Experiences, knowledge, and preferences of Canadian parents regarding preterm mode of birth

Objectives To describe Canadian parents’: 1) experiences with mode of birth in preterm singleton pregnancies; 2) knowledge about maternal and infant risks of different modes of preterm birth, particularly breech birth; and, 3) communication preferences around mode of birth. Methods We conducted an online survey of Canadian parents who had experienced a preterm birth of a live-born infant between 2010 and 2019. Data were collected from August-September 2019. The sample size was calculated as requiring 96 participants. Results Of the 153 respondents, 152 were mothers. They were approximately evenly split between those who had experienced an extremely preterm birth before 28 weeks, a very preterm birth between 28-31 weeks, or a moderate-to-late preterm birth from 32-36 weeks. Most parents reported that mode of birth was discussed before the birth (amongst extremely, very and moderate-to-late preterm parents: 61.7%, 73.3% and 77.3%, respectively). The minority of parents reported being given a choice about mode of birth (20.8%, 23.0% and 36.4%, respectively). The use of written material during discussion on mode of birth was rare (2.1%, 3.3% and 6.8%, respectively). Of women who had a Cesarean section, 39.6% (36/91) were unaware of maternal risks. Many parents expressed preference for both oral and written communication during counselling on mode of birth (62.6%). Conclusions Few Canadian parents reported receiving a choice about mode of preterm birth, being aware of associated risks, or receiving written information. There is an urgent need to develop tools that provide information for parents facing preterm birth.