Understanding What Women Want During Childbirth
Jul 19, 2018 Cedars-Sinai Staff
Having a baby is the #1 reason people are admitted to the hospital.
Understanding the different needs of each of the 3.9 million moms giving birth in US hospitals each year is a daunting task, and Cedars-Sinai researchers are taking it on.
Dr. Kimberly D. Gregory, a maternal-fetal medicine specialist, is leading the charge. She and her team have already completed a national survey and live focus groups with women.
Their next step is to survey women at 9 hospitals in Southern California to determine if women's needs vary based on the type of facility they choose when they give birth.
"Our ultimate goal is to give hospitals solid recommendations on how they can identify what women want when they're having babies and work with them to meet their wishes," Dr. Gregory says.
Despite childbirth being the most common reason for hospital admission, little work has been done to find out what women want when delivering their babies.
What they've learned so far:
Women have different needs around breastfeeding
Some moms are breastfeeding pros, having done it before. Others have done their research and decided that breastfeeding won't work for them. Some women are looking to their care team in the hospital to help them navigate the pros and cons.
Knowing these preferences matters. For example, a woman who cannot or doesn't want to breastfeed may interpret visits from a lactation specialist as unwanted pressure.
"Breastfeeding is personal," says Samia Saeb, a clinical research coordinator on the study. "Some women want to, some don't. Others really want to, but for whatever reason, can't make it happen. They can have all sorts of negative emotions around that. It's helpful to note a woman's breastfeeding wishes in her chart. That way, it's addressed."
Not all women want to leave the hospital right away
Some women want to go home right away. Other women value the extra time and support from nurses and lactation specialists that a longer hospital stay allows. First-time moms especially may want the expert help while they gain confidence taking care of their new babies.
Women have different needs around managing their pain
Some women, especially those who haven't given birth before, may not know their pain threshold. Some of them want the option of knowing how well they handle their contractions before deciding on an epidural.
Epidural anesthesia is the most common method of pain relief during labor. It blocks pain to the lower part of the body, and is delivered through a thin tube inserted just outside the membrane surrounding the spinal cord.
"Childbirth educators feel that instead of the pain ratings we use when someone has had an injury or a surgery, we should be asking, 'How well are you coping with your pain?'" Dr. Gregory says. "That's a different frame of reference."
Women need room to move
Some of the changes are easily implemented, like giving women the option to move around or change positions during labor. A birthing stool or birthing ball is portable and easily storable and it gives women the chance to find a position that's more comfortable.
Having a childbirth plan can help
Many women have a birth plan, and hospitals often provide them, like the Choices in Childbirth [PDF] form Cedars-Sinai uses. These can act as a guide to get you thinking about what you want from your birth experience, so you're prepared to communicate clearly with your care team.
At the same time, prioritize what is most important to you and be flexible. "Be careful," Dr. Gregory says. "Having too many preferences on your list can set you up for disappointment."
Clear communication and a carefully considered plan are a good start. Dr. Gregory and her colleagues hope that, in time, they will help hospitals build smart procedures that tailor the childbirth experience to the needs of each woman.
DISCLOSURE: Co-investigators Lisa M. Korst and Moshe Fridman own 50% of Maternal Metrics which has filed a preliminary patent application for analytics being used in the study. They could receive future royalty income from intellectual property related to this research. Principal Investigator, Kimberly Gregory, MD, has no financial conflict of interest.