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Experiences, Knowledge, and Preferences of Canadian Parents Regarding Preterm Mode of Birth

Published:December 07, 2020DOI:https://doi.org/10.1016/j.jogc.2020.10.020

      Abstract

      Objectives

      To describe Canadian parents’ experiences with mode of birth for preterm singleton pregnancies; knowledge about maternal and infant risks of the different modes of preterm birth, particularly breech birth; and communication preferences with respect to mode of birth.

      Methods

      We conducted an online survey of Canadian parents who had experienced the preterm birth of a live-born infant between 2010 and 2019. Data were collected from August to September 2019. The sample size was calculated as requiring 96 participants.

      Results

      Of the 153 respondents, 152 were mothers. Respondents were approximately evenly split between those who had experienced an extremely preterm birth (<28 wk), a very preterm birth (28–31 wk), or a moderate-to-late preterm birth (32–36 wk). Most parents reported that mode of birth was discussed before the birth (61.7%, 73.3% and 77.3% for extremely, very, and moderate-to-late preterm births, respectively). The minority of parents reported being given a choice about mode of birth (20.8%, 23.0%, and 36.4% for extremely, very, and moderate-to-late preterm births, respectively). The use of written material during discussion on mode of birth was rare (2.1%, 3.3% and 6.8% for extremely, very, and moderate-to-late preterm births, respectively). Of women who had a cesarean delivery, 39.6% (36/91) were unaware of the maternal risks. Many parents expressed preference for both oral and written communication during counselling on mode of birth (62.6%).

      Conclusion

      Few Canadian parents reported receiving a choice about mode of preterm birth, being aware of associated risks, or receiving written information. There is an urgent need to develop tools that provide information for parents facing preterm birth.

      Résumé

      Objectifs

      Décrire les expériences de parents canadiens relativement au mode d'accouchement prématuré pour les grossesses monofœtales; les connaissances sur les risques pour la mère et le nourrisson en ce qui concerne les différents modes d'accouchement prématuré, en particulier en cas d'accouchement du siège; et les préférences en matière de communication quant au mode d'accouchement.

      Méthodologie

      Nous avons mené un sondage en ligne auprès de parents canadiens qui avaient fait l'expérience d'une naissance vivante avant terme entre 2010 et 2019. Les données ont été recueillies entre août et septembre 2019. La taille d’échantillon requise a été établie à 96 participants.

      Résultats

      Sur les 153 répondants, 152 étaient des mères. Les répondants ont été répartis de façon presque égale entre les groupes de parents qui ont vécu l'accouchement d'un très grand prématuré (< 28 semaines d'aménorrhée.), d'un grand prématuré (28-31 semaines d'aménorrhée) et d'un prématuré (32-36 semaines d'aménorrhée). La plupart des parents ont rapporté que le mode d'accouchement avait fait l'objet d'une discussion avant la naissance (61,7 %, 73,3 % et 77,3 % pour les accouchements d'un très grand prématuré, d'un grand prématuré ou d'un prématuré, respectivement). Une minorité de parents ont signalé s’être fait offrir un choix relativement au mode d'accouchement (20,8 %, 23,0 % et 36,4 % pour les accouchements d'un très grand prématuré, d'un grand prématuré ou d'un prématuré, respectivement). L'utilisation de documents écrits lors de la discussion sur le mode d'accouchement était rare (2,1 %, 3,3 % et 6,8 % pour les accouchements d'un très grand prématuré, d'un grand prématuré ou d'un prématuré, respectivement). Parmi les femmes qui ont accouché par césarienne, 39,6 % (36 femmes sur 91) n’étaient pas au courant des risques maternels. De nombreux parents ont fait part de leur préférence pour la communication orale et écrite lors du conseil sur le mode d'accouchement (62,6 %).

      Conclusion

      Peu de parents canadiens ont indiqué avoir pu choisir un mode d'accouchement prématuré, avoir été informés des risques associés ou avoir reçu des renseignements écrits. Il est urgent de mettre au point des outils pour fournir l'information nécessaire aux parents qui doivent faire face à une naissance avant terme.

      Keywords

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