Media influences on primiparous women's mode of birth choice

Introduction
Caesarean section rates are high and rising, exceeding World Health Organisation recommendations. Primiparous women are almost three-times more likely to have a primary caesarean birth in comparison to multiparous women. Maternal choice has been cited as a common reason for caesarean birth however, there are limited data regarding these elective procedures. Literature exploring women’s decision-making surrounding mode of birth highlights that tokophobia resulting from a previous birth experience strongly influences women’s birth choices. To date, there has been limited investigation of why primiparous women elect for specific modes of birth.

Aim
To explore how media influences the perceptions and decision-making of primiparous women regarding their chosen mode of birth.

Methods
An online questionnaire yielded quantitative and qualitative responses from 509 primiparous women. Quantitative data were analysed using descriptive and inferential statistical tests while qualitative responses were analysed using a descriptive and inductive thematic analysis. Ethical approval was gained.

Result and findings
This findings of this study showed that media frequently portrayed birth as painful, and less often as calm. Respondents reported that normal vaginal birth was portrayed as more painful than the major abdominal surgery experienced during a caesarean section with media rarely depicting caesarean birth in a negative way. Despite this, viewings influenced the desire for a spontaneous vaginal birth and inferred some ambivalence surrounding caesarean section. Certain demographics, especially age and ethnicity, were less likely to desire normal vaginal birth when viewing media depicting labour and birth as painful. Three main themes were identified from qualitative data: 1) Media depiction of childbirth as painful, 2) Media influencing fear of birth, and 3) Media depiction of childbirth as unrealistic.

Conclusion
These results suggest that primiparous women are influenced by media portrayal regarding their perceptions and preferences for birth. Women exposed to more frequent viewings of painful birth may be more likely to develop tokophobia and in turn, may have less desire for a vaginal birth. Modifications to media portrayal could be useful in reducing fear of birth and rates of caesarean section. Further research is required to support these conclusions.