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The purpose of this research is to analyze emerging trends in delivery. The research will look at the influence doctors, families, childbirth classes and other modes of gaining knowledge have on the choice of delivery method. An unstructured survey will be the most appropriate method of measurement for gathering the information required for analysis. My sample would comprise of 1500 first time pregnant women in their third trimester of pregnancy out of which I would expect to have a 75% response rate. The samples would consist of both natural United States citizens and un- naturalized immigrants. Due to the anticipated large number of possible candidates, a cluster sampling of women in different types of educational classes and in hospitals in New York would be done. New York City is an appropriate location for my research because it has both urban and rural communities with people from different ethnical and financial backgrounds. Thus if either of these variables were to be related, it could be closely examined.
I have targeted American women giving birth for the first time in my survey. This is because in most cases, it is these women who harbor uncertainty and fears which could possibly influence them to opt the c-section way as opposed to natural birth. The primary reason for my choice of American women rather than immigrants is that I am concerned that immigrants could lead to skewed results either because of language or cultural barriers. Women in the “low risk” category can choose between the two models of birth thus women in “high risk” category or with any sort of medical condition are not illegible for this test. The research focuses on women in their third trimester who are novices in giving birth and don’t know what to expect. In this survey, I will attempt to determine their perceptions on childbirth and the methods in which they have obtained information regarding the topic. This will be helpful in finding out why they prefer C-section to using natural childbirth methods. More importantly, what type of delivery method do they prefer and their influence to decide on the methods.
The survey will incorporate multiple variables that are crucial to its success. Prior research has been conducted on the relationship between educational classes and the outcomes of pregnancy. Conversely, limited research has been done on the relationship between the education and the selection of the birth model. This is an attempt to retest those hypotheses and measure the most significant factor in the decision making. The participants are to be divided into two groups: one based on their income level and the other on ethnical background. These are two consistent variables in the research. Both groups would be surveyed and measured on the basis of two models. During the interview process, they would be asked a series of questions designed to gather information along with some questions designed to analyze their knowledge of the various childbirth options and the ones they are exposed to. Being able to determine the available methods of education and the ways in which that information was gathered by the subjects would be most helpful in determining the primary influencing factors in selecting a childbirth method.
Since C-section is an expensive undertaking, it might be assumed that women with higher income will select it more often than those with limited income. It would be interesting to see the difference between the higher income and lower income women in determining if income affects the decision making process, thus making this not a choice but something that is forced upon them based on economic status. The period of staying in the hospital after the surgery is the same thus the cost is the same, it’s the fact that it’s easier and more effortless that causes women to prefer surgery. In this case, health care and insurance companies play a large role. According to Bost,
“Health care providers could equalize the costs of elective cesarean delivery and attempted vaginal delivery. If hospitals continue to seek reimbursement on a global charge basis and are unable to track or charge outside parties for the specific costs that are attributable to each patient, they should consider charging the same price for attempted vaginal delivery as for elective cesarean delivery because it reflects more accurately the true usefulness of resources to provide obstetric care. Physicians should consider doing the same. This would remove the economic interest of outside parties in the decision for route of delivery (namely, insurance companies and the government) and, in the opinion of this author, make tracking of the cesarean delivery rates of hospitals and physicians of historic interest only. This change could open the door for a policy of cesarean delivery on demand”.
The results from this group should indicate the extent of doctor’s influence on the person’s choice by asking them “Did your doctor suggest c-section?” or “Did you do any research in addition to your doctor’s advice?” Previous studies have shown that women covered by private insurance have the highest caesarean section cases. “Women covered by Medicaid, those covered by health maintenance organizations (HMOs) and those without sources of payment (self-pay) have lower C-section rates. Lower C-section rates also are observed in teaching hospitals, public hospitals and salaried physicians” (Stafford).
The implication of having a Caesarean section is a blur to many woman and many doctors gladly support a section rather than fully explain both options. It is a very intriguing choice: have your baby at a time and place that you choose without ever having to go through labor. This idea is being promoted to a greater extent by celebrities who are under pressure to remain fit and beautiful in readiness for their shows right after surgery. Subsequently, after giving birth, since they are already under heavy anesthesia, these movie idols endanger their lives by undergoing plastic surgery. A study by L. Penna and S.Arulkumarann illustrated the influence of social peer pressure on women’s decision making; taking an example of famous celebrities was one of them. The other factor is the amount of influence the people close to the subject have. Based on the experiences of others, uninformed pregnant women make assumptions. Women look up to others for guidance; they hear horror stories of a person being in labor for three days or inspiring stories of how natural birth given them the ultimate spiritual experience. At the end, like any human being, pregnant women conform to the social behaviors such as people influencing them on their decision.
Participants must be U.S born citizens since immigrants have different cultural backgrounds and their backgrounds could be biased towards natural childbirth. Linda Lee conducted a study which illustrated the influence of Chinese culture on labor. This section will therefore avoid any interruptions. Even though most women in the United States come from different ethnic backgrounds, their second generation is more Americanized. Therefore, the subject’s ethnicity becomes an important variable which necessitates their being third generation and non-immigrants. I have also included age as a minor factor. Regardless of their age, women who are pregnant for the first time do not have a clear understanding of what to expect. Nonetheless, the more mature they are, the less likely they are to be at risk. On the other hand, there is an increasing proportion of c-section among women under 25 (Atura).
As the number of c-sections increase, there is need for more and more studies to be directed towards this topic. Although prior studies have measured different variables and perspectives of this topic, my research would evaluate previous tests and demonstrate which factors most influence women’s decisions regarding the type of birth model they choose. The weakness of this study is that it is difficult to measure a variable. For example, the attitude of a metropolitan city vs. a country city. Metropolitan cities are on the fast pace thus might help in evolution of such trends, whereas in the country midwives are mostly used in childbirth.
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