Grant: Undergraduate Student Research Awards (USRA)

The physiological processes of pregnancy and childbirth share known commonalities. However, expectations and perceptions of childbirth are complex and influenced by cultural and situational factors. The impact of meeting or not meeting patients' expectations of childbirth may provide insight into ways to improve maternal care. In Newfoundland and Labrador, geography influences the provision of maternal care services. Further, midwifery is only available in one health region in the province where the health authority employs five midwives (1,2). Thus, maternal care relies heavily on nurses and obstetric specialists. Unfortunately, in the current model of maternal care, our province has the highest rates of caesarean section and the lowest breastfeeding rates in Canada (3). Further, approximately 20% of new mothers report having symptoms of postpartum depression in this province (4). Poor mental health outcomes in postpartum have been linked with unmet birth expectations (5-8). For example, women who strongly preferred non-surgical birth but received a caesarean section had higher scores on a postpartum depression questionnaire, indicating higher rates of depression when expectations were not met (9). To improve maternal care in this province, a maternal health care team comprised of nurses and physicians in a rural birthing hospital created a new care pathway that included co-creating a birthing plan with a nurse. The current project will examine the differences in birth expectations (pre-childbirth), birth experience (post-childbirth), and perinatal mental health outcomes during pregnancy and postpartum between patients who belong to this new care pathway and those who experience childbirth in a traditional maternal care model.