Grant: Knowledge Translation Supplement

Cesarean section rates in Canada continue to rise, and for the first time maternal and perinatal mortality are rising as well. Over 80% of births in Canada involve medical intervention (CIHI 2008-2010), while our research shows that both expectant women and care providers have significant knowledge gaps about the risks of common maternity care interventions. The lack of awareness of Canadian women of many procedures used in birth presents an opportunity to explore and explain controversies in the evidence. We propose to develop innovative online activities that engage expectant women in accessing evidence-based information vital to informed decision-making. We conducted a pilot project on the topic of epidural analgesia with positive results from Canadian women. Our interactive activities include quizzes and a narrative simulation of the childbirth process. Our activities are unique; most childbirth information is presented passively, in blocks of text or video. Our informed decision-making activity is critical to women's health, as informed autonomy is the centerpiece of woman-centred care and will have positive lifelong health consequences for women and their children. We request funding to develop similar activities for issues where our research shows women and care providers have significant knowledge gaps, and which may include controversies in evidence. These include the site and mode of delivery, indications for induction, routine electronic fetal monitoring, optimal use of episiotomy, and the role of doulas. Our goal is to improve the likelihood of fully informed maternal choice by creating demand from pregnant women for evidence-based discussion with providers, with the ultimate goal of lowering unnecessary intervention rates and optimizing birth outcomes. Reducing unnecessary interventions and resultant morbidity and mortality will lead to fewer maternal/perinatal complications and admissions, and reduction in healthcare costs.