Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Green & Baston (1) found that childbearing women in 2000 were significantly more likely to accept obstetric interventions than in 1987. Maternity care providers themselves would prefer elective Cesarean sections (CS) over vaginal deliveries if given the option (2-8). This increased reliance on technology has culminated in a medicalized culture of childbirth where normal spontaneous birth is rare. "The whole ethos of the culture is that if the technology exists, we should use it," says Davis-Floyd (9) "So, not using it looks like you are giving your baby substandard care." Studies in Canada and worldwide that compare hospital birth with planned home birth consistently show that perinatal outcomes are not compromised in the low tech home setting (10-15). In fact, the best available evidence from the obstetric literature suggests that many interventions during labour and birth are associated with less than optimal perinatal outcomes (16-23). However, rates of elective obstetric procedures (like epidurals for pain relief, induction of labour and elective cesarean section) will continue to rise if childbearing women continue to request them or are unable to offer resistance to health care providers' preference for elective interventions. The purpose of my dissertation research is to analyze data from 2,675 female university students who participated in an electronic survey about childbirth attitudes in 2007. I aim to understand which factors contribute to young women's confidence in childbirth and belief in their ability to cope with labour (a phenomenon called childbirth self-efficacy or CBSE). This is important because a lack of CBSE is associated with a preference for obstetric interventions, like epidural anesthesia and delivering a baby via Cesarean section (CS) (24). Planned CSs are associated with negative health effects for mothers and babies compared to planned vaginal deliveries (25), and are more costly to the health care system (26-27).