Reading just one magazine article promoting childbirth without medical intervention makes women want a more natural birth. This is the finding of research we recently published in the peer-reviewed journal Women and Health. Our research suggests the media could play a role in reducing rates of unnecessary medical intervention in childbirth.
Such intervention is associated with preventable maternal and infant ill health, and it places an extra burden on the health-care system.
Epidural, for instance, is associated with increased risk of the mother having very low blood pressure and fever, as well as the use of forceps and vacuum extraction. And caesarean section in low-risk births is associated with increased risk of babies needing intensive care.
Intervening too much
Several things contribute to the over-use of medical intervention in birth. Whether the hospital is publicly funded or a private one makes a difference, as do hospital policies that restrict birth options for certain women, such as those who’ve had a previous caesarean section.
Maternity care providers, such as midwives and obstetricians, also contribute to these rates. One study found a large proportion of women were not informed about the risks and benefits of the medical procedures being recommended to them.
Selective communication by care providers and directive communication that’s biased towards particular options inhibits women’s ability to make informed decisions about their care.
While maternity care providers have the primary responsibility for talking to women about birthing, other sources of information also influence their understanding of the risks of birth and the need for medical intervention. Our work shows that even brief exposure to alternative information and perspectives in a single magazine article can have an impact.
Essentially, long before women are directly receiving maternity care, any information about birthing they’re exposed to influences their preferences for and expectations about the amount of medical intervention they will be comfortable with.
But research shows popular media, including reality television shows and women’s magazines, are also biased towards promoting the benefits of medical intervention, such as induction of labour, epidurals and caesarean births, even when there’s little medical necessity for mother and baby.
A little test
Given women’s magazines are a popular source of information on birth, we wanted to test whether they could be used to communicate evidence-based information about the benefits of avoiding medical intervention.
We randomly exposed 180 childless women of childbearing age (18 to 35 years) to one of three different magazine articles. Two of the test articles – one featuring celebrities and one with “real life” people – included information on the benefits of birth without medical intervention.
The articles presented birth as a natural physiological event rather than a high-risk medical condition, which is how it’s often portrayed in the popular media. And they gave examples of non-medical interventions that women report as useful for managing labour and birth, such as [changing positions](http://www.ncbi.nlm.nih.gov/pubmed/24105444](http://www.ncbi.nlm.nih.gov/pubmed/24105444) and [using a pool](http://www.ncbi.nlm.nih.gov/pubmed/24310807](http://www.ncbi.nlm.nih.gov/pubmed/24310807) to labour or birth in.
They also highlighted how different maternity care providers are appropriate for different types of pregnancies. We know that midwifery care, for instance, is [associated with the best health outcomes](http://www.ncbi.nlm.nih.gov/pubmed/23963739](http://www.ncbi.nlm.nih.gov/pubmed/23963739) for women and babies with no substantial medical complications.
The third article was a control piece on organic eating. We included this to test whether just reading an article endorsing “natural” health-related approaches was responsible for any observable effects.
The way forward
We found reading an article about the benefits of giving birth without medical intervention reduced women’s willingness to accept such intervention. Profiling the experience of celebrities didn’t appear to affect impact, but explanations of the risk involved in birth and associated medical interventions did.
Of course, a single magazine article is unlikely to counteract the current collective bias toward overuse of medical intervention in birth information. But a change in the media’s approach could address women’s exaggerated perceptions of the risk of birth and provide balanced information about the benefits of natural birthing.
Still, it’s important to be mindful of the fact that some women may want and benefit from interventions that are not based on medical necessity. Any attempt to reduce medically unnecessary intervention in birth should not focus on restricting access to available options. Rather, maternity care stakeholders should seek to level the current bias and inaccuracy in the information we provide to the media so women can make the best decisions for themselves.
Our findings suggest this may simultaneously combat the increasing use of medical intervention and avoidable associated health-care costs.