How do informal information sources influence women\u2019s decision-making for birth? A meta-synthesis of qualitative studies

Ruth A Sanders,Kenda Crozier

doi:10.1186/s12884-017-1648-2

Abstract

BackgroundWomen approach birth using various methods of preparation drawing from conventional healthcare providers alongside informal information sources (IIS) outside the professional healthcare context. An investigation of the forms in which these informal information sources are accessed and negotiated by women, and how these disconnected and often conflicting elements influence women’s decision-making process for birth have yet to be evaluated. The level of antenatal preparedness women feel can have significant and long lasting implications on their birth experience and transition into motherhood and beyond. The aim of this study was to provide a deeper understanding of how informal information sources influence women’s preparation for birth.MethodsSeven electronic databases were searched with predetermined search terms. No limitations were imposed for year of publication. English language studies using qualitative methods exploring women’s experiences of informal information sources and their impact upon women’s birth preparation were included, subject to a quality appraisal framework. Searches were initiated in February 2016 and completed by March 2016. Studies were synthesised using an interpretive meta-ethnographic approach.ResultsFourteen studies were included for the final synthesis from Great Britain, Australia, Canada and the United States. Four main themes were identified: Menu Birth; Information Heaven/Hell; Spheres of Support; and Trust. It is evident that women do not enter pregnancy as empty vessels devoid of a conceptual framework, but rather have a pre-constructed embodied knowledge base upon which other information is superimposed. Allied to this, it is clear that informal information was sought to mitigate against the widespread experience of discordant information provided by maternity professionals.ConclusionWomen’s access to the deluge of informal information sources in mainstream media during pregnancy have significant impact on decision making for birth. These informal sources redefine the power dynamic between women and maternal healthcare providers, simultaneously increasing levels of anxiety and challenging women’s pre-existing ideations and aspirations of personal birth processes. A lack of awareness by some professionals of women’s information seeking behaviours generates barriers to women-centred support, leaving an experience expectation mismatch unchecked.Trial registrationCRD42016041491 17/06/16.

Highlights

Women approach birth using various methods of preparation drawing from conventional healthcare providers alongside informal information sources (IIS) outside the professional healthcare context
The methods employed by women in preparation for birth vary depending on demographic differences including age, relationship status, educational level, socio-economic position and societal environment as well as parity and previous birth experience bearing strong influence [3, 4]
Meta-synthesis is acknowledged to be an effective way of collating, interpreting and representing synthesised qualitative data, arguably the most recognised format of synthesising qualitative studies [30, 31], with processes of the method documented by many authors [32, 33]

Summary

Introduction

Women approach birth using various methods of preparation drawing from conventional healthcare providers alongside informal information sources (IIS) outside the professional healthcare context. An investigation of the forms in which these informal information sources are accessed and negotiated by women, and how these disconnected and often conflicting elements influence women’s decision-making process for birth have yet to be evaluated. Women negotiate a complex array of decision-making processes involved in preparing for birth. This involves aspects of care including different approaches toward birth preparation, choice of birth environment, exploration of mode of birth, all framed within women’s individual perceptions, unique aspirations and wishes. The methods employed by women in preparation for birth vary depending on demographic differences including age, relationship status, educational level, socio-economic position and societal environment as well as parity and previous birth experience bearing strong influence [3, 4]. Decisionmaking in healthcare is motivated by factors including elements of problem-solving and informed choice, requiring a collaborative dynamic of women-carer relationship [7, 8] until a consensus is reached through deliberation and consideration

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Discussion

Conclusion