New Survey Shows Pregnant Women Not Getting the Care They Need

Conversations about pregnancy and birth are happening virtually everywhere – mommy blogs, social media, television shows – but new data show that when women visit their health care providers, many important conversations simply aren’t happening.

A survey of women, released in September 2012 by the American College of Nurse-Midwives (ACNM), shows that major health issues are being overlooked and that women may be walking out of medical appointments without the information they need.

Of the women surveyed who have given birth or are pregnant, 62% said their care provider did not discuss how to stay healthy during their pregnancy, 80% said that preparing for motherhood was never discussed, and only about half said their provider spent a great deal of time with them throughout labor and birth.

“Women can play a critical role in getting the good health outcomes they want, especially when it comes to childbirth. But women can only succeed if they are equipped with the best information,” said ACNM President Dr. Holly Powell Kennedy, a professor of midwifery at the Yale University School of Nursing. “They need the opportunity to discuss and make decisions on all of their care options with their provider, especially during pregnancy and childbirth, and they shouldn’t settle on care that is not right for them.”

And that’s what is happening – women are settling for health care that is not what they’re looking for because they either don’t know they have a choice or don’t fully understand the issues facing them. Most say they are not getting many of the services they want.

The absence of important conversations with health care providers could be leading women down a path of less than optimal care. Yet, 60% said they would agree to an unnecessary cesarean and 90% would agree to have their labor induced, even if there was no medical reason.

“Evidence shows that interventions, like early labor inductions and cesarean sections, can mean a more difficult labor and tougher recovery for both women and their babies,” said Dr. Eugene Declercq, a professor of community health sciences at the Boston University School of Public Health who has researched cesarean section use. “Every woman wants the best for her baby, but the data clearly show that women are not being informed of the risks of medically unnecessary procedures.”

These findings beg the question: How can women receive the best care possible during their pregnancy and childbirth?

Today, women and midwives are joining together as part of a new awareness effort to answer that question.Our Moment of Truth™: A New Understanding of Midwifery Care asks women to take a moment to examine the type of health care they are receiving, evaluate what they want from their health care experience, and ensure important conversations with their provider take place. This nationwide awareness initiative also encourages women to become aware of their full range of options by showing how midwives can address a range of women’s health needs.

“Persistent myths about midwives prevent women from seeing a provider who can give them the attentive care they say they want during pregnancy and childbirth,” said ACNM Executive Director Lorrie Kline Kaplan. “Women deserve a health care provider who presents different care options during pregnancy and birth, and who takes careful precautions to avoid unnecessary childbirth procedures that may inflict harm on them and their baby, but also uses them when they are medically necessary. Understanding these care options will allow women to play a more active role in their own health decisions and outcomes. The good news is, as more women learn about the high-quality care midwives provide, more women are turning to midwives as partners in their care.”

The Centers for Disease Control and Prevention reports that midwife-attended births are on the rise in the United States, reaching a record high of 8.4% in 2010. In some states, such as New Mexico, more than 1 in every 3 women are seeking the care of a midwife with 37.6% of vaginal births midwife-attended births in 2010[i].

As part of the new Our Moment of Truth™ initiative, ACNM helps women to take charge of their health with the launch of a new series of tools that help women get the truth about what’s best for their bodies and their baby’s health. Visit www.ourmomentoftruth.com to learn more about how the high-quality care of a midwife can meet many of the desires women are looking for in their care.

Survey Methodology

The Our Moment of Truth™ survey was fielded by Lightspeed Online Research, Inc. in August 2012. The survey was completed by 1,252 women between the ages 18 and 45, of a variety of cultural backgrounds, from across the United States. The survey, consisting of 23 questions, was fielded through the SurveyMonkey online platform.

About Our Moment of Truth™: A New Understanding of Midwifery Care

Our Moment of Truth™: A New Understanding of Midwifery Care presents midwifery as a solution for many women who are looking for more out of their care. Recognizing that many women are not receiving the care they desire, Our Moment of Truth™ challenges women to take a moment to examine the type of health care they are receiving, evaluate what they want from their health care experience, and become aware of their full range of options. Our Moment of Truth™ offers women the information and tools they need to ask the right questions of their provider and have an important dialogue on critical health issues before moving forward with a care plan. Explore the new Our Moment of Truth™ tools and resources for finding desired health care atwww.ourmomentoftruth.com.

About the American College of Nurse-Midwives
The American College of Nurse-Midwives (ACNM) is the professional association that represents certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States. ACNM promotes excellence in midwifery education, clinical practice, and research. With roots dating to 1929, our members are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health. ACNM provides research, administers and promotes continuing education programs, establishes clinical practice standards, and creates liaisons with state and federal agencies and members of Congress to increase the visibility and recognition of midwifery care. Visit www.midwife.org for more information.

Contact: Melissa Garvey
Office: 240-485-1826
E-mail: mgarvey@acnm.org

[i] Data adapted from: Centers for Disease Control and Prevention. National Center for Health Statistics. VitalStats. http://www.cdc.gov/nchs/vitalstats.htm. Accessed September 23, 2012.

Pregnancy and Birth Resources

FCL’s Bookstore Selections for Pregnancy and Birth and Conscious Conception

Watch Ina May Gaskin speak on the Human Impact of Hi-Tech Birth.

American Pregnancy Association. The American Pregnancy Association is a national health organization committed to promoting reproductive and pregnancy wellness through education, research, advocacy, and community awareness.

Association for Prenatal and Perinatal Psychology and Health. APPPAH illuminates the life-long impact of conception, pregnancy and birth on babies, families and society. APPPAH’s mission is to educate professionals and the public about, and advocate for, the life-changing discoveries made in the area of prenatal and perinatal psychology and health.

Birthing the Future. The mission of Birthing The Future®, is to gather, synthesize, and disseminate the finest world wisdom about birthing and the care of mothers and babies from pre-conception to the first birthday.

The Bradley Method of Natural Childbirth. The Bradley Method® teaches natural childbirth and views birth as a natural process. It is our belief that most women with proper education, preparation, and the help of a loving and supportive coach can be taught to give birth naturally.

CAPPA, Childbirth and Postpartum Professional Association.  For over a decade, CAPPA’s mission has been to offer comprehensive, evidence-based education, certification, professional membership and training to childbirth educators, lactation educators, labor doulas, antepartum doulas and postpartum doulas worldwide. CAPPA is proud to provide new and expectant families access to these professionals here.

Cesarean Statistics for Your Local Hospital.  Find C-section and VBAC, vaginal birth after Cesarean, rates for your local hospital.

Citizens for Midwifery. The goal of Citizens for Midwifery is to see that the Midwives Model of Care is available to all childbearing women and universally recognized as the best kind of care for pregnancy and birth. Citizens for Midwifery also endorses the Mother-Friendly Childbirth Initiative™. 

Coalition for Improving Maternity Services. The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and well-being of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.

Doulas of North America. Pardon us for bragging, but we are the oldest, largest and most respected doula association in the world. Our founders are among the foremost experts on doula care, and DONA International certification is a widely respected measure of quality and professionalism. We are an international, non-profit organization of doulas that strives to have every doula trained / educated to provide the highest quality / standards for birth and/or postpartum support to birthing women and their families.

International Cesarean Awareness Network. The International Cesarean Awareness Network, Inc (ICAN) was formed over 25 years ago in order to support women in their journey towards understanding the risks of cesarean section and with the purpose of helping them have healthy births and healthy lives after undergoing the surgery that changed them.

International Cesarean Awareness Network & VBAC Information. This is a collection of fact sheets and information put out by the International Cesarean Awareness Network (ICAN) and other sources. Information includes how to prevent an unnecessary cesarean, Vaginal birth after cesarean (VBAC), how to find resources in your community, information about ICAN, and how to become a part of ICAN.

International Childbirth Education Association. ICEA is an organization of over 4,000 members from throughout the United States and 42 countries who believe in freedom of choice based on knowledge of alternatives in family-centered maternity and newborn care.

Midwives and Mothers in Action, MAMA, The MAMA campaign is a collaborative effort by the National Association of Certified Professional Midwives (NACPM), Midwives Alliance of North America (MANA), Citizens for Midwifery (CfM), International Center for Traditional Childbearing (ICTC), North American Registry of Midwives (NARM), and the Midwifery Education Accreditation Council (MEAC). This partnership is now at work to gain federal recognition of Certified Professional Midwives so that women and families will have increased access to quality, affordable maternity care in the settings of their choice.

Midwives Alliance of North America, MANA, In 1982, the Midwives Alliance of North America (MANA) was established as a professional organization for all midwives, recognizing the diversity of educational backgrounds and practice styles within the profession. Its goal is to unify and strengthen the profession of midwifery, thereby improving the quality of health care for women, babies, and communities.

National Association of Certified Professional Midwives.  

North American Registry of Midwives.  

Midwifery Today. Well-written technical articles by doctors, midwives, doulas, childbirth educators, nutritionists, herbalists and other practitioners. Birth stories that are beautifully written and have something to teach the practitioner. Stories about midwifery practices in other countries. Well-written academic articles on the subject of midwifery by experts.

Spinning Babies. Spinning Babies is a unique, step-by-step approach to Optimal Fetal Positioning. The techniques described here were found around the world. But, “what to do when” is found right here. Your labor can be shorter and less painful. Easier, in other words, than a posterior labor.

Ten Moons Rising.  Ten Moons Rising* is a non-profit organization committed to educating the public about Prenatal & Birth Psychology – how our earliest experiences influence our sense of self and experience of life – and offering resources for healing early trauma in infants, children and adults.

The Unnecesarean is a patient advocacy Web site that pulls back the curtain on the practice of prophylactic cesarean surgery for suspected fetal macrosomia and illuminates the experiences of women who have been harmed by the aggressive practice of defensive medicine. The site provides information about preventing an unnecessary cesarean and resources for making fully-informed decisions about childbirth while offering an irreverent take on the maternity care crisis in the United States and beyond. The most recently released data from the CDC on childbirth showed that 32.9 percent of U.S. babies in 2008 were born by surgery.  This is the twelfth year in a row that the rate has risen.  Rates of severe maternal morbidity have increased, yet maternal and infant mortality have not seen a decline with the aggressive use of this life saving surgery.

VBAC.com. VBAC (vaginal birth after cesarean) is a safe alternative to a routine repeat cesarean. Our aim is to provide evidence-based  resources and support about VBAC  from a variety of sources; scientific studies, professional guidelines, government reports, birth advocacy groups, as well as successful and established VBAC programs. Our goal is to help women make informed decisions about how they want to give birth and to encourage an honest and respectful dialogue with their caregivers.

Ina May Gaskin on the Human Impact of High Tech Birth