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ABSTRACT

Certified nurse-midwives (CNMs) influence patient decision-making environments through their disclosure practices. Disclosure is the provision of specialized information by nurse-midwives to patients and their families relative to methods of pain management available for use in childbirth. This study investigates the influence that patient characteristics have on the disclosure practices reported by nurse-midwives. Data were collected by a mailed questionnaire that included patient vignettes. Nurse-midwives were asked to respond to the vignettes rating the content, the method, and timing of disclosure. The questionnaire was sent to a random sample of 500 CNMs. Two hundred eighty-five CNMs completed and returned the survey; 220 questionnaires were used in statistical analyses. Results of the study indicated that CNMs reported disclosing more items of information relative to natural childbirth methods but less items of information relative to chemical methods of pain management (p < 0.0001). Contrary to expectations, there was no association between variations in patient characteristics and the content disclosed by CNMs. Results from this study raise the question for future investigation of the influence low and high levels of disclosure have on women's use of pain management methods during delivery and women's coping and adaptation during childbirth and postpartum.