If you have any problems related to the accessibility of any content (or if you want to request that a specific publication be accessible), please contact (firstname.lastname@example.org)
A Behavior Analytic Approach to Childbirth: A Contingency Analysis and Preliminary Investigation
AltmetricsView Usage Statistics
The “cascade of interventions” associated with analgesia use during childbirth has contributed to the U.S. having some of the poorest birth outcomes of any developed nation (Clark, Belfort, Byrum, Meyers, & Perlin, 2008; Kuklina, Meikle, & Jamieson, 2009) and one of the highest rates of cesarean section, with 1 in 3 women delivering their babies via surgery (Boyle, Reddy, & Landy, 2013). In a report summarizing the World Health Organization’s principles of perinatal care, appropriate methods for pain relief are suggested to all be behavioral (Chalmers, Mangiaterra, & Porter, 2001) and a meta-analysis of non-pharmacological approaches for pain management demonstrates better outcomes than use of medical pain management (Chaillet et al., 2014). Despite these conclusions, over 80% of women in the U.S. use an epidural during labor and almost 50% of women who do not want epidurals also end up receiving them (Goer & Romano, 2012). The lack of fluency with labor coping strategies and partner support skills has been highlighted as a contributing variable to the over-reliance on heavy narcotics during childbirth. Research has suggested that childbirth education is ineffective at generalizing learned coping strategies and that better methods of prompting non-pharmacological pain management strategies are needed (e.g., Slade, Escott, Spiby, Henderson, & Fraser, 2000). The purpose of this study was to address the common practices within childbirth; outcomes associated with such practices were discussed, contingency analyses of the barriers were identified, and a behavior analytic technology within the current system was proposed and evaluated. Results of this preliminary study conclude that the introduction of a behavior analytic software using in-vivo prompting and video modeling increases the frequency of labor behaviors and variability of labor behaviors during unmedicated labor for women and their support partners.