Family theory in childbirth intervention research: A critical review

Background: Childbirth interventions have received increased scrutiny in the U.S. due to their medical and financial consequences. Furthermore, C-section rates have consistently climbed, accounting for nearly one-third of all births. The proportion of C-sections among low-risk, primiparous women also remain high. Although C-sections are often medically necessary, short and long-term risks remain. Previous research has focused on mother's knowledge and beliefs and the provider environment. However, little research has examined childbirth interventions through a family perspective. We aim to explore the extent to which family theory is used in childbirth intervention research.

Methods: A critical review of the literature was conducted to examine the breadth, depth, and relevance of the utilization of family theory in childbirth intervention research. Peer-reviewed databases (PubMed, Sociological Abstracts, and Web of Science) were searched utilizing a combination of terms relating to childbirth, intervention, and family theories/constructs.

Results: Findings suggest there is a dearth of literature examining childbirth interventions through a family perspective. Among the few articles that applied a family theory lens, three main theories emerged: feminist framework; political economy; and family-centered care.

Conclusion: Decreasing unnecessary C-sections remains a significant public health priority as reflected in Healthy People 2020. Although childbirth is an important transition point in which an individual or dyad becomes a ‘family,' this social unit is often ignored in research. Understanding the role that family plays in childbirth intervention can inform research, policy and practice that better reflects the current realities and improve health and well-being among all those affected.