Changes in perceived knowledge about childbirth among pregnant women participating in the Senses of Birth intervention in Brazil: a cross-sectional study

Abstract

Background: Senses of Birth (SoB) is a health education intervention in Brazil that aims to reduce unnecessary cesareans in the country by providing information on reproductive rights, benefits and risks of childbirth, and use of intrapartum evidence-based practices (EBP) which are recommended by the World Health Organization (WHO) to improve childbirth outcomes and satisfaction. This study evaluates the impact of the SoB on pregnant women's perceived knowledge about normal birth (NB), cesarean, and use of EBP. Methods: 1287 pregnant women answered a structured survey immediately after their visit to the intervention, between March 2015 and March 2016. To estimate the potential impact of the intervention on women's perceived knowledge, and possible associations between sociodemographic characteristics and perceived knowledge, statistical analyses were performed, including paired T-tests, ANOVA, and logistic and linear regressions. Results: The mean score (MS) of perceived knowledge after the intervention was higher than the MS before experiencing the intervention for all three knowledge domains: Normal Birth (MS Before = 3.71 x MS After = 4.49), Cesarean (MS Before = 3.54 x MS After = 4.26) and EBPs (MS Before = 3.14 x MS After = 4.14). The results suggest that perceived knowledge increased more for low-income women (B = 0.206; p < 0.001 for EBP), women without private health insurance (OR 2.47, 95% CI: 1.49-4.09 for NB), with private prenatal care (OR 2.42, 95% CI: 1.59-3.66 for NB), experiencing their first pregnancy (

Validity and reliability of the lederman Prenatal Self-Evaluation Questionnaire (PSEQ) in Brazil

“…In Brazil, women, especially those with low socioeconomic backgrounds, do not traditionally prepare themselves for labor, and this may have interfered with their understanding of the questionnaire statements. A recent study carried out in Brazil showed that knowledge about the type of birth and the use of evidence-based practices during childbirth was low among women with characteristics similar to those of our study sample [ 35 ].…”

Brazilian women’s use of evidence-based practices in childbirth after participating in the Senses of Birth intervention: A mixed-methods study

“…The group of women who participated in this study can be identified as a group of well-informed women for the EBP, Normal Birth, and Cesarean knowledge domains. The women also showed improved awareness of their reproductive rights and choices after participating in the SoB intervention [ 41 ]. Access to quality information during prenatal care increased women’s self-efficacy and perceived control [ 37 , 52 – 54 ], allowing women to question unnecessary interventions, move away from exclusively medical-centered care, and avoid the repetition of a TMTS model.…”

“…Perceived Knowledge. The perceived knowledge variables were grouped into three different domains, based on the results of factor analysis of a previous study [ 41 ]. The domains are: 1) EBP Knowledge, 2) Normal Birth Knowledge, and 3) Cesarean Knowledge.…”

“…For each knowledge domain, a mean score before the intervention (based on recall) and a mean score after the intervention were computed from the sum of all variables in that domain, ranging from 1 to 5 points [ 41 ]. A specific change score was calculated for each domain, representing the women’s perceived variation of knowledge using the difference between the mean after and the mean before, ranging from -5 to 5 [ 41 ]. Women who did not perceive an increase in knowledge after the intervention ranked within -5 and 0.…”

“…Women who did not perceive an increase in knowledge after the intervention ranked within -5 and 0. Women who perceived knowledge increase after the intervention ranked between 0.1 and 5 [ 41 ].…”