Women's Decision-Making And Factors Affecting Their Choice Of ...
Women's Decision-Making And Factors Affecting Their Choice Of ... Women's Decision-Making And Factors Affecting Their Choice Of ...
could therefore be used to provide good quality unbiased information to childbearing women in maternity units. The information could then be distributed to women by word of mouth by all caring for them, as well as in written form. Information about all available services could be printed as part of the antenatal record. Women would therefore have the information with them at all times and accept it as part of their antenatal care. It could also be useful to get women with experience of different options to talk to others about both the positive and negative points about each option. This would give women enough information to choose with more confidence. The information could involve the pros and cons of each option, and the screening procedures, if any, that are used to help decide the suitability of women for each available option. While women clearly need more information about the available options, an important question is when and how to reach all or the majority who might benefit from the information. The mass media would seem to be a good alternative, with programs introducing women to options available at the different areas of the country, as well as the philosophies of the options (Mather 1980). The mass media could target different groups of women, such as, through community educational programs, childbirth educational programs, women's groups and church groups. Implications for Midwives According to the history of place of birth reviewed in Chapter 1, the rate of home deliveries fell dramatically from about 35% in the 1960's to 1% in the 1980's. The current rate is about 2%, and Chamberlain et al (1997) have observed that midwives who trained when the home birth rate was high ended their careers around 1994. The midwives currently in practice may not have experience of 193
conducting home births, which might explain why they are reluctant to give information about home births, because they might not feel confident to conduct them. Studies have found that up to 32% of midwives have not attended a home birth in the past year (Chamberlain, Wraight, and Crowley 1997; Floyd 1995; Northern and Yorkshire Regional Health Authority 1994). It has been suggested that midwives' personal anxieties and lack of experience with home birth may lead them to encourage hospital births as a way of alleviating their own distress rather than helping women to make decisions congruent with their needs (Price 1995). It is important to determine the effect of the midwives' lack of experience of conducting home births on the information they give women about available services. It is also important to find ways of empowering midwives to conduct home birth. It has been argued that if midwives are to become confident in conducting home births, they need time to study and adapt to the responsibilities associated with it (Chamberlain Wraight and Crowley 1997). Finally, as Stapleton (1997) has observed, woman-centred care means fostering an atmosphere where all women — midwives and clients — are encouraged to express their opinions without fear of getting it wrong. If women, or indeed midwives are afraid of retribution if things go wrong, then there will never be free choice about the place of birth. Implications for research Results of this study should be accepted only tentatively, and must be verified since they comprise perhaps a first attempt to investigate women's perceptions of risk as related to the birth process. Hence, results only offer hypothesis for further testing, and point to an urgent need for more exploratory 194
- Page 143 and 144: you have to be veru persuasive. her
- Page 145 and 146: waiAted to go to [name of hospital]
- Page 147 and 148: wavut to ask about it, and theo.. V
- Page 149 and 150: dedn't sort o-F tru AAA persuade me
- Page 151 and 152: anuthLng went wrong theyol have aLL
- Page 153 and 154: sometKng eLse when she saist, the h
- Page 155 and 156: arou.nd their necIR. all the time A
- Page 157 and 158: senuona: Mu fLrst one I had Ln hosp
- Page 159 and 160: agaLvt. when I had mu episiotomu th
- Page 161 and 162: khuma. iviu first daughter was a ca
- Page 163 and 164: nolope: olzau, I'LL give uou a fi.n
- Page 165 and 166: thought it would be, thlngs have oh
- Page 167 and 168: wtedwefe came around and spolze to
- Page 169 and 170: Some of the spontaneous responses f
- Page 171 and 172: or home. One woman thought that pro
- Page 173 and 174: N yttx1R,IA: we have got more contr
- Page 175 and 176: Sixty-nine percent of women plannin
- Page 177 and 178: expectations of what would best rep
- Page 179 and 180: Committee 1992) who observed that t
- Page 181 and 182: One of the fascinating findings of
- Page 183 and 184: Summary The qualitative study has r
- Page 185 and 186: Government policy about maternity c
- Page 187 and 188: choose (DiMatteo 1994), without any
- Page 189 and 190: Prospect theory (Kahneman and Tvers
- Page 191 and 192: IRYLOW, we tAIR,e eVeruthi.ne im, o
- Page 193: that may impact on the choices they
- Page 197 and 198: looked after her during one of her
- Page 199 and 200: Appendices Appendix 1: (Information
- Page 201 and 202: Appendix 3a Consent form I the unde
- Page 203 and 204: 22. because I was in a hospital and
- Page 205 and 206: 76. the next one was being born her
- Page 207 and 208: 130. why are you wasting the hospit
- Page 209 and 210: 183. on the floor in agony go ahead
- Page 211 and 212: 237. went up and ran the bath for h
- Page 213 and 214: 292. not going near me, you know an
- Page 215 and 216: 346. and I said, well, you know, I
- Page 217 and 218: 401. it's not as ifsomething goes w
- Page 219 and 220: 455. you, I said , you're here to d
- Page 221 and 222: 510. nice. And the funny thing was
- Page 223 and 224: 566. through friends as well, they'
- Page 225 and 226: Appendix 5: Reflective notes Nnese
- Page 227 and 228: what do you think ofthe situation w
- Page 229 and 230: going horribLu wrong and suoldenlu
- Page 231 and 232: and he was quite sort of happy with
- Page 233 and 234: 60. you are dealing with somebody y
- Page 235 and 236: 112. Well I didn't Feel, you are to
- Page 237 and 238: 1.o6. like Doctors ncl nurses and t
- Page 239 and 240: 218. we are anti hospitals or anyth
- Page 241 and 242: Appendix 8: Thematic analysis Home
- Page 243 and 244: References Abraham, C., Sheeran, P.
could therefore be used to provide good quality unbiased information to<br />
childbearing women in maternity units. The information could then be distributed<br />
to women by word of mouth by all caring for them, as well as in written form.<br />
Information about all available services could be printed as part of the antenatal<br />
record. Women would therefore have the information with them at all times and<br />
accept it as part of their antenatal care. It could also be useful to get women with<br />
experience of different options to talk to others about both the positive and<br />
negative points about each option. This would give women enough information<br />
to choose with more confidence. The information could involve the pros and cons<br />
of each option, and the screening procedures, if any, that are used to help decide<br />
the suitability of women for each available option.<br />
While women clearly need more information about the available options,<br />
an important question is when and how to reach all or the majority who might<br />
benefit from the information. The mass media would seem to be a good<br />
alternative, with programs introducing women to options available at the different<br />
areas of the country, as well as the philosophies of the options (Mather 1980).<br />
The mass media could target different groups of women, such as, through<br />
community educational programs, childbirth educational programs, women's<br />
groups and church groups.<br />
Implications for Midwives<br />
According to the history of place of birth reviewed in Chapter 1, the rate<br />
of home deliveries fell dramatically from about 35% in the 1960's to 1% in the<br />
1980's. The current rate is about 2%, and Chamberlain et al (1997) have observed<br />
that midwives who trained when the home birth rate was high ended their careers<br />
around 1994. The midwives currently in practice may not have experience of<br />
193
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