Addressing rising cesarean section rates through social health marketing

Background: Nationally, cesarean section deliveries (c/s) are rising. Although social health marketing is increasingly becoming an important public health tool, there is little data on utilizing this strategy to proactively address childbirth choices. Objective: To develop an awareness campaign to reduce unnecessary elective inductions and elective primary c/s prior to 39 weeks gestation. Methods: A mixed methods approach to data collection/analysis was utilized. Five consumer focus groups (FG, N=19) and eleven key opinion leader interviews (KOLI) were conducted with participants from 3 NY Counties to determine how families make childbirth delivery mode (DM) decisions. Results: A preliminary analysis of FG and KOLI reveals the dynamic nature of the decision-making process on desired DM. Birth planning is not generally practiced by primiparas. Regardless, most women noted the significance providers have on DM choice. Although consumers wished for more information from providers, there was a general distrust that information was not always given about the actual risks and benefits (RAB) of DM. KOLI demonstrated knowledge of increased risks of c/s vs. vaginal delivery. In addition to provider conversations and traditional media outlets, peer-led discussions and social media outlets were noted by FG and KOLI as reputable dissemination methods. Conclusions: FG and KOLI demonstrate women do not have an accurate understanding of the RAB of DM. Consumers are eager for more educational opportunities related to childbirth. Campaign strategies and images will be developed for consumers based on these data. DM tracked prior and after the launch of the awareness campaign will determine effectiveness.