Mothers' reports of their maternity experiences in the USA and Canada

This study compares results from national surveys of maternity care in the US and Canada. The US Listening to Mothers II survey (n=1573) was based on a combined online and telephone sample of mothers who gave birth in 2005 while the Canadian Maternity Experiences Survey (n=6421) was a national random stratified sample drawn from the Canadian Census focusing primarily on births from early 2006. Mothers reported experience with the medical model of birth including ultrasound use (29% of mothers reported 4 or more ultrasounds in Canada; 37% 4+ in US), attempted induction in vaginal birth (45% Canada; 49% US); epidural use in vaginal birth (57% in Canada; 71% in US); supine birth position in vaginal birth (48% Canada; 57% US); episiotomy (21% Canada; 25% US) and cesarean section (26% Canada; 32% US). US mothers consistently reported higher levels of intervention while Canadian mothers reported greater use of drug-free pain relief methods. Canadian mothers reported high levels of overall satisfaction with their care (Canada - 54% very positive, 26% somewhat positive). US mothers rated the US maternity care system positively - 35% excellent, 48% good. Both surveys reveal the value of incorporating mothers' views into evaluation of maternity care systems.