title: Health literacy and the information needs and dilemmas of first-time mothers over 35 years.
abstract: OBJECTIVE
  This paper aims to highlight the information-based dilemmas of a particular group of healthcare patients, first-time mothers over 35 years.
  
  
  BACKGROUND
  In recent years, there has been a proliferation of health-related information and a move towards greater public access to health information as an important step towards patient education and empowerment. Information technologies, such as the Internet, have added considerable momentum to this trend. Many health professionals now consider the provision of detailed health information to patients as requisite for informed decision making. Within the literature there is some emphasis on the importance of patient understanding of information received; however, to date, few studies have considered information over-consumption as problematic.
  
  
  METHODS
  Using in-depth interviews, a sample of 22 first-time mothers over 35 years was interviewed over three junctures: 35 weeks gestation, 10-14 days postpartum and six to eight months postpartum. Three focus group interviews of midwives and maternal and child health nurses were also conducted. This paper was undertaken as part of a larger project to evaluate the experience of first mothering over 35 years.
  
  
  RESULTS
  Mothers in this study were found to have access to large volumes of health information. This tendency was driven by both the women and the health professionals who cared for them. Midwives and maternal and child health nurses revealed a tendency to provide older first-time mothers with considerable health information of a medical orientation, understanding that this is what the women required. However, despite common perceptions of empowerment, the consumption of medical-type information proved frightening and many mothers described feeling overwhelmed by 'knowing too much'.
  
  
  CONCLUSIONS
  This study contributes to the limited understanding of the information needs of a growing group of childbearing women, first-time mothers over 35 years. By providing an insight into the 'downside' of extensive health information, nursing staff, in particular, may consider the amount and type of information they distribute. Some suggestions are offered to health professionals to ameliorate the information-based dilemmas of these women.
  
  
  CONCLUSIONS
  As the number of childbearing women over 35 years continues to grow, it is important for health professionals to understand the particular needs of this group. In doing so, doctors, midwives and maternal and child health nurses may be in a position to provide more meaningful maternal support.
authors.affiliation: Healthcare, Technology and Place, University of Toronto, Toronto, ON, Canada. mary.carolan@utoronto.ca
authors.forename: Mary
authors.initials: M
authors.lastname: Carolan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D004522:Educational Status; D005260:Female; D017144:Focus Groups; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008423:Maternal Age; D016389:Maternal-Child Nursing; D008875:Middle Aged; D009035:Mothers / Q000193:education / Q000523:psychology; D020380:Needs Assessment / Q000458:organization & administration*; D015404:Nursing Methodology Research; D010298:Parity; D010353:Patient Education as Topic / Q000458:organization & administration; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014739:Victoria