With half a million babies being born in California every year, childbirth is the number one reason for hospitalization in the state. Yet little is known about women’s childbearing experiences, outcomes, and preferences. The Listening to Mothers in California survey aims to fill these knowledge gaps and identify opportunities for improving the experience and outcomes of pregnancy and childbirth.

Listening to Mothers in California is the first fielding of the national Listening to Mothers survey at a state level and in Spanish. It was conducted in 2017 and included California women who gave birth to a single infant in a hospital in 2016. Listening to Mothers in California: Results from a Population-Based Survey of Women’s Childbearing Experiences reports selected findings from this survey and highlights important differences by race, ethnicity, and insurance coverage (Medi-Cal, California’s Medicaid program, pays for nearly half of California births).

Key findings include:

• While the vast majority of women used an obstetrician for their prenatal care and births, over half of women said they would definitely want (17%) or would consider (37%) a midwife for a future pregnancy.
• Three-quarters of California’s childbearing women agree that childbirth is a process that should not be interfered with unless medically necessary. Black and Latina women, and women with Medi-Cal coverage, held this belief most strongly.
• Four in 10 women reported that a health professional tried to induce their labor (starting labor before it started on its own). Three-quarters of women who felt pressured by a health professional to have their labor induced had the intervention.
• Only one in seven women with a prior cesarean had a vaginal birth after cesarean (VBAC), despite nearly half of women with repeat cesareans reporting interest in VBAC. Women with prior cesareans reported that providers disproportionately focused discussions and recommendations on having a repeat cesarean birth.
• One in five California women reported symptoms of anxiety, and one in 10 reported symptoms of depression during pregnancy. Across racial and ethnic groups, Black women were on the high end of the range for symptoms of anxiety and depression, during and after pregnancy.

The full data snapshot, as well as a file of the individual charts, is available to download below. Also available are three one-page fact sheets on care team and place of birth (PDF), cesarean births (PDF), and maternal mental health (PDF)

This paper was authored by Carol Sakala, PhD, director of Childbirth Connection Programs at the National Partnership for Women and Families; Eugene R. Declercq, PhD, of the Boston University School of Public Health; and Jen Joynt and Jessica M. Turon, independent consultants.