The Maternity Support Survey is the first study to explore three different, but related, careers in terms of their approach to maternal support and care. This comprehensive research will survey doulas, childbirth educators, and labor and delivery nurses from across the United States and Canada about their knowledge and attitudes toward current childbirth practices, technologies and support. Topics that the survey will investigate include: whether doulas and childbirth educators view their maternity support work as a career, how doulas and childbirth educators establish their expertise, how technology affects workload among labor and delivery nurses, how maternity support workers are affected by managed care and litigation concerns, and emotional burnout among maternity support workers.
The Maternity Support Survey invited the following organizations to collaborate in the recruitment of participants: Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN); Birthing from Within; Lamaze International; International Childbirth Education Association (ICEA); BirthWorks; DONA International; toLABOR (was ALACE); CAPPACanada, and Health Connect One.
There is an increasing awareness in the United States and Canada that maternal outcomes are worsening despite spending more on health care than other developed countries. The quality improvement initiative in medicine has newly arrived in obstetrics, with The Joint Commission updating its perinatal core measure set in April 2010, for the first time in several years. This gives hospitals the opportunity to report on their rates of low risk cesareans among first time mothers and elective deliveries at less than 39 weeks’ gestation.
While there are a variety of views of contemporary North American maternity care outcomes, research has shown that support during labor and delivery has a significant impact on method of delivery, maternal and neonatal morbidity, and rates of postpartum depression. Yet existing research in maternity care has tended to explore how mothers and families view their care, with less attention to the views of individuals who provide support to women during pregnancy and birth. Similarly, research on maternity clinicians has largely focused on midwives and to a lesser extent, obstetricians but there has been no systematic research focused on non-provider roles in maternity care: nurses, childbirth educators and doulas.
It is an opportune time for the findings from this unique study to be of value to key stakeholders in health care reform and quality improvement. Most directly, the information will be of use and interest to the organizations who represent the interests of these maternity care workers. In many ways, the changes that some maternity advocates seek cannot be undertaken without a better understanding of the views and values held by the frontline workers in maternity care: labor and delivery nurses, childbirth educators and labor support doulas. These workers provide pregnant women with information, support, and advocacy as they approach labor and experience childbirth. For the most part, research on childbirth has overlooked these workers. The findings from this research will inform analysis and theory in nursing, public health, and social sciences around improving maternity care in the United States and Canada.
Measuring quality in maternity care requires resources, in terms of data collection and reporting, and is the topic of several legislative bills before Congress. We plan to seek funding from public and private sources. If you have a funding source to recommend, please click here.
If you click here you can read about the team that has formed this independent research project and about team members’ specific research interests. We have acquired our IRB approval through the University of Arizona IRB under Principal Investigator, Associate Professor Louise Roth.