing a high, ever-increasing cesarean section (CS) rate that is currently at 43%. Crucially, reports have revealed that the attitudes, experiences, and skills of clinicians directly contribute to this elevated CS rate. Methods: This cross-sectional study, which included 748 Polish medical students, aimed to identify medical students’ attitudes regarding birth methods. A descriptive questionnaire was distributed via the academic email addresses of surveyed medical students. Group comparisons were performed using Welch’s t-test for continuous data or a Chi-squared test for categorical data. We also used the Mann–Whitney U test and Kruskal–Wallis H test. Results: Midwifery students (96.2%) were the most unified group of students, with most agreeing that VB (vaginal birth) presents a safer option for women at low risk for VB-related complications vs. cesarean section. Of Medical Faculty students, 68% believed that fewer complications typically occur during vaginal birth than during CS. Students in their final vs. initial years of study furthermore considered VB more beneficial for women than CS. Conclusions: An important factor identified at the individual clinician level is the presence of leadership and executive support. For medical students, we can interpret this as support from their trainers and supervisors.

The development and the psychometric evaluation of the Adolescents Intentions towards the Birth Options Scale in Greek

INTRODUCTION

Worldwide, the rising of caesarean section rates is a major public health issue. Little is known regarding birth attitudes held by students who are the next generation of parents. The aim of this study was to develop and assess the psychometric properties of the Adolescents Intentions towards Birth Options Scale (AIBOS), a self-report and short instrument assessing intentions towards birth options in young adolescents.

METHODS

The AIBOS was framed by Ajzen's theory of planned behavior and developed in a three-phase process using an integrated mixed-methods approach that included literature reviews, professional focus groups, and a psychometric survey evaluation. The psychometric evaluation was conducted by recruiting a sample of 480 high school students. Content validity, exploratory factor analysis, discriminant and construct validity, test-retest reliability and internal consistency were explored.

RESULTS

The expert panel determined that the content validity was satisfactory. The final 17-item scale consisted of five factors explaining 48.9% of the total variance in the data. Discriminant validity was satisfactory. Cronbach's α coefficient was over 0.7 for each factor, indicating acceptable internal consistency of the questionnaire. There was significant agreement in all subscales as emerged from test-retest.

CONCLUSIONS

The AIBOS demonstrated good content validity, an easily interpretable five-factor structure, acceptable internal consistency, high test-retest reliability, and satisfactory discriminant and construct validity with sample characteristics. It is an easily comprehensible, easily completed tool, which matches the culture of young adolescents.

Students' Attitudes Towards Birth Decisions

Background:Numerous approaches have been examined to reduce unnecessary cesarean sections. Recently, concerns regarding both the psychosocial and behavioral factors that affect birth decisions have been raised. Adolescents perceive conception, pregnancy, and birth as important aspects of sexual health education; however, they exhibit poor knowledge regarding the aforementioned concepts. Aim:To identify data that examine attitudes toward birth choices among adolescents and young adults. To indicate the necessity of educational interventions, among young populations, in order to provide positive attitudes towards birth choices. Materials and methods:We reviewed PubMed, MEDLINE, and Google Scholar for research - and respective reference lists - published between 1997 and 2020. Results:We found a total of 13 papers, all in English, that examined attitudes and beliefs toward birth options in young populations. Conclusion:Regardless of a recorded rise in the rates of cesarean sections, young students who are introduced into a medicalized birth culture report vaginal birth preference in a healthy future pregnancy. Future research must examine all circumstances and factors that influence the discrepant correlation of the aforementioned vaginal birth preference and the high rates of cesarean sections.

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

The 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.

Attitudes and preferences of young women with low and high fear of childbirth

We examined constructions of labor and birth for 461 Canadian women who attended the University of British Columbia (Canada) and participated in an online survey about pregnancy and birth, using a combination of Likert items and open-ended questions. We performed a content analysis of women's open-ended responses about their feelings toward birth and analyzed comments of women with high and low fear of childbirth separately. Students with high fear of birth described childbirth as a frightening and painful ordeal and viewed obstetric interventions as a means to make labor and birth more manageable. Students with low fear constructed birth as a natural event and regarded interventions more critically. Students in both groups supported women's autonomous maternity care decisions. Our findings contribute to care providers' and educators' knowledge about preferences and fears expressed by the next generation of maternity care consumers and potential strategies to reduce their fear of childbirth.

Knowledge of the Birth Process Among Undergraduates: Impact of Screening of a Documentary Featuring Natural Childbirth in Low-Risk Pregnancies

PURPOSE: Little is known about knowledge of birthing practices, among young adults in the United States; specifically, knowledge regarding the impact of these practices on mothers and newborn. Therefore, the purpose was to assess U.S. undergraduates’ knowledge regarding risks of cesarean deliveries (medically indicated or not), before and after viewing a documentary featuring unmedicated vaginal birth in low-risk pregnancy and subsequent expert panel discussion.

STUDY DESIGN: Uncontrolled before/after study.

MAJOR FINDINGS: Of the 225 attendees, 206 completed the pretest (91.5%) and 163 completed the posttest (72.4%). Of the 206 completing the pretest, 152 identified as undergraduates, and 123 (80%) of these 152 completed the posttest. Results indicate exposure to the documentary and expert discussion panel resulted in significant increases in knowledge of risks of cesarean deliveries, regardless of gender. In addition, witnessing or viewing birth in the media was significantly associated, at posttest, with greater increases in knowledge of some risks.

MAIN CONCLUSION: These findings are important in light of the increasing trend in cesarean deliveries in the United States. Educating this population and providing credible information on delivery options should be informed by further research into these domains.

"It's all the rage these days": University students' attitudes toward vaginal and cesarean birth

BACKGROUND

At 30 percent, British Columbia has the highest cesarean section rate in Canada. Little is known about the childbirth views and birthing preferences of college-aged women and men. The objectives of this study were to document (a) the prevalence of cesarean versus vaginal delivery as the preferred mode of delivery among nonpregnant university students without a history of childbirth, (b) the reasons for reported childbirth preferences, and (c) confidence in vaginal birth as a predictor of childbirth preference.

METHODS

A cohort of 3,680 male and female university students without a history of childbirth participated in an online survey of childbirth preferences. The study used a mixed methods approach (quantitative thematic analysis and logistic regression modeling). Prevalence of, and reasons for, preferred mode of delivery were analyzed separately for male and female respondents.

RESULTS

Most men and women responded that they preferred vaginal delivery, with 9 percent stating a preference for cesarean delivery. Reasons for preferred mode of delivery were similar for men and women. For women, confidence in vaginal birth emerged as a significant predictor of childbirth preference.

CONCLUSIONS

Results indicate that a preference for cesarean section is linked to fear of childbirth and driven by low confidence in vaginal birth. Educational strategies targeting university-aged men and women may be helpful in alleviating fears of vaginal birth and providing evidence-based information about different birth options.

Study of subjectivity in the perception of cesarean birth

This study defined the structural patterns of subjectivity in the perception of cesarean birth. Q methodology was used on 71 statements collected through interviews with seven persons and a literature review followed. Twenty-nine Q samples were selected and administered to 22 persons, and four types of subjectivity were revealed by the QUANL PC Program. Type 1, or the 'naturalist', is characterized by a passive tendency and dislikes artificial methods, feeling that they are performed for hospital income and the trend for social preference. Type 2, 'logical thinker', thinks that cesarean birth should be selected if there are obstetric complications and severe anxiety about labor, even though it results in low intimacy with the baby. Type 3, 'maternal instinctivism', values the maternal-baby relationship and the sense of accomplishment from childbirth. Type 4, 'egocentric', thinks that cesarean section should be chosen when the woman has severe anxiety about labor or when the obstetric condition becomes dangerous. Before commencement of the patient's labor pains, the nurses and medical personnel who are participating in the delivery should assess the structural pattern on parturient woman's subjectivity in the perception of cesarean section. As a further step, they should encourage the woman and her family to participate in the decision-making process for considering the type of delivery the mother wants.

Psychosocial outcomes of vaginal and cesarean births in Taiwanese primiparas

The purpose of this study was to examine differences in psychosocial outcomes between primiparas experiencing vaginal deliveries and primiparas experiencing cesarean deliveries. One hundred and ninety-four vaginal delivery primiparas and 81 cesarean delivery primiparas from the Kaohsiung city area in Taiwan were recruited at 6 weeks postpartum to participate in this study. Using two-sample t tests, we found no significant differences in perceived stress, self-esteem, or depression between vaginal and cesarean delivery primiparas. However, the cesarean delivery primiparas showed a significantly higher level of perceived social support than vaginal delivery primiparas. Types of cesarean (planned vs. unplanned) and types of anesthesia (general vs. epidural) were not significant factors influencing psychosocial outcomes for cesarean delivery primiparas. The lack of substantial differences between the groups may be a result of the normalizing effect of the high cesarean birthrate and greater social support given to this method of childbirth. Cultural concerns of offspring gender and choosing an auspicious time for delivery may also have ameliorative effects on the occurrence of psychosocial difficulties with a cesarean delivery in Taiwan.

Attitudes and beliefs about childbirth among college students: results of an educational intervention

BACKGROUND

Research on knowledge of childbirth has focused primarily on expectant mothers. The purpose of this study was to investigate college student beliefs, knowledge of, and interest in learning more about childbirth.

METHODS

Qualitative research methods were used to analyze college students' written responses to a childbirth video as the first stage in a research project aimed at understanding nulliparous and prepaternity knowledge of childbirth among adolescents and young adults. Participants were 65 students at a liberal arts college in upstate New York.

RESULTS

The findings demonstrated a range of levels of awareness, interest, and knowledge. In their responses, students described childbirth as a miraculous event associated with fear of pain; students primarily knew that childbirth takes place in the hospital, where "safe and effective" pain medication is administered; students liked seeing the experiential aspect of birth; and students wanted to know about the risks and benefits of various hospital procedures, and the "spiritual" emotional aspects of giving birth.

CONCLUSION

The findings contribute insights into how college students think about pain in childbirth, suggesting that their fear is associated with a lack of knowledge. Teaching high school students specifics about pregnancy and childbirth practices and procedures holds promise for reducing anxiety, increasing maternal control, and supporting positive birth experiences.