Oh, Baby! Mining The Maternity Survey Data Motherlode

As someone who is always looking for new data about conception, pregnancy, childbirth, and the postpartum experience from a Canadian perspective, I’ve been awaiting the birth of the Canadian Maternity Experiences Survey with great anticipation.

This survey -- and the motherlode of data that accompanies it -- will provide mothers and researchers with plenty of material for discussion and analysis for many years to come.

The Toronto Star made the survey its lead story in its print edition this morning -- an indication of the significance of the research. Based on interviews with 6421 Canadian moms, the Canadian Maternity Experiences Survey is the first large-scale national maternity study to be conducted in this country.

The survey included more than 300 questions addressing such topics as socio-economic and demographic information; reproductive history; folic acid use; prenatal care; smoking, alcohol and street drug use; stress and support; physical and sexual abuse; information received about pregnancy, birth and postpartum issues; interventions during pregnancy, labour and delivery; postpartum health and care; postpartum depression; and infant feeding.

I expect to be writing about this body of data repeatedly -- both here at ParentCentral.ca, and as I finish updating my pregnancy and baby books. These notes are a few of my preliminary impressions as I begin to mine the motherlode of data.

Type of prenatal care provider
Obstetrician/gynecologist: 58.1%
Family physician: 34.2%
Midwife: 6.1%
Nurse/nurse practitioner: 0.6%

Note: This data is quite interesting, given the lack of choice of prenatal care providers in many communities; and the chronic shortage of both family doctors and obstetricians/gynecologists.

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?

Most useful sources of information about pregnancy
Health care provider (32.2%)
Books (22.3%)
Previous pregnancy (17.1%)

Note: This data is very different from what other similar studies have revealed. They have indicated that moms-to-be tend to turn to close female friends and female relatives for support and information during pregnancy.

So what do you think? Where did you go for information when you were pregnant? Do the answers to this question make sense to you?

Folic acid supplementation
Almost a quarter (22.4%) of women did not know, prior to pregnancy, that taking folic acid before pregnancy could help prevent some birth defects.

Note: Public education campaigns aimed at increasing awareness of the need to take folic acid prior to pregnancy have existed in Canada since the early 1990s. Clearly, these campaigns are failing to reach about 1 in 4 moms-to-be. New research indicates that folic acid can help to prevent preterm birth if it is taken a year before pregnancy. Prospective mothers now need to be thinking about increasing their folic acid intake a year before they start trying to conceive. Health educators now need to be thinking about ways to get this message out -- an even greater challenge.

 

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)?

Place of birth
Hospital or clinic 97.9%
Home birth: 1.2%
Birthing centre: 0.8%

Older women and women giving birth to their second or subsequent baby had higher proportions of out-of-hospital births.

Note: These statistics do not necessarily reflect what a woman would choose for herself, but rather what choice she made given the options that were available to her.

A 1999 survey indicated that 31% of Canadian women would choose to deliver in a birth centre. In reality, relatively few Canadian women have the option of giving birth in a birthing centre. Birth centres only exist in certain provinces/communities; some are privately funded. Likewise, midwives are not accessible to all women in all communities, and some provinces do not fund their services; so home birth is not an option for all Canadian women.

Did you feel you had adequate choice in terms of a place to give birth? Did you wish you had more options?

I will continue to blog about more data from the Maternity Experiences Survey during the days and weeks ahead, helping you to make sense of that motherlode of numbers. If you have any questions or comments, please feel free to post them below or to contact me @anndouglas

NOTE: Please see this amazing roundup of comments over at PhD in Parenting ("Canadian Maternity Experiences Survey: My Answers & Your Answers"). Annie, thank you for taking this discussion over to your blog, getting your readers engaged in such a powerful way, and then letting me know what happened so that I could link to that discussion. How fabulous.

Comments

[Andrea]

Very cool. I'm looking forward to reading what you have to say about this!

[Dorothy G]

My birthing experiences were more than 45 years ago and in another country - but I note that the more things change, the more they stay the same.
Type of provider: I was lucky, there was a village doctor, a GP.
Information - I did not have my mother available, I asked other women - who else would you ask? (And why was this not an option?)
Folic Acid - yes - as soon as the Dr saw me, he prescribed it.
Birthing Place - Luckily, the hospital - since I was in labour for more than 80 hours before the decision was made to do a Caesarian (In Mexico, home births are much more frequent.)

[Holly]

I gave birth to my first child in Vancouver, BC in 2007. My daughter was born at home with midwives and a doula in attendance. I felt that I had lots of choice in care provider, although I knew that the midwives got booked up very quickly.

I got most of my information from books (I constantly had books on hold at the library, including some of yours, Ann!) as well as information from my lengthy appointments with the midwives.

I knew all about folic acid and had been taking it for months, but hadn't heard the info about preterm birth.

I had a choice between the hospital or home and was very happy that my home birth worked out the way it did. Having the option of a birthing centre would have been great! I'd like to know where the Canadian birthing centres are located.

[radmama]

I suppose some of the answers would be shaped by the questions. ie. were friends and relatives one of the options for information?

No Birth Centres in NS. And midwifes were only regulated last week. Only 6-8 will be hired, provincially, each serving fewer than 40 women per year. The feeling is that home births, although allowable under legislation, will be few and far between because of the way health boards have arranged things.

[Annie @ PhD in Parenting]

I posted my answers to your questions and so did a bunch of my readers here:

http://www.phdinparenting.com/2009/03/26/canadian-maternity-experiences-survey-my-answers-your-answers/

[babyREADY]

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

[mommyofone]

I just had a baby 3 months ago:) I had a fantastic birthing experience. In answering your questions,
1. I had midwives and they were great. I don't have a doctor in the area, and this was my first choice. If I had wanted a dr, I wouldn't know where to start.
2. I got info from books, yours... I'm glad you're updating them, my midwife appointments (it's so great that they're 45 min), the internet and from friends/mom. My girlfriends are all starting to have babies and we talk about everything.I love to arm myself with info so I was pretty well versed by the time my babe came along.
3. I knew that taking folic acid was important but I didn't know that you should start taking it before conceiving. When I thought I was pregnant and read that online I was shocked. I started taking over the counter prenatals before my pregnancy was confirmed.
4. I gave birth at the hospital and could have done so at home. This is how I wanted it for my first, but I think that I would likely want to give birth at home for future babies.
Looking forward to the rest of your thoughts.

[Ann Douglas]

Your answers are amazing -- so insightful -- everyone. I am looking forward to continuing to blog my way through the survey (and I hope you'll continue to blog along).

I'll be breaking up the flow by writing about a few other things as we go (1) because I've researched some other columns and need to get them written up as well; and (2) I think I might drive some people crazy if I turned this into the All-Maternity-Survey-Channel. :-)

But I'll be back at this in the next day or two. So stay tuned for another progesterone-fueled installment of the Canadian MES blogging mamas (and papas: all are welcome).

[tubal reversal]

A tubal ligation pregnancy, also known as a tubal or ectopic pregnancy, is an abnormal pregnancy in which the egg does not successfully reach the uterus and instead implants in the woman’s fallopian tube. Since the symptoms of an ectopic pregnancy are just about the same as they for a viable pregnancy, at least in the beginning, the fact that the pregnancy is ectopic may not be discovered until the mother has a problem and seeks the advice of her doctor or goes to the emergency room. For the most part, the first symptom of the pregnancy being tubular is pain in the abdomen. Most often, the pain is mostly on one side and can be fairly severe. It is often described as sharp or shooting and it may come and go.