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  Pregnant Woman Questionnaire
  Maternity Care Research Group
L408 - 4480 Oak Street, Vancouver, BC, V6H 3V4
Tel: 604-875-2196   Toll Free: 1-866-523-3360   Email: info(at)maternitycare(dot)ca
  This questionnaire is for PREGNANT WOMEN who are going to have their FIRST BABY.
  We would be grateful if you would take the time to complete the following questionnaire. Please complete all questions.
  If you are expecting your first baby, we request your participation by completing this survey.
(If you previously experienced a stillbirth, miscarriage, or for any reason had a pregnancy that ended early, we would still like you to participate.)
  Purpose of the Study:
You are invited to participate in this National Maternity Care Attitudes and Beliefs study, funded by Canadian Institutes of Health Research and supported by professional associations representing Obstetricians, Family Doctors, Midwives, Nurses, and Doulas.  Through this research project we seek to gain a better understanding of the attitudes and beliefs of women who are expecting their first baby as well as the views of maternity care-givers (Obstetricians, Family Physicians, Midwives, Nurses, and Doulas).  We are interested in learning more about how women and care-providers think about key issues and challenges concerning maternity care in Canada.  We believe that your views on this issue are most important in helping to shape future practice, education, policy, and organizational models.
  Study Procedures:
This questionnaire will take approximately 10 minutes to complete.  Your participation in this study is voluntary and you may withdraw from it at any time.  By completing and submitting the questionnaire, it is assumed that you have given your consent to participate in this study.  Confidentiality will be respected throughout this process.  No information that discloses your identity will be released or published, and only the researchers listed will have access to the data.  As researchers we are focusing only on group, not individual, responses. Please complete this survey only once.
  Contact Information:
If you have any concerns about your rights as a research participant and/or your experience while participating in this study, contact the Research Subject Information Line at the University of British Columbia, Office of Research Services at 604-822-8598.  For all other enquiries, please contact Jessica Rosinski at 604-875-2196.
  Should you prefer to fill out a paper questionnaire, please call us at: 1-866-523-3360, or email us at: info(at)maternitycare(dot)ca to request one.
  Thank you for your support and input.
  Investigators:
Michael C. Klein, MD, CCFP, FAAP (Neonatal/Perinatal), FCFP, ABFP; William Donald Fraser, MD, MA, FRCSC; Robert Liston, MB ChB, FRCSC, FRCOG, FACOG; Patricia McNiven, RM, PhD; Lee Saxell, RM; Sharon Dore, RN, PhD; Wendy Hall, RN, PhD; Kathleen A. Lindstrom, CD (DONA International), Doula Educator; Rollin Brant, PhD; Janusz Kaczorowski, PhD; Jude Kornelsen, PhD; Oralia Gómez-Ramírez, MA, Research Assistant; Azar Mehrabadi, MSc, Research Assistant; Jessica Rosinski, MA, Project Manager
  By completing this questionnaire, you are consenting to participate in this study.
1) Are you pregnant with your first baby? (If you previously had a stillbirth, miscarriage, or for any reason had a pregnancy that ended early, we still want you to answer this questionnaire.)
 
2)
 
3) Currently, I live in:
 
 
4) I plan to give birth in a:
 
5) If needed, would you be able to access a surgeon within 30 minutes?
 
6) Where are you planning to give birth?  
 
7) Currently, I live in a:
 
8) Is it possible for you to give birth in the area where you are living?
 
9) Are there services that allow you to have a complicated birth in the area where you are living (for example a cesarean section)?
 
10) How many babies are you planning to have in total?
 
11)
 
12) In this pregnancy, how did you become pregnant?
 
13) Have you ever had a (Check ALL that apply to you):
 
14) Who is your main maternity care provider in this pregnancy?
 
 
15) In which month of this pregnancy (e.g. 1, 2, 3 ... or 9) did you begin your pregnancy care with any one or more of the following maternity care providers? (Make your best guess and fill in the box(es) that apply to you)
 
 
16) For pregnancy care, how many times have you seen one or more of the following maternity care providers? (Make your best guess and fill in the box(es) that apply to you).
 
 
17) How would you describe your pregnancy?
 
 
18) Are you planning to give birth vaginally?
 
19) Are you planning to give birth by cesarean section?
 
20) Would you follow your maternity care provider's recommendation if it did not fit your plan?
 
 
21) If you had a choice, who would you prefer to deliver your baby? (Check ONLY one)
 
 
22) How did you decide on the previous question? (Check ALL that apply to you)
 
 
23)
 
24) Do you already have, or are you planning to have, a doula for your current pregnancy? (A doula is trained support person for the mother other than a partner or a family member)
 
  The following sections contain questions pertaining to your opinions and beliefs about maternity care. Make your choice by selecting the box from the scale that most accurately represents your opinion. The scale ranges from strongly disagree to strongly agree. You are also given the option to answer "I don't know" in the far right column.
  Attitudes and Beliefs
25) Attitudes and beliefs about maternity care:
 
  Childbirth can only be considered normal after you’ve given birth.
  The most important thing in having a normal birth is the woman’s own confidence in her ability to give birth.
  Home birth is more dangerous than hospital birth, even in an uncomplicated pregnancy.
  If available, out-of-hospital birth centres can provide safe maternity care for women with no pregnancy problems.
  Obstetricians should provide maternity care only for women who have problems in their pregnancy.
  I support regulated/licensed midwifery in my province.
  I believe that sexual abuse can have an important effect on the course of labour and birth.
   
  Childbirth usually requires medical technology.
  Women who want a cesarean section for no medical reason should pay for it.
  I believe that having a vaginal birth is a more empowering experience than delivering by cesarean section.  
  It is a woman's right to choose a cesarean section for herself, even if there are no medical reasons to have it.  
  If my baby was in a bottom-first position rather than in a head-first position, I would prefer to try a vaginal birth over a cesarean section.
  When a woman is in labour, the safest place for her to be is in the hospital.
  Women who deliver their baby by cesarean section miss an important life experience.
   
  Having a birth plan (written outline of preferences for labour and birth) is a good idea for a pregnant women.  
  Vaginal birth helps a child's brain development.
  There is a need for doula services in maternity care.  
  I believe doulas have a positive effect on birthing experience.  
  I believe that having babies by cesarean delivery is less embarrassing than having them vaginally.
  I believe that a woman recovers faster after a cesarean section than after vaginal birth.  
  I believe that breast feeding makes a woman’s breasts less attractive.  
  Epidural (Epidural is a pain reliever given through a needle in the back.)
26) Epidural:
 
  An epidural should be routinely offered to all women in labour.
  An epidural increases the use of forceps (a two-bladed instrument to assist the baby moving down the birth canal) and vaccum extractors (a suction device to assist the baby moving down the birth canal).
  Epidurals interfere with the normal progress of labour.
  An epidural, when used early in labour (less than 4 cm of cervical dilatation), may cause more back labour (when the baby's head is pointing at the mother's back rather than toward the front--leading to back pain and slowing of labour).
  An epidural should be administered whenever a woman requests it.
  This section contains multiple choice questions. Please complete all questions.
  Clinical Approaches Used in Maternity Care
27) If I have not given birth by a week and half past my due date, I would prefer to: (Check ONLY one)  
 
28) For the delivery of the afterbirth (also called placenta), I would prefer to: (Check ONLY one)  
 
29) To get relief from my labour pain, my preferred method is: (Check ONLY one)  
 
30) During my labour, I would prefer the condition of my baby in my womb to be assessed/evaluated by: (Check ONLY one)
 
31) Overall, I think the current cesarean section rate in Canada is: (Check ONLY one)
 
  This section contains questions pertaining to your opinions/beliefs about maternity care. Make your choice by selecting the box from the scale that most accurately represents your opinion. The scale ranges from strongly disagree to strongly agree.
  Cesarean Section (Cesarean section is a surgery on the uterus performed to deliver a baby. It is also known as c-section)
32) Cesarean Section:
 
  Compared with vaginal birth, cesarean section prevents bladder problems (such as urine frequency, urgency or loss) in the future.
  Compared with vaginal birth, cesarean section prevents future sexual problems for the mother.
  Compared with vaginal birth, cesarean section is more convenient for mothers.
  Compared with vaginal birth, cesarean section is more convenient for maternity care providers.
  Cesarean section is a less painful method of delivery than vaginal birth.
  Compared with vaginal birth, cesarean section helps women regain their previous shape.
  Cesarean section costs more for the health care system than vaginal birth.
  Compared with vaginal birth, cesarean section is safer for the baby.
  For women, cesarean section is as safe as vaginal birth.
  Having a baby by cesarean birth creates more problems than it solves.
33) I believe that important reason(s) for the rising cesarean section rate in Canada could include:
 
  Women’s belief that a cesarean section by mother’s choice is safer for the baby than a planned vaginal birth.
  Women’s belief that cesarean section by mother’s choice is safer for themselves than a planned vaginal birth.
  Physician’s belief that performing a cesarean section reduces their chance of being sued.
  Women’s belief that a cesarean section is less painful than a vaginal birth.
  Changing population characteristics (such as increases in mother’s age at birth and increases in obesity) among pregnant women.
  Early hospital admissions before the start of the active phase of labour.
  Increasing interventions by professionals (e.g. induction, continuous electronic fetal monitoring, etc).
 
34) I believe that important approach(es) for supporting vaginal birth could include:
 
  Changing medical and nursing education to encourage more positive attitudes toward vaginal birth.
  Requiring doctors to get a compulsory second opinion from another doctor before performing a cesarean section.
  Providing more midwifery services.
  Providing more doula services.
  Encouraging more family doctors to provide labour and delivery care.
  Reducing the number of inductions of labour (artificially starting labour with medications).
  Increasing the number of nursing staff in order to provide one-to-one care for labouring women.
 
  Episiotomy (Episiotomy is a cut made at the bottom of the vagina to enlarge the opening for birth.)
35) I believe that episiotomy, if done routinely:
 
  Prevents urinary problems in the future.
  Prevents sexual problems in the future.
  Can prevent large vaginal tears.
  Causes more problems than it prevents.
  Opinions
36) What is your overall opinion about the safety of childbirth for the mother? Given the scale below, check one box: one as not dangerous for the mother and ten as extremely dangerous for the mother.
 
 
 
 
 
 
 
 
 
37) What is your overall opinion about the safety of childbirth for the baby? Given the scale below, check one box: one as not dangerous for the baby and ten as extremely dangerous for the baby.
 
 
 
 
 
 
 
 
 
38) In general, how would you rate your pain tolerance or ability to deal with pain? Given the scale below, check one box: one as not tolerant and ten as very high tolerance.
 
 
 
 
 
 
 
 
 
39) How would you rate your fear about your upcoming birth experience? Given the scale below, check one box: one as not fearful and ten as extremely fearful.
 
 
 
 
 
 
 
 
 
40) How do you rate your self-confidence about your upcoming birth? Given the scale below, check one box: one as not confident and ten as extremely confident.
 
 
 
 
 
 
 
 
 
  This section pertains to demographic information. As with previous sections, all information will be kept confidential and will not be used to identify individual respondents.
  Demographics
41) How did you obtain or hear about this survey?
 
 
42) Marital Status:
 
43) Was your current pregnancy?
 
44) What is your ethinic origin?
 
 
45) What is your religion, if any?
 
 
46) What is the level of your education?
 
47) Are you using a translator to complete this questionnaire?
 
48) Approximately what is your annual household income before taxes? (If unsure make your best guess)
 
  You have completed the questionnaire. Please ensure that you have responded to all questions. We welcome any further comments in the space below.
 
  Thank you for your time. Your input is very valuable to us.
  Maternity Care Research Group
L408 - 4480 Oak Street, Vancouver, BC, V6H 3V4
Tel: 604-875-2196   Toll Free: 1-866-523-3360   Email: info(at)maternitycare(dot)ca