Do mothers of NICU babies understand delivery risks?

Background:Prematurity and cesarean section (c/s) delivery rates are rising nationally for unknown reasons, although maternal request for c/s has been implicated. Little is known regarding maternal knowledge of full term (FT) pregnancy length, and how that relates to her understanding of the safety of elective c/s (Ec/s).

Objective:To asses NICU mothers' knowledge of the length of FT pregnancy, advisability of c/s, and whether this knowledge influenced attitudes towards late preterm Ec/s.

Methods:Mothers having a NICU infant were surveyed over a 6 week period. Chi square and Fisher's Exact Test used.

Results:Of 46 eligible mothers of NICU infants approached, 28 (61%) consented and completed the survey. When asked about an uncomplicated delivery, 32% of the study population didn't know that vaginal delivery (VD) was safer then Ec/s. Although knowledge of FT pregnancy (37-41 wks) was absent in only 8%, 39% were unclear of the advisability of scheduling delivery for convenience between 35-36 wks. Knowledge of safety of c/s vs. VD was linked to that of advisability of scheduling a delivery at 35-36 wks (p=0.004). Married mothers had more knowledge that c/s is not safer than VD, but this knowledge did not vary by race/ethnicity, income, or age. Knowledge of the advisability of scheduling delivery at 35-36 wks was associated with previous births, ethnicity, but not race.

Conclusions:In NICU mothers, there are surprising knowledge gaps of safety and timing of delivery mode. These data support the association of rising prematurity and c/s, and emphasize the importance of preconception education.