Obstetrician, Family Physician, or Midwife: Preferences of the Next Generation of Maternity Care Consumers

Nichole Fairbrother, PhD, RPsych; Kathrin Stoll, MA, PhD (Cand.); Laura Schummers, BSc; and Elaine Carty, MSN, CNM

ABSTRACT
Objective: The purpose of this study was to identify the views of a cohort of Canadian university students related to maternity care provider preferences and the reasons for these preferences. Relationships between care provider preferences, childbirth attitudes, and desire for epidural anesthesia and cesarean section (CS) were also examined.
Methods: This was a large cross-sectional survey (N = 3,680) of male and female university students at the University of British Columbia (male, 991; female, 2,676). Students were invited to participate via an electronic letter of invitation containing a link to this online survey.
Results: Approximately half of all participants (51.8% for women and 43.7% for men) selected an obstetrician as one of their preferred care providers; somewhat fewer selected a family physician (40.1% for women and 32.8% for men), and even fewer selected a registered midwife (30.1% for women and 18.0% for men). Among the 11 reasons for these preferences (coded from open-ended responses), the most common were expert/specialist, safety, and quality of relationship with care provider. Attitudes toward vaginal birth as well as mode of delivery and pain management preferences were found to relate to caregiver preferences.
Conclusion: Provider preferences among university students are largely driven by perceived risk, level of confidence in birth, and attitudes toward obstetric interventions. These preferences, in combination with the current shortage of maternity providers in Canada, indicate a need for restructuring maternity care human resources.

KEYWORDS
Birth choice, maternity care providers, attitudes, university students

This article has been peer-reviewed.