Opting for natural birth: A survey of birth intentions among young Icelandic women.
OBJECTIVE
To describe and analyse factors associated with natural birth intentions in a sample of pre-pregnant Icelandic women.


METHODS
An internationally validated tool was used to survey pre-pregnant women about their attitudes towards birth. The online survey was sent to all students at the University of Iceland in November 2014. Log binomial regression was used to calculate crude and adjusted relative risks (RRa), and corresponding 95% confidence intervals (CI), for intentions of natural birth (defined as vaginal birth without epidural analgesia) by high, moderate and low childbirth fear and by high, moderate and low confidence in birth knowledge. Models were adjusted for socio-demographic and psychological factors.


RESULTS
410 eligible women completed the cross-sectional survey. Women with low fear of birth were more likely to have natural birth intentions when compared to women with moderate (RRa= 2.83; 95% CI; 1.48-5.41) and high (RRa= 4.86; 95% CI; 1.37-17.27) fear. Women with high confidence in their birth knowledge were more likely to have natural birth intentions compared to women with moderate (RRa= 2.81; 95% CI; 1.51-5.22) and low (RRa= 3.42; 95% CI; 1.43-8.18) confidence in their birth knowledge.


CONCLUSIONS
Pre-pregnant women with low fear of birth and high confidence in their birth knowledge are more likely to have natural birth intentions. Addressing concerns about pain, safety, the perceived unpredictability of birth and worries about the physical impact of childbirth may strengthen natural birth intentions.
Department of Nursing, University of Iceland, Eirberg vid Eiriksgotu, 101 Reykjavik, Iceland. Electronic address: ems23@hi.is.
Emma Marie
EM
Swift
Department of Nursing, University of Iceland, Eirberg vid Eiriksgotu, 101 Reykjavik, Iceland; University Dept. of Obstetrics and Gynecology, Women's Clinic, Landspitali University Hospital.
Helga
H
Gottfredsdottir
Department of Medicine and Centre of Public Health, University of Iceland, Stapi v/Hringbraut, 101 Reykjavik, Iceland.
Helga
H
Zoega
Midwifery Research and Education Unit, Department of Obstetrics, Gynaecology & Reproductive Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Mechthild M
MM
Gross
School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3.
Kathrin
K
Stoll
D000328:Adult; D003430:Cross-Sectional Studies; D003657:Decision Making; D036861:Delivery, Obstetric / Q000523:psychology; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007055:Iceland; D033182:Intention; D009321:Natural Childbirth / Q000523:psychology; D011247:Pregnancy; D013334:Students; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult
Childbirth fear; Confidence; Health promotion; Midwifery; Natural childbirth; Pre-pregnant