The First Baby Study: What women would like to have known about first childbirth. A mixed-methods study

Background: Although prenatal care providers aim to prepare women for first childbirth, little research has explored retrospectively what birthing people would like to have known before first childbirth.

Aim: To describe women's reports of what they would like to have known before first childbirth but feel they were not told.

Methods: This is a secondary analysis of the First Baby Study, a large prospective cohort study conducted in Pennsylvania, USA. Telephone interviews were conducted with 3006 women 1 month after their first childbirth. Women were first asked: "Was there anything that you would have liked to have known before your delivery that you were not told?". If "yes" they were asked a second question: "Please tell me what you would have liked to have known before your delivery".

Analysis: A convergent mixed-methods analysis including descriptive analytics to compare characteristics of women by answers to the first question, and qualitative content analysis of women's open-ended answers to the second question.

Findings: A total of 441 women (14.7%) reported there was something they would like to have known before their first childbirth. Women described that communication with care providers was their main concern. They would have liked a better understanding of their options before birth, more agency in decision-making, and more information about the topics of their body, their birth, their baby, and what to expect beyond birth.

Conclusions: Results highlight important topics for childbirth education, and the impact of gaps in shared decision-making, patient-provider communication, and supportive care practices for first childbirth, especially where women have identified vulnerabilities.