Fear of Childbirth and Preference for Cesarean Delivery

Congratulations Kathrin!

Kathrin Stoll, Joyce Edmonds, and Wendy Hall’s full article in Birth: Issues in Perinatal Care is linked here: Stoll_et_al-2015-Birth

ABSTRACT:

Background: Fear of birth and mode of delivery preferences are similar among pregnant and non pregnant women, suggesting that attitudes toward birth are formed in young adulthood or earlier. Understanding why some young women fear birth and prefer obstetric interventions can inform public health initiatives aimed at reducing fear and promoting birth as a normal life event.

Methods: We conducted an online survey with 752 American nulliparous young women to assess their preferences and attitudes toward childbirth. We identified explanatory variables associated with reported fear of childbirth and cesarean delivery (CD) preferences.

Results: A preference for CD was reported by 14 percent of young women and 27 percent had scores indicating elevated fear of birth. Fear of birth increased the likelihood of cesarean preference (adjusted relative risk (ARR) 3.84 [95% CI 2.49-5.95]) as did a family history of CD (ARR 1.65 [95% CI 1.13-2.42]). The likelihood of reporting elevated childbirth fear was increased among young women who reported concerns about the physical changes pregnancy and birth have on women’s bodies (ARR 2.04 [95% CI 0.42-0.87]). Access to childbirth information was also associated with a decreased likelihood of fear of birth (ARR 0.75 [95% CI 0.59-0.95]).

Conclusions: Young women reporting high levels of childbirth fear are nearly four times more likely to prefer a CD. Specific fears, such as worries over the influence of pregnancy and birth on the female body, need to be addressed before pregnancy.

 

 

Publishing notes

Two journals to think about if you’re looking to publish:

The International Journal of Birth and Parent Education is seeking more Canadian content.

and,

Paediatric and Perinatal Epidemiology‘s Impact Factor has risen from 2.811 in 2014 to 3.131 in 2015, ranking the journal at 12/79 in Obstetrics and Gynecology, 11/119 in Paediatrics, and 29/162 in Public, Environmental and Occupational Health. The top articles of 2014 are online free right now.

 

Writing: Challenge and Strategy

From the Language and Literacy Education program at UBC, some more thoughts and resources on the specific challenge of  graduate and postdoctoral student writing.  Their presentation here discusses rethinking writing as a process and a situated social act, and strategizing not only for better products, but for building better writing process.

Additional link available for  Writing Resources at UBC

 

 

Structure of a Journal Article

Writing a Journal Article

Introduction (from general-specific)
1. Set the context and background – What’s the problem?
2. What is the scientific/clinical/public health importance of this problem?
3. Demonstrate the gap in research to date, i.e. what makes your work unique – no one has done it before.
4. Objectives – State the specific research question you are addressing.

Methods
o Name the study design.
o Describe exposures of interest and primary and secondary outcomes. Justify these.
o State hypotheses.
o Describe inclusion and exclusion criteria.
o Describe study setting
o Include power calculations
o Describe analysis plan. Name variables that you will be evaluating as potential confounders and effect modifers.

Results
o Describe number of subjects in comparison groups, rate of participation among eligible subjects.
o Compare baseline characteristics of comparison groups. This material will be in Table One –give an overview in the text.
o Describe findings – make your primary and secondary outcomes clear.
o Present adjusted and non-adjusted estimates of risk (Table two).
o Findings from subgroup analyses if relevant.

Discussion (from specific  general)
o Summarize your main findings—What is the punch line?
o Explain findings – what was the mechanism linking outcomes to exposure?
o Use Hill’s criteria for causality to explore if this is a causal relationship: biological gradient, temporality, consistency with other findings, strength    of association (size of RR, OR), biological plausibility, coherence with what is known about the subject.
o Discuss study imitations (with a rebuttal). Think one step ahead of the reviewer.
o Conclusion
o Implications for practice, if relevant.
o Recommendations for future research.

Read Journal of the American Medical Association, American Journal of Epidemiology, New England Journal of Medicine, and Lancet as examples of good writing.

Giving Great Talks

This comes from the series at SPPH:

Going Public with Impact
by Jennifer Gardy
http://spph.ubc.ca/seminar-series/going-public-with-impact-seminars/

I found an interesting tip from Jennifer was to write out your script first – concentrating on your key message – and then go back and start making slides.  But there are many more tips in the attached pdf that focus on:

1. Delivering a clear, concise message

2. Creating memorable visuals

3. A confident and authentic delivery

The most important take home message was – of course – Rehearse, rehearse, rehearse!

GPWI_Giving Great Talks

Peer Writing Groups – Tips and Resources

Earlier this month I attended a workshop at UBC titled:

Break the Isolation: Strategies for Improving Your Academic Writing through Peer Support

The workshop was coordinated by Jacqui Brinkman and Graduate Pathways to Success (GPS).  She noted that GPS is going to focus more attention on writing for graduate students due to strong feedback suggesting that students are interested in improving this skill.  In other words, I got the impression that she is hoping to strengthen the resources available for graduate students to work on their writing.

Regarding this workshop, I will share the links and slides that we went over.  The facilitators were from the UBC Writing Centre, and they presented best practices on forming writing groups.  I didn’t need any convincing about the advantages of using a writing group (or other writing management strategies), but the facilitators did go over these topics briefly.  We were left to network with the other participants by the end in hopes of forming a potential writing group.  A few key points that I took away were:

Consider interdisciplinary groups.  The obvious advantage is to learn to receive and give feedback to students from other disciplines.  On the other hand, sometimes it is very useful to have peers in your area looking at your writing, especially if they are on a similar career track.

Writing goals. The facilitators cautioned about tying your goals to upcoming deadlines.  Instead, they reported that the most productive groups make goals around the kind of writing they would like to improve upon.  This adds to sustainability of the group too.

Set some ground rules. Make some decisions about how often to meet, communication, how to exchange drafts, who will provide feedback, etc. and then commit to it.

Work and Play. In that order – plan some time at the end of the meeting to relax when the work is done.

Workshop slides: Graduate Writing Groups Feb 3 2015_Final

Workshop handout: Questions for Writing Groups


 

Here are some additional related links for resources and reading that were provided at the end of the workshop… Continue reading