What do women think of due dates?

A survey of pregnant women planning a hospital birth in Australia offers interesting food for thought in relation to women’s views and knowledge about the ‘due date’ and the timing of birth.

As many readers of my work will know, estimated due dates, ‘post-term’ pregnancy and women’s experiences of the effects of these ideas are topics that I’m pretty passionate about. I wrote my PhD thesis on this topic. I have written two bestselling books on induction, and it’s something I talk about a lot. So I was really interested in this research and on what it might be able to add to our knowledge.

The study itself comprised a survey of 769 women who were attending four hospitals in Sydney, Australia. So the results might not be representative of every woman in the world (or even Sydney, because it didn’t include, for example, those having births out of hospital, having private care, women who didn’t speak English or people living in rural settings), but it is large enough to be credible and the analysis is detailed and thoughtful.

So what did the study find?

In Your Own Time was written to help parents and professionals better understand the issues and the evidence relating to the current induction epidemic. Looks at the evidence relating to due dates, ‘post-term’, older and larger women, suspected big babies, maternal race and more.

First, most of the women in the study understood that the expected date of birth (EDB) is imprecise.

But even more pertinently, the majority of women wished that the estimated timing of their birth could be given in less specific format than an EDB, with the majority of women preferring the idea of an estimated week or fortnight of birth.

There are some other interesting findings:

“Among the 769 women who responded to the question about expected timing of birth, 42% expected they would birth sometime before their due date, 16% sometime after their due date, 15% within a day or so of their due date, and 27% had no expectations. The expectations of nulliparous women were significantly different from those of multiparous women (χ² = 15.4, p = 0.002): nulliparous women were much more likely to expect to give birth before their due date.” (Todd et al 2016)

And another insight that caught my attention was this one:

“Women who completed the survey early in pregnancy (≤24 weeks) were more likely to have no expectations about their timing of birth; those between 25 and 36 weeks were more likely to expect birth sometime before their due date; and those at term (≥37 weeks) were more likely to expect birth after their due date.” (Todd et al 2016)

The authors of this research discuss their results within the framework of woman-centredness, and I would recommend looking this paper out if you can access it. It is a thoroughly fascinating piece of research and I am really looking forward to discussing it further with colleagues and students.

Todd AL, Zhang LY, Khambalia AZ and Roberts CL (2016). Women’s views about the timing of birth. Women and Birth, In press – corrected proof. http://dx.doi.org/10.1016/j.wombi.2016.09.002

The Research

Background: Estimated date of birth (EDB) is used to guide the care provided to women during pregnancy and birth, although its imprecision is recognised. Alternatives to the EDB have been suggested for use with women however their attitudes to timing of birth information have not been examined.

Aims: To explore women’s expectations of giving birth on or near their EDB, and their attitudes to alternative estimates for timing of birth.

Methods: A survey of pregnant women attending four public hospitals in Sydney, Australia, between July and December 2012.

Results: Among 769 surveyed women, 42% expected to birth before their due date, 16% after the due date, 15% within a day or so of the due date, and 27% had no expectations. Nulliparous women were more likely to expect to give birth before their due date. Women in the earlier stages of pregnancy were more likely to have no expectations or to expect to birth before the EDB while women in later pregnancy were more likely to expect birth after their due date. For timing of birth information, only 30% of women preferred an EDB; the remainder favoured other options.

Conclusions: Most women understood the EDB is imprecise. The majority of women expressed a preference for timing of birth information in a format other than an EDB. In support of woman-centred care, clinicians should consider discussing other options for estimated timing of birth information with the women in their care.