The development and process evaluation of an information-based intervention for pregnant women aimed at addressing rates of caesarean section


Dr R. Walker, Department of Public Health, University of Adelaide, South Australia 5005, Australia.


Objective  Few strategies aimed at addressing rising rates of caesarean section have explicitly involved information-based approaches for pregnant women. This study describes the development and evaluation of such an intervention for pregnant women, encompassing pamphlets and a peer support network (PSN).

Design  Process evaluation.

Setting  The study was undertaken at a metropolitan teaching hospital in Adelaide, South Australia.

Population  A consecutive sample of pregnant women attending the ultrasound clinic over a two-month period, recruited at 18 weeks of gestation.

Methods  Participants received two pamphlets at 18 weeks of gestation and information on a PSN at around 28 weeks of gestation. A questionnaire was sent to women at seven weeks postnatal, asking them to evaluate the intervention.

Main outcome measures  The extent to which the intervention resources were used and participants were satisfied with the resources they received.

Results  Ninety-two women returned questionnaires (response rate of 62%). Women generally resisted engaging with the informational resources, citing irrelevance to their situation, for example, 53% (49/92) read all of the pamphlets. None of the women used the PSN. Women who had experienced childbirth previously and those of higher education were significantly more likely to read the pamphlets. While generally satisfied with pamphlet content, one in five women reported feeling distressed by some of the information.

Conclusions  This exploratory study casts doubt on the notion of information provision for pregnant women as a panacea for addressing rising rates of caesarean section.