Childbirth is changing: what now?

To examine women's experiences, ideas, attitudes, and opinions about their prenatal care and childbirth in the first decade of the 21st century during a societal paradigm shift in birth practices. This change in birth practices seems to be away from high-touch care toward ever-increasing high-tech interventions.

Focus group qualitative data were obtained from 12 women in two focus groups recruited from a large Midwestern obstetrical practice. Constant comparative analysis was used to describe substantive themes. Focus group data were validated by a postpartum questionnaire administered 3 months after the focus groups to 185 women in the same obstetrical practice.

Three themes emerged from analysis of the women's childbirth experiences: Trust ("she was competent...calm"), Information ("information provided allowed me to make choices"), and Control ("I like having a doctor who is in charge, but will listen to me").

These results confirm a shifting birth paradigm away from the model of natural, unmedicated birth prevalent in the second half of the 20th century and affirm that women want both high-tech and high-touch care. As healthcare providers, we need to respect women's choices, especially when the women's choices would not be our personal choices. If providers are to embrace the paradox of changing birth practices, it could mean accepting high-tech practice while at the same time advocating for birth defined by women and evidence.