The First Baby Study: What women would like to have known about first childbirth. A mixed-methods study

Although prenatal care providers aim to prepare women for first childbirth, little research has explored retrospectively what birthing people would like to have known before first childbirth.

To describe women's reports of what they would like to have known before first childbirth but feel they were not told.

This is a secondary analysis of the First Baby Study, a large prospective cohort study conducted in Pennsylvania, USA. Telephone interviews were conducted with 3006 women 1 month after their first childbirth. Women were first asked: "Was there anything that you would have liked to have known before your delivery that you were not told?". If "yes" they were asked a second question: "Please tell me what you would have liked to have known before your delivery".

A convergent mixed-methods analysis including descriptive analytics to compare characteristics of women by answers to the first question, and qualitative content analysis of women's open-ended answers to the second question.

A total of 441 women (14.7%) reported there was something they would like to have known before their first childbirth. Women described that communication with care providers was their main concern. They would have liked a better understanding of their options before birth, more agency in decision-making, and more information about the topics of their body, their birth, their baby, and what to expect beyond birth.

Results highlight important topics for childbirth education, and the impact of gaps in shared decision-making, patient-provider communication, and supportive care practices for first childbirth, especially where women have identified vulnerabilities.