A Snapshot of Women’s Attitudes and Preferences Toward Labor Epidural Analgesia and Cesarean Delivery
Bibliographic record
Abstract
Studies have historically demonstrated associations between women's acceptance of, or access to, LEA and their education, socioeconomic status, ethnicity, insurance status, and urban versus rural residence, regardless of the type of health care system (public or privately funded) involved [9][10][11][12].More recent work, however, suggests that factors associated with acceptance of LEA or primary elective CD may be changing.For example, research conducted in Canada suggested that healthy multiparous Abstract Purpose: Popular media and health services data suggest a shift in pregnant women's attitudes toward increasing acceptance of labor epidural analgesia (LEA) and primary elective cesarean delivery (CD) in North America.We sought to provide a snapshot of women's attitudes towards these interventions within our institution.Methods: Following REB approval and consent, women were recruited in three groups to participate in a mixed methods survey examining attitudes/preferences for LEA and delivery mode.Groups were: (1) young non-pregnant women (18-25 years) from a university campus, (2) pregnant women attending antenatal clinic at Sunnybrook Health Sciences Centre (SHSC), and (3) older (>50 years), non-pregnant women providing non-professional labor support at SHSC.Results: 281 women participated.Thirty-two percent (38/120) of Group 1, 52% (54/103) of Group 2, and 64% (36/56) of Group 3 indicated that they would choose LEA for pain avoidance, to enjoy childbirth, conserve energy, and "no good reason not to".Conversely, 7.5% (9/120) of Group 1, 16% (16/103) of Group 2 and 16% (9/56) of Group 3 indicated that they would not want LEA for fear of risks and resistance to medical interventions.Notably, 6% (7/119) of Group 1, 10% (10/104) of Group 2 and 13% (7/56) of Group 3 indicated a preference for CD to avoid labor pain and perineal injury, maintain control and for perceived safety.Conclusions: Rising LEA and cesarean rates may reflect their increasing acceptance by women regardless of age and pregnancy status.Further work is required to explore our findings across a larger number of settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".