"Listening to
Mothers"
In 2002, a national survey was performed by a group called
“Listening to Mothers.” The survey was conducted by the Maternity
Center Association and performed by Harris Interactive. Many of the
survey questions had never before been asked at the national level
in the U.S.
The survey included 1,583 women from across the United States
during May and June of 2002. All of the women had given birth
within 24 months of completing the survey, and the survey focused
on their experiences relating to their most recent birth -
including pregnancy, labor and birth, and the weeks and months
following delivery. The survey was designed to reflect the national
profile of childbearing women, with some limitations (they did not,
for example, include women who had given birth to twins or women
whose babies were not living at the time of the survey).
Here are some of the findings from the national survey:
Location of Births
97% of surveyed mothers’ births took place in hospitals.
Medical Interventions
Less than 1% of mothers gave birth “naturally” – that is,
without pain medication or medical interventions. The majority of
the 1% came from the home birth mother’s group.
Overall Birth Interventions
| One or More Vaginal Exams | 87% |
| Intravenous Fluids | 86% |
| Broken Membranes | 55% |
| “Pitocin” (after labor began) | 53% |
| Bladder Catheter | 52% |
| Stitching Near Vagina | 52% |
| Internal Check of Uterus After Birth | 49% |
| Episiotomy | 27% |
| Cesarean Section | 24% |
| Pubic Hair Shave | 19% |
| Vacuum Extraction | 7% |
| Enema or Laxative | 6% |
| Forceps | 3% |
Walking in Labor
Most mothers (71%) did not walk around, primarily because they
were hooked up to instruments, could not walk because of pain
medications or were told by their caregivers not to walk around.
Reasons for Not Walking Around
During Labor
| Connected to Things | 67% |
| Unable to Support Self Due To Pain Medication | 32% |
| Told Not To Walk Around | 28% |
| Chose to Stay in One Place | 21% |
| Groggy Due To Pain Medication | 20% |
| Don’t Remember | 1% |
Positions of Delivery in Vaginal Births
74% of women who gave birth vaginally did so on their backs
while pushing their baby out. 23% delivered in an upright position
(either propped up, squatting or sitting). 3% gave birth lying on
their side.
Labor Induction
Almost half (44%) of all mothers and half (49%) of those giving
birth vaginally reported that their caregiver tried to induce
labor, most commonly through the use of artificial oxytocin
(Pitocin). Almost 1/5 of those mothers stated a non-medical factor
as partially the reason for the attempted induction. The drugs used
actually caused four out of five women’s labors to begin.
VBAC’s
Of women with a previous cesarean, 26% had vaginal deliveries.
42% of women with previous cesarean births were denied the option
of a VBAC. Medical concerns and caregiver unwillingness were the
leading reasons for denial of a VBAC. A small proportion reported
hospital unwillingness.
Epidural Use
Almost 2/3 of the mothers received epidurals, including 59% who
had vaginal deliveries. Mothers gave high ratings to the ability of
epidurals to relieve labor pain but between 26-41% of mothers were
unable to respond to questions about side effects associated with
epidurals.
Pain Relief Methods Rarely Used
Although birth balls, bathtubs and hot showers are highly rated
(by the mothers who used them) to reduce labor pain, these
approaches were used by 8% or fewer of the women surveyed.
Cesarean Delivery
24% of mothers had a cesarean delivery. About half of those
deliveries were planned, predominantly among women with a previous
cesarean delivery.
Descriptions of Labor and Birth Experiences
Mothers’ Descriptions of How They Felt During Labor
| All Respondents (n=1583) |
|---|
| Positive | % | Negative | % |
|---|
| Alert | 82 | Overwhelmed | 48 |
| Capable | 77 | Weak | 41 |
| Confident | 65 | Frightened | 39 |
| Calm | 63 | Agitated | 36 |
| Unafraid | 44 | Groggy | 27 |
| Powerful | 34 | Helpless | 25 |
Feelings After Birth
How Women Felt in Weeks and Months After Childbirth
| All Respondents(n=1583) |
|---|
| Positive | % | Negative | % |
|---|
| Rewarded | 85 | Tired | 93 |
| Supported | 84 | Messy | 60 |
| Contented | 74 | Unsure | 39 |
| Confident | 73 | Isolated | 35 |
| Clear-headed | 26 | Discouraged | 26 |
| Rested | 14 | Confused | 25 |
Baby’s Location After Delivery
In the first hour of birth, most babies were in their mother’s
arms (40%) or in their partner’s arms (13%). Of those babies with
hospital staff, most were there for routine care (69%) and the rest
for some type of special care (30%). Most mothers (56%) said they
had their baby with them at all times.
Breastfeeding
67% of overall mothers intended to breastfeed their babies. 59%
of mothers were exclusively breastfeeding at one week postpartum.
While most mothers said the hospital was supportive of their
decision to breastfeed, 80% of breastfeeding mothers reported
receiving free formula samples and offers from hospital staff. 47%
of breastfed babies were given water or formula to supplement their
breastmilk.
General Postpartum Health
The most commonly described postpartum problems were physical
exhaustion (76%), sore nipples/breasts (74%), lack of sexual desire
(59%), backache (51%), or painful perineum (44%). The problems that
were most likely to persist for at least 6 months were lack of
sexual desire (16%) and physical exhaustion (11%).
Cesarean Postpartum Health
For women who received a cesarean delivery, the most commonly
identified health problem was pain in the area of incision in the
first two months after birth (83%). 25% of these mothers cited this
as a major problem while 58% said it was a minor issue. About 7% of
mothers with a cesarean said this problem persisted at least 6
months after birth.
Doulas and Midwives
While doulas and midwives are the
most highly rated providers of labor support, they were only used
by 5% and 11% of the mothers, respectively. The following charts
reflect the rating of supportive care received by the surveyed
mothers.
Base: Received Supportive Care
From Specified Person | Excellent
% | Good
% | Fair
% | Poor
% |
|---|
| Doula or Trained Labor Assistant | (n=81) | 71 | 15 | 8 | 6 |
| Midwife | (n=163) | 66 | 21 | 9 | 4 |
| Another Family Member or Friend | (n=733) | 60 | 24 | 7 | 9 |
| Partner/Husband | (n=1469) | 59 | 24 | 7 | 11 |
| Doctor | (n=826) | 52 | 30 | 10 | 7 |
| Nursing Staff | (n=1337) | 48 | 33 | 12 | 7 |
