The authors of the article are professionals in their respective fields of study. Sarah Munro is a holder of a Masters’s degree from the University of British Columbia. She is a doula and breastfeeding consultant. Jude Kornelsen on the other hand has a Ph.D., and she is an Assistant Professor in the department of family practice at the University of British Columbia, Vancouver, Canada. Eileen Hutton holds a Ph.D., and she is also an assistant dean in the Faculty of Health Sciences at Mc Master University in Hamilton, Ontario in addition, she serves as an Associate Professor at the Department of Obstetrics and Gynecology.
The abstract of this article conclusively summarizes the research paper. For instance, the author argues that there is a significant increase in the number of cesarean delivery cases that expectant women choose to have. Such decisions are made by the women themselves and are based on stories they hear from others and also the knowledge that is passed from one generation to another. Such ideas are likely to influence the decision of the expectant women to go for cesarean birth as compared to the normal birth procedures. Stories from close friends, family members, and other sources of information such as the internet, television programs, and video shows have had a great influence on the women and led them to make up their minds on the form of delivery that they would most likely go for.
The information gained is always in support of cesarean birth and against normal birth; hence the women choose cesarean birth instead. It is, therefore, necessary for health practitioners, healthcare providers, childbirth educators, and policymakers to be aware of the social influences that impact women’s decisions on the mode of delivery (Munro et al. 2009). According to the authors of this article, there is a need to make truly informed decisions on the mode of delivery by the expectant mothers based on both social and cultural influences. It is also important to incorporate medical knowledge into their decisions. The aims of the study were: to determine the part played by stories of birth told on the women’s view of birth by cesarean section, to determine decisions of birth by cesarean, and to determine factors that contribute to the mode of delivery. Questions asked include: “Tell us about your decisions to have a cesarean section?”, “What sources of information informed your decision?”, “Who had input your decision-making process?” and “Did you experience resistance to your decision?”(Munro et al. 2009).
The sample population consisted of seventeen women from urban settings who had previously given birth through cesarean section by choice. Determination of the sample size was done by a standard grounded theory while data collection methods used included interviews which lasted sixty minutes with three parties involved. These parties were; the interviewee, the interviewer, and the person taking the notes. The statistical analysis program used in the study was Nvivo. The data obtained from the study supported the three important themes.
The study was done in identified sites which comprised of five urban maternity hospitals and two semi-rural hospitals in four provincial health authorities. Ethical approval was sought and obtained through the appropriate university behavioral research ethics board and individually through each study hospital.
Results revealed that women got stories about delivery from the antenatal clinic classes, family members, and friends. Such stories were geared towards the acceptable virtues of cesarean births and the disadvantages of normal birth procedures. A quantitative research study was undertaken involving theory techniques and in-depth open-ended interviews. Questions asked during the interviews revealed that the video and television programs that the women watched had a great influence on their views about normal births and hence they opted for cesarean section. ‘‘[At prenatal class] they show you all the options and I saw all the videos and stuff and I thought, ‘This is just awful. I don’t want to do it.’ And they showed a video of a cesarean and I said that’s awful too but I don’t know…. it just goes faster.’’(Munro et al. 2009).
Some women heard the experience of fellow women and these influenced their decision making, others opted for cesarean births because people they believe in and trust underwent the same and confirmed the results to be good. Generally, family members and friends had a great influence on such decisions.
Fear of pain associated with labor, fear of the damage that occurs during normal birth; for instance the tears, risks that are thought to bring injury to the infant and the pelvic floor made women opt for cesarean births (Munro et al. 2009). Also, the advantages of C-section such as fast and efficiency, shorter periods of labor attached to it, and the ability to know the exact time of delivery by the mothers to enable them to make decisions on the appropriate time for them informed their decision.
Books read by women and the internet also influenced their decisions about the mode of delivery they preferred. However, getting the best book that does not mislead remains a crucial issue as most books have wrong and misleading ideas about the Cesarean section. Partners of the women also had some influence on the mode of delivery based on what they had previously heard or watched in the television programs and videos.
The study findings revealed that health care providers to some extent also contributed to the decisions made by women on the mode of delivery. The women were allowed to find out for themselves then the health care providers would come in later and help them understand. However, this was only on rare occasions as most women had already made up their minds on what mode of delivery they were to go for. The health practitioner’s duty was to help them understand the health concerns with such modes of delivery. The issue of the cost of cesarean delivery as compared to the normal delivery was also a subject of contention as this was based on the notion that a number of women with first birth cases of cesarean delivery would most likely have subsequent births through the same method. However, there were increased costs in such instances, due to nursing costs incurred in labor (Munro et al. 2009).
From the research study, it was clear that the participant’s decision depended on the information gathered earlier from close friends, family members, television programs, videos, and the internet which made them opt for a cesarean section. Authoritative information has its support from science and this is passed on by health practitioners in medical set-ups, embodied knowledge on the other hand comes as a result of personal experiences and material practices.
The research question on the influences of birth stories on women’s decision on cesarean section delivery was adequately answered and hence the suggestion that health practitioners should be well equipped with the knowledge from media, social and cultural settings, and published texts to be able to address its drive on women without biasness. There must be adequate information about normal birth and women’s involvement in such decisions. However, the study should have included multiparous women in the study population to correct perceived risks of cesarean section in women. My reason for choosing this article is because it covers the subject matter comprehensively and it’s written by specialists in that area. It is also an area of great interest to me.
References
Munro, S., Kornelsen, J. and Hutton, E., (2009). Decision Making in Patient-Initiated Elective Cesarean Delivery: The Influence of Birth Stories. J Midwifery Womens Health, vol 54:373-379.