Wednesday
Mar252009
Canadian Maternity Experiences Survey: Your Turn
Wednesday, March 25, 2009 
The Public Health Agency of Canada just released the results of the Maternity Experiences Survey, a survey of 6000 Canadian women on their experiences, perceptions, knowledge and practices before conception and during pregnancy, birth and the early months of parenthood.Pregnancy and parenting author Ann Douglas (who is on twitter by the way: anndouglas), has put up the first of what she anticipates will be many posts interpreting and discussing the results:
Oh, Baby! Mining The Maternity Survey Data Motherlode
Take a look at the survey results, give Ann's post a read, and join me in answering the questions that popped into her mind as she read the results:
- How much choice did you have when it came to finding a prenatal care provider? Lots of choice? Or was the choice made for you?
- Where did you go for information when you were pregnant?
- Did you know about the importance of taking folic acid prior to conceiving? Had you heard about the new research about the role folic acid can play in preventing preterm birth (if you take it one year before becoming pregnant)?
- Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options?
I'll put up my answers over the next few days and if you blog about your answers, I'll link to them too (please link your answer back to this post so that I know that you blogged about it). I'd love to see answers from any country, but please indicate which country you are from in your answer so that we know which ones relate directly back to the Canadian experience and which ones are useful for comparative purposes.
Can't wait to see what you all have to say!
Reader Comments (21)
I should also note, if you are not a blogger and you want to answer the questions, you can e-mail your answers to me at phdinparenting at gmail dot com and I can post them here for you.
How much choice did you have when it came to finding a prenatal care provider? Lots of choice? Or was the choice made for you? There were choices, and I made my own. The only thing that wasn't made clear to me was that not all of the Dr.s on that list would do the actual delivery. So I felt I had spent all this time getting to know this Dr. and then it really didn't matter because he wasn't even on call. If I had known this when making my choice I probably would have chosen a Dr. that would show up for the delivery.
Where did you go for information when you were pregnant? I would ask my Dr. or my Ob, I also went online for LOTS of information.
Did you know about the importance of taking folic acid prior to conceiving? Had you heard about the new research about the role folic acid can play in preventing preterm birth (if you take it one year before becoming pregnant)? Yes, I had. I didn't manage to take it for a full year before becoming pregnant (since I got pregnant a month after I HAD to have my IUD removed) But since we knew about 4 or 5 months before it was actually removed I started taking folic acid then. The 2 births previous to this one were both before 35 wks, (no folic acid supplemented with those) with this birth I was very surprised that he stayed in until 38 almost 39 wks.
Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options? I had 2 choices for giving birth. Here in my home town or driving the hour to Halifax. Based on my previous birthing experiences I decided that driving to Halifax wouldn't be the wisest choice. Birthing here in my home town was fine. They initially tried really hard to follow my birthing plan but as the baby became distressed things changed, but most of the birthing plan was still followed. Over all I wouldn't change much. I do wish that the provincial health plan would help cover the cost of midwives or Doula. My husband really tried his best to be my voice but I think having one other person there that could help him and me make decisions and explain things fully to us may have helped even more.
[...] read on Twitter about this Canadian Maternity Experiences survey and then went on over to both PhDinParenting’s blog and Ann Douglas’ blog. And of course I have to [...]
~ I'm here in South Carolina. I felt I had plenty of options on my birthing center. Finding a doula and having a home birth would have been hard in my area but that's not really something I felt comfortable with anyway.
Well when I wanted information when I was pregnant I had tons of options for help. My doctor, my friends, my mom, and of course books and the internet!
I did know about the importance of taking folic acid prior to becoming pregnant. I had been taking a prenatal vitamin for 3 years when I became pregnant. It's actually the only daily vitamin I use. Makes my nails and hair strong even before we were trying to have a baby.
I did feel like where I gave birth at was too impersonal. The nurses were rude and not very understanding. You'd think women that had children of their own would know the emotional roller coaster I was on after the birth of my first child and handled situations differently.
How much choice did you have when it came to finding a prenatal care provider? Lots of choice? Or was the choice made for you?
For my first child, I called the local hospital to find out if there were any OBs taking patients – there were two, and I chose the female over the male. Of course she was not actually on call when I gave birth, so I ended up seeing the male OB anyway, but after recommending a c-section, his shift ended, and I got yet another OB, who said I did not need a c-section after all (which is great in retrospect, but the man’s bedside manner was atrocious, leading me to choose midwifery care the second time around!) Though I was glad I was able to go with midwives for my second baby, it wasn’t like I got to choose who I saw, I had to go with the practice in my area, and the midwives with space (fortunately, I was happy with them, and my primary m/w was actually there for the birth).
Where did you go for information when you were pregnant?
My caregivers, online, and books. Unfortunately, I didn’t consider midwifery with my first child – I learned so much more about pregnancy/birth the second time around, because midwives are all about educating the mother and letting her choose. In my experience, OBs often make decisions and give instructions based on what is convenient for them, not what is best for the mother/baby (hence women labouring and giving birth on their backs and being rushed into c-sections when surprise, surprise, labour stalls!) IMHO OBs should be restricted to high-risk pregnancies/birth, and low-risk cases should be handled by midwives.
Did you know about the importance of taking folic acid prior to conceiving? Had you heard about the new research about the role folic acid can play in preventing preterm birth (if you take it one year before becoming pregnant)?
I did know about it , though not in regards to preventing preterm birth, or that it was supposed to be taken for a year beforehand (though I have heard that all women of childbearing age should be taking it, just in case.) I took it, but probably not for a year prior to getting pregnant the first time.
Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options?
I chose hospital birth both times, even when I used midwives. I am glad I had the option of homebirth but it was not what we decided to do. A birthing centre might have been a nice compromise, but I am fine with the two choices available – I just wish that the nurses in the hospitals I gave birth in had been properly educated about breastfeeding. I got and overheard the worst advice, it’s no wonder breastfeeding rates are so low! I think nurses working in L&D and NICU should be required to be certified lactation consultants before getting anywhere near new mothers.
Hi! Did you mean first birth? My answers vary from my first birth to my second so I'm assuming you mean the first birth, right?
@Alina Either the first one or both (explaining the differences). I'll probably touch on some of the differences between my two when I answer.
Where did you go for information when you were pregnant?
Books, my midwives, online, resources, friends.
Did you know about the importance of taking folic acid prior to conceiving? Had you heard about the new research about the role folic acid can play in preventing preterm birth (if you take it one year before becoming pregnant)?
Yes, I knew about folic acid and had been taking it even before I had planned to become pregnant.
Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options?
I had wonderful and supportive midwives for all three births. I had fabulous choices and was empowered by my midwives to make the best decision for me and my babies. We chose to have them at home, but were happy to have other choices had we needed/wanted them.
In my first birth:
Choice -- I knew I could choose from all the OBs in my network. But I didn't know that midwives were an option to deliver in a hospital. Interestingly, the OB's office I picked has a well-known Chicagoland midwife who practices with the OBs, side-by-side. But upon my first visit, the OB never inquired as to how I might want my prenatal care to go and if I might want to consider prenatal care by their midwife.
Info - this was my first child and I was the among the first of my friends to be pregnant. I went to my only friend who had given birth. She was pretty shy when it came to discussing intimate details. Although she breastfed her son she never once offered to tell me anything about breastfeeding. She also delivered naturally but her advice on the labor was to "take each contraction alone". My husband and I heard about doulas and interviewed a couple but we had no money. None of the doulas were interviewed mentioned that we could have found a free doula (in training). I assumed I would have an epidural since everyone seemed to have one. My main source of info was books: what to expect.. girlfriend's guide... and the free book given by the OB. (Meanwhile I spent all my time researching strollers and highchairs and cribs -- HA!!!)
Folic Acid -- I knew it was necessary once you were pregnant. I assumed women took extra folic acid while they were trying to conceive, just in case they become pregnant. Until this blog post, I didn't know there is any reason to take folic acid prior to trying to conceive.
Place to Give birth -- I thought the only option was the hospital. I didn't know homebirths existed (except in rural areas). I did not know about birthing centers.
My 2nd birth was quite different since I was pursuing a VBAC. After ending up with a traumatic and (possibly) unnecessary c-section, I did my research. I found the KellyMom web site and forums where other likeminded women were glad to advise me on books, tips, thoughts. I joined the ICAN listserv and went to a few meetings where I found out which midwives were supportive of VBACs near our suburb. My husband and I took a hypnobirthing class together. But during all of this prep the 2nd time, I never heard the idea of taking folic acid during the time prior to conception.
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Choice — I am in Nashville, TN USA. We have some options in the area- no stand alone birthing centers that are less than 1-2 hours away. But there is a large midwifery practice that is tied to the big university hospital - Vanderbilt. I was able to make my own choice. However eventhough I planned on having a natural vaginal birth, I ended up with a last minute C-section mainly because I never went into labor 2.5 weeks "late" and because she was frank breach at the last minute.
Info - My mother was a LLL leader so I knew a lot from her about breastfeeding and from LLL meetings. For pregnancy I read a lot of the Sears books, Childbirth without fear, took a hypnobirthing class, the girlfriend book, Active Birth
Folic Acid — I knew about it because we had some nursing students give a presentation at our office and because I crossed paths with a pre-conception project through my work at Planned Parenthood.
Place to Give birth — When I first started this journey I was so terrified of birth I assumed, hospital, doula( who was that?) , possibly planned C-section & drugs. After doing a tremendous amount of reading I wanted a midwife, natural vaginal birth and had a doula (180 degrees from where I started). There are midwives who will deliver at home here. I only wish there was a free-standing birthing center more accessible to me.
[...] These are questions posed on the latest post at PhD in Parenting taken from Ann Douglas’ blog on the results of a recent Maternity survey. [...]
I didn't have much choice in prenatal care in the town that I was living in at the time. It was either the partner of my family doctor or a doctor I'd never met. The family practice doctor wasn't going to work. I didn't feel comfortable with him at all and to be honest he kind of creeped me out. The doctor I'd never met worked out really well. He had a really quirky sense of humour but once I got used to it everything with him went really smoothly. So, the choice wasn't made for me but it was very limited.
I read A LOT when I was pregnant. Books were my resource of choice although the internet was a huge resource. I also attended pre-natal classes and I used the local Health Unit to find classes to attend, like Building Blocks For Better Babies (which I attended as long as I could!).
Despite all of that I'd say that pregnant bloggers and mommy bloggers were where I learned the most. Any question that I ever had was always answered by a ton of people with different perspectives. I still turn to other moms and dads for advice.
Until I told my cousin I was pregnant I had no idea that I should have been taking any kind of vitamin or folic acid. Until I read the information on my prenatal vitamins I had no idea that all women of child-bearing age should be taking a folic acid supplement.
When I did do some research it was easy to find all of the information and the results of new research -- I just hadn't had any idea that I should be looking for it before then.
I made sure to link back to you on my blog!
"Over at Phd in Parenting, they are discussing the results of the Canadian Maternity Experiences Survey. Ann Douglas at The Mother of All Parenting Blogs was looking over the data collected in the survey, and wondered how much of the responses were influenced by the birthing climate in various communities."
[...] I posted about the Canadian Maternity Experiences Survey and asked you to answer a few questions about your birth experience, either on your blog, in the [...]
I'm in Ontario, Canada.
* How much choice did you have when it came to finding a prenatal care provider? Lots of choice? Or was the choice made for you?
I had the choice of an OB or a registered midwife. My doctor scared us into having an OB. My experience was actually great - my OB was a woman about my age, and supportive of going into labour naturally (wasn't a fan of S&S even), and natural childbirth. Unfortunately she wasn't "on" the day that I gave birth, but her support prenatally, combine with two awesome L&D nurses, gave me the confidence to give birth naturally. She came to visit me the next day and gushed about how "nature is amazing." For future pregnancies, I plan to have a midwife, but if I couldn't get one, I'd happily go back to this OB.
* Where did you go for information when you were pregnant?
Everywhere! Books (Sears Baby Book was my bible), breastfeeding books, prenatal classes, internet sites.
* Did you know about the importance of taking folic acid prior to conceiving? Had you heard about the new research about the role folic acid can play in preventing preterm birth (if you take it one year before becoming pregnant)?
I knew about the role in preventing neural tube defects. I hadn't heard until right now about the impact on preterm births.
* Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options?
As far as I know my choices are hospital (OB) or home (OB or midwife). I would love to have the option of a low-risk natural birthing centre - I live too far away from a hospital to be comfortable delivering at home, but for my first birth, a hospital was overkill!
My short answer, to your questions, are as follows:
1. How much choice did you have when it came to finding a prenatal care provider? Lots of choice? Or was the choice made for you?
** I had no choice in care provider with my first birth. I have chronic hypertension (210/154 when I was hospitalised at 18 for my idiopathic hypertension) and the fear was about what my BP would do in labour. It was fine. Intervention riddled but fine.
2. Where did you go for information when you were pregnant?
** The only resource I had, despite working in the health care field, was my OB. I didn’t know where else to source information. Therefore, I only had OB sanctioned information to draw answers and resources from. I found the “What to Expect . . .” books but didn’t like the tone in them so discarded them. No one thought to direct me to “The Pregnancy Book,” or “The Birth Book” when I was pregnant. The internet had some resources but, over a decade ago, you can appreciate why this wasn’t my first place to look. There just weren’t the sites available then that there are now.
3. Did you know about the importance of taking folic acid prior to conceiving? Had you heard about the new research about the role folic acid can play in preventing preterm birth (if you take it one year before becoming pregnant)?
** I did know about the folate and was taking it for many months prior to conception. My first pregnancy was 12 years ago so what is new now was not known then.
4. Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options?
** Choice of birth place? No. One option and it wasn’t presented as an option. It was presented as fact.
I did take some time penning (typing?) a few thoughts about the article from my perspective as someone who works, hands-on, in the birth field on a daily basis but NOT as a doctor, nurse or midwife. I provide labour support to expectant families. The blog entry I just wrote about this article can be found at: http://tinyurl.com/d7uj72
Thanks for taking the time to investigate this further.
Sam of babyREADY
[...] at PhD in Parenting they are discussing the results of the Canadian Maternity Experiences Survey. and Ann Douglas at [...]
[...] over at PhD in Parenting wrote a post last week about the Canadian Maternity Experiences Survey with some follow up [...]
I'm not Canadian...and I know I'm doing this way late, but I just discovered your blog...I'm from Los Angeles, CA-USA.
* How much choice did you have when it came to finding a prenatal care provider? Lots of choice? Or was the choice made for you? -- I had quite a bit of choice. But it was relegated to OB's. I chose an OB I hoped would be a good match for me based on my desire to have a natural birth. Later in my pregnancy I found that she was an awful choice for me and that was when I ran into a lack of options. I wanted to switch to a midwife and have a home birth. My insurance repeatedly told me that a midwife would not be covered. I finally got it out of them that this wasn't exactly true. A midwife would be covered if I had my baby at a birthing center (which is pretty illogical if you think about it). This infuriated me. But I found a birthing center that was an hour away (without LA traffic) and that is where I had my baby. For #2 I am paying out of pocket to have a home birth despite the ridiculous amount of money we pay monthly to have insurance.
* Where did you go for information when you were pregnant? I went on line, I asked my family and I took a Bradley birthing class. I also took several classes at the birthing center I had my baby at.
* Did you know about the importance of taking folic acid prior to conceiving? Had you heard about the new research about the role folic acid can play in preventing preterm birth (if you take it one year before becoming pregnant)? I didn't know anything about taking folic acid a year before becoming pregnant. I did know to take folic acid and started taking it and prenatals as soon as my husband and I started to try to conceive.
* Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options? No. I wish I had more options. Despite being in Los Angeles, there were few birthing centers to choose from and I ended up finding one that was over an hour away. If I had my way I would have had the baby at home but my insurance would not allow it.
I'm really joining this conversation late... but I only just found your site today, and was compelled to reply seeing that you live in the same area as me. I'm in Ontario, but very close to the Quebec border. I moved to Ontario a year ago, and before that, I was in Montreal, which is where I had my first two children (7 and 10 years ago).
I was woefully uninformed with both of my kids. I didn't know anything about anything, and my only resource was What to Expect when you're Expecting, which led me to ask my OB the most ridiculous (in hindsight!) questions.
Did I have a choice of practitioner? No. I had heard about birthing centres, and briefly entertained that idea, but the waiting list was long, it was far from home, and there were plenty of naysayers and "OMG THAT's DANGEROUS" comments that I ended up going to one of the downtown hospitals where I was assigned an OB.
I didn't know anything about folic acid until after my first appointment with an OB.
Choice in terms of place to give birth? This is pretty well tied to choice of practitioner, I'd say. I could have chosen a different hospital to go to for my first appointment, but I had nothing other than proximity to judge by. Birthing centre, like I said was an esoteric option, and not a true option.
This time round, I started researching midwives before I got pregnant. I also started taking folic acid before having my IUD removed, although not a year in advance. I only knew about the links to neural tube defects. Regardless, low birthweight has not been a problem for me. Both babies were pretty big.
I was disappointed to learn that I could only choose between hospital or home. I would have liked the option of a birthing centre. I was happy to know that a midwife was a totally legit option, and that I was not restricted to an OB. I had some difficulty, due to where I live, finding a midwife who would take me. The Orleans practice wouldn't take me, but the Cornwall practice would, even though it's over an hour away. I find it somewhat lacking that there aren't more midwife practices in the area, but so far, I am very pleased with my midwife team.
I'm at 10 weeks now, and looking forward to the experience of a midwife-assisted homebirth. I feel informed and on top of things, rather than shuffled around from one unexplained compulsory procedure to another.
:)
K.
[...] on Twitter about this Canadian Maternity Experiences survey and then went on over to bothPhDinParenting’s blog and Ann Douglas’ blog. And of course I have to [...]