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Exploring caesarean section decision-making in newcomer and Canadian-born women in Edmonton, Alberta

Abstract
Caesarean section (C-section) deliveries are conducted when there is a failure to progress in labor, or compromised fetal status. However, they place women at higher risk for immediate complications compared to vaginal deliveries. Mumtaz et al. (2014) showed that newcomer women in the prairie provinces experienced significantly higher C-section delivery rates compared to Canadian-born women, even though rates of recommendations by healthcare providers was equal. This on-going study aims to understand this trend, and explore how decisions regarding C-section deliveries are made within the experiences of newcomer and Canadian-born women. A focused ethnography was conducted at a universityaffiliated hospital in Edmonton, Alberta for an 8-month period in 2015. The study population comprised: 1) newcomer women who immigrated to Canada after 2004 and 2) Canadian-born women. Both groups consisted of women who have a higher risk of undergoing a C-section. Data collection strategies included participant observation of prenatal appointments, labour and delivery along with in-depth interviews with the women. Preliminary findings indicate that decisions to have emergency C-sections were solely due to physician recommendations. Women stated the safety of the baby as the main reason for following physician recommendations.
Authors: P. Sivananthajothy,Z. Mumtaz Publication Date: 8/20/2016

Publication Type: Journal Article

URL:https://annalsofglobalhealth.org/articles/10.1016/j.aogh.2016.04.501
Notes

Community organizations: n/a

Integration timeline: not defined

Key findings:

  • Decisions to have emergency C-sections were solely due to physician recommendations.
  • Women stated the safety of the baby as the main reason for following physician recommendations.
  • Both newcomer and Canadian-born women revealed deep-rooted trust in the recommendations, which was rarely questioned when the health of the baby could be compromised.
  • When exploring decision-making of processes, which did not compromise the health of the baby, Canadian-born women were more likely to question the decisions of healthcare providers, and actively provide their opinions compared to newcomer women.
  • Canadian-born women were more likely to recognize their patient rights, especially if they or their family members were part of the medical community.

Key populations:

  • newcomer women
  • Canadian-born women

Key recommendations: Continue research and associated policy and practice changes to ensure newcomer women have an active and informed role in decision-making processes regarding labor and delivery.

Future research / gaps identified: The findings indicate a discrepancy in the role of the Canadian-born and newcomer women as patients, and further research is required to ensure newcomer women play an active, informed role in decision-making processes.

Location: Edmonton, AB

Open access: No


Collections children-youth-and-elderly , physical-and-mental-health , women

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