OBJECTIVE: To investigate the factors that influence women to deliver their babies in small rural communities rather than in larger centres that have more comprehensive obstetric services, including cesarean section capability and epidural anesthesia. DESIGN: Self-administered survey. SETTING: Marathon, Ont, a rural community of 4500 in north western Ontario that offers low-risk obstetric services and has no local cesarean section capability. The closest referral centre, Thunder Bay, is 300 km away. PARTICIPANTS: Sixty-four women between 16 and 40 years old living in Marathon. MAIN OUTCOME MEASURES: The relative importance of personal and systemic factors and of beliefs that influence women to choose to give birth in Marathon rather than a larger centre. How well informed women are about local obstetric services. How likely women would be to choose to deliver in Marathon if they had low-risk pregnancies. RESULTS: Beliefs were more important than personal and systemic factors in influencing women's decisions. Respondents were moderately well informed about local obstetric services (mean proportion of correct responses was 66%). Most women with low-risk pregnancies would choose to deliver in Marathon (77.8%). CONCLUSION: For women in Marathon, beliefs are much more important than personal and systemic factors in influencing the decision to give birth in this small rural community.
OBJECTIVE: To investigate the factors that influence women to deliver their babies in small rural communities rather than in larger centres that have more comprehensive obstetric services, including cesarean section capability and epidural anesthesia. DESIGN: Self-administered survey. SETTING: Marathon, Ont, a rural community of 4500 in north western Ontario that offers low-risk obstetric services and has no local cesarean section capability. The closest referral centre, Thunder Bay, is 300 km away. PARTICIPANTS: Sixty-four women between 16 and 40 years old living in Marathon. MAIN OUTCOME MEASURES: The relative importance of personal and systemic factors and of beliefs that influence women to choose to give birth in Marathon rather than a larger centre. How well informed women are about local obstetric services. How likely women would be to choose to deliver in Marathon if they had low-risk pregnancies. RESULTS: Beliefs were more important than personal and systemic factors in influencing women's decisions. Respondents were moderately well informed about local obstetric services (mean proportion of correct responses was 66%). Most women with low-risk pregnancies would choose to deliver in Marathon (77.8%). CONCLUSION: For women in Marathon, beliefs are much more important than personal and systemic factors in influencing the decision to give birth in this small rural community.