Opting for natural birth: A survey of birth intentions among young Icelandic women.

ABSTRACT

OBJECTIVE: To describe and analyse factors associated with natural birth intentions in a sample of pre-pregnant Icelandic women. METHODS: An internationally validated tool was used to survey pre-pregnant women about their attitudes towards birth. The online survey was sent to all students at the University of Iceland in November 2014. Log binomial regression was used to calculate crude and adjusted relative risks (RRa), and corresponding 95% confidence intervals (CI), for intentions of natural birth (defined as vaginal birth without epidural analgesia) by high, moderate and low childbirth fear and by high, moderate and low confidence in birth knowledge. Models were adjusted for socio-demographic and psychological factors. RESULTS: 410 eligible women completed the cross-sectional survey. Women with low fear of birth were more likely to have natural birth intentions when compared to women with moderate (RRa = 2.83; 95% CI; 1.48-5.41) and high (RRa = 4.86; 95% CI; 1.37-17.27) fear. Women with high confidence in their birth knowledge were more likely to have natural birth intentions compared to women with moderate (RRa = 2.81; 95% CI; 1.51-5.22) and low (RRa = 3.42; 95% CI; 1.43-8.18) confidence in their birth knowledge. CONCLUSION: Pre-pregnant women with low fear of birth and high confidence in their birth knowledge are more likely to have natural birth intentions. Addressing concerns about pain, safety, the perceived unpredictability of birth and worries about the physical impact of childbirth may strengthen natural birth intentions.