Women’s attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth Yael Benyamini a, *, Maya Lila Molcho a , Uzi Dan b , Miri Gozlan b , Heidi Preis a a Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv 6997801, Israel b Women’s Health Center, Maccabi Health Services, 1 Lishansky St., Rishon Le’zion, Israel A R T I C L E I N F O Article history: Received 29 January 2017 Received in revised form 16 March 2017 Accepted 21 March 2017 Available online xxx Keywords: Medicalization Caesarean section Natural childbirth Attitudes Fear of birth A B S T R A C T Problem: Rates of medical interventions in childbirth have greatly increased in the Western world. Background: Women’s attitudes affect their birth choices. Aim: To assess women’s attitudes towards the medicalization of childbirth and their associations with women’s background as well as their fear of birth and planned and unplanned modes of birth. Methods: This longitudinal observational study included 836 parous woman recruited at women’s health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at <28 weeks gestation when filling in the questionnaire were asked to fill in a second one at 34 weeks. Phone follow- up was conducted 6 weeks postpartum to assess actual mode of birth. Findings: Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births. Discussion: Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned. Conclusion: Understanding women’s views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth. © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved. Statement of Significance Problem or issue Medicalization of childbirth is on the rise and it is important to understand what influences women’s inclination to use or reject birth-related medical technology. What is already known Women have become more accepting of medical technolo- gy but at the same time there is a growing demedicalization trend. Both medicalization and demedicalization have been linked to women’s birth choices. What this paper adds Women’s socio-demographic and obstetric background is related to their attitude toward medicalization of childbirth, which in turn is linked to their birth choices and planned and unplanned modes of birth. 1. Introduction 1.1. Medicalization and demedicalization The dominant birthing model in most of the Western world is medicalized childbirth. 1,2 This is evident in the overall high use of * Corresponding author. Fax: +972 3 6409182. E-mail address: benyael@post.tau.ac.il (Y. Benyamini). http://dx.doi.org/10.1016/j.wombi.2017.03.007 1871-5192/© 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved. Women and Birth xxx (2017) xxx–xxx G Model WOMBI 629 No. of Pages 7 Please cite this article in press as: Y. Benyamini, et al., Women’s attitudes towards the medicalization of childbirth and their associations with planned and actual modes of birth, Women Birth (2017), http://dx.doi.org/10.1016/j.wombi.2017.03.007 Contents lists available at ScienceDirect Women and Birth journal homepage: www.elsevier.com/locate/wombi