Table 1 Questionnaire for birth-related knowledge. Correct answers are in bold letters

1

What types of facilities or places are there in Germany where women can give birth?

Hospital (outpatient/inpatient), birth center, home birth

2

How long does a birth take on average for women giving birth for the first time?

A birth in a first-time woman takes about 8–17.5 h.

3

What are signs of the beginning of the birth?

a) gushing of amniotic fluid

b) drop by drop of amniotic fluid

c) body temperature above 38 °C

d) discharge of mucus from the vagina

4

During birth, the extent to which the cervix is open is checked regularly. How is this done?

a) The midwife inserts a speculum (metal examination instrument) with a measuring tip into the vagina, the cervical dilation can be read.

b) The midwife calculates the cervical dilation using the circumference and length of the abdomen.

c) The midwife inserts two fingers into the vagina and feels the cervical dilation.

d) The midwife performs a visual diagnosis during the vaginal examination and estimates the cervical dilation.

5

During birth, a cardiotocography (CTG) is usually done to measure labor strength and fetal heart sounds. How is this done?

a) During CTG, fine measuring needles are inserted into the outer abdominal wall.

b) During CTG, a belt with ultrasound plates is placed around the abdomen.

c) During CTG, electrodes are sticked to the abdomen.

d) During CTG, measuring sensors are inserted into the vagina.

6

An episiotomy refers to the surgical incision of perineal tissue to widen the birth canal.

Which statement(s) is/are true?

a) An episiotomy is intended to prevent uncontrolled tearing of the tissue.

b) An episiotomy is usually necessary in first-time mothers.

c) An episiotomy is only performed when medically necessary.

d) By making the incision and then stitching the pelvic floor tightly together, the pelvic floor strength is improved.

7

What happens after the birth of the child?

a) The birth of the child is followed by the afterbirth, during which the placenta is expelled.

b) After the birth of the child, the umbilical cord must be cut immediately.

c) After the birth of the child, the cervix is sutured shut again.

d) After the birth of the child, a healthy newborn may immediately go to the mother.

8

What percentage of children are born by cesarean section in Germany?

30%

9

What are the reasons for performing a cesarean section?

a) A cesarean section is performed when clear amniotic fluid is discharged from the vagina.

b) A cesarean section is performed when the baby’s head does not fit through the mother’s pelvis.

c) A cesarean section is performed in case of premature detachment of the placenta.

d) A cesarean section is performed when the baby is transverse.

10

What should be considered after a cesarean section?

a) After a cesarean section, the woman must also deliver all future children by cesarean section.

b) After a cesarean section, just as with a vaginal birth, so-called regression courses are necessary.

c) After a cesarean section, the newborn is often healthier than after a vaginal birth.

d) After a cesarean section, the woman must stay in the hospital for about 5 days.

11

What remedies are used to relieve pain during vaginal birth?

Various means from the fields of alternative methods and medicinal procedures.

12

What are the recommendations for the birthing position?

a) Women should not give birth in an upright position (e. g., standing or squatting) because the risk of falling increases the risk of head injury to the newborn.

b) Whenever possible, the woman should give birth lying on her back, as this is the most efficient birthing position.

c) The birthing position can be chosen by the woman herself, although changes of position and movements are helpful for the birth process.

d) Births are performed in the bathtub by default, as this relaxes the woman’s muscles.

13

What are the recommendations for eating and drinking with regard to childbirth?

a) Even small meals have a negative effect on the birth process, so women should not eat any food during birth.

b) At the latest two days before the expected date of delivery, the woman should begin to increase her food intake in order to build up sufficient energy reserves for the birth.

c) To prevent circulatory problems, women giving birth should at least double the amount they usually drink.

d) During birth, only sugar-free foods should be consumed to prevent hyperglycemia of the child.

None of the above options is correct.

14

What are the recommendations for going to the toilet during childbirth?

a) At the beginning of the birth, an enema is given and a catheter is placed so that the bowel and bladder are emptied.

b) Often the woman can take advantage of a voluntary enema.

c) The woman must wait until after the birth to go to the bathroom.

d) Usually, due to hormonal release, there is an urge to defecate at the beginning of childbirth when the woman is still able go to the toilet on her own.