Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116432

Eileen A. Yam, MPH, Regional Office for Latin America and the Caribbean, Population Council, Panzacola 62 Int 102, Col Villa Coyoacan, Mexico City 04000, Mexico, 52-55-5999-8630, eyam@popcouncil.org.mx, Amy Hawkins Grossman, Department of Maternal and Child Health, University of California at Berkeley, 140 Warren Hall #7360, Berkeley, CA 94720, Sandra G. Garcia, ScM, ScD, Director of Reproductive Health for Latin America and the Caribbean, Population Council, Regional Office for Latin America and the Caribbean - Mexico City, c/o One Dag Hammarskjold Plaza, New York, NY 10017, and Lisa A. Goldman, MPH, Department of Epidemiology, University of California, Berkeley, 140 Warren Hall #7360, Berkeley, CA 94720.

Context: Most Mexican women receive maternity care at health facilities, but maternal health is still poor and Cesarean section rates are unnecessarily high. Preparation of birth plans - documents that outline women's desires for their labor and birth experiences - may empower women to have greater involvement in labor and birth decisions by facilitating communication between them and their providers. Our pilot study at a private hospital in Ciudad Juarez sought to document the acceptability and feasibility of introducing birth plans.

Methods: We recruited 20 women in their sixth or seventh month of pregnancy to complete birth plans as well as pre-and post-delivery questionnaires on basic demographics, past birth experiences, knowledge of pregnancy and childbirth, and expectations for the current birth. Participants had access to an interactive maternal health education computer program. We also performed in-depth interviews with six social workers, nurses, and physicians.

Results: Nineteen women completed birth plans and gave birth during the study period. None had previously heard of birth plans. 100% expressed complete satisfaction with the experience of completing a birth plan, despite the fact that not all of their wishes were fulfilled during labor and delivery. 37% of the participants had a Cesarean birth, compared to a 49% Cesarean rate at the hospital overall. Data analysis will be completed in spring 2005.

Conclusions: Introduction of birth plans to empower women to participate in the decision-making process regarding their labor and birth experiences is feasible and acceptable. Birth plans may help lower unnecessarily high Cesarean rates.

Learning Objectives: