The Birth Choice Survey

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Georgia State University
College of Health Science and Human Sciences
Byrdine F. Lewis School of Nursing

Informed Consent

Title:  Understanding the Health Beliefs of First Time Mothers.
Principal Investigators:  Dr. Cecelia Grindel
                                           Deborah MacMillan RN, CNM

Co Investigators:               Dr. Laura Kimble
                                            Dr. Sandra Hewell
                                            Dr. Victoria Handa

I.     Purpose:

You are invited to participate in a research study. The purpose of this study is to understand the health beliefs of first time mothers as they make decisions about their upcoming childbirth. We are inviting women to participate who are first time mothers who plan a cesarean birth and also first time mothers who plan a vaginal birth.  A maximum of 128 women will be recruited for this study.  If you decide to be in the study it will require approximately 1 – 2 hours of your time over a 6 to 10 week period of time.

II.      Procedure for this study will be as follows:
If you agree to be in this study, you will be asked to fill out a brief form that asks some basic questions: such as name, age, race number of children, and anticipated date of delivery. You will also be asked some basic questions about your past medical history to determine if you are eligible to be in the study. 
If you are eligible, then you will be asked to fill out a brief questionnaire. This will take approximately 20 minutes of your time. An additional follow-up questionnaire will be available for you to fill out after you have delivered your baby at six weeks postpartum. This will also take approximately 15 to 20 minutes.
Once you enroll in the study you will receive a weekly email with educational information about nutrition and comfort measures for the remaining few weeks of your pregnancy and postpartum period. These emails will request that you go the study site and let us know when you deliver your baby so that we can contact you to fill out the 2nd questionnaire at 6 weeks postpartum.
III.      Risks
In this study, we do not anticipate that you will have any more risks than you would in a normal day of life. However, recalling memories about events can sometimes be unpleasant or stressful.  If that happens to you, we encourage you to contact your healthcare provider for a referral for counseling. If you should need counseling, any expense incurred would be your responsibility.
IV.       Benefits:
Overall, we hope to gain information about what it is like for first time mothers to make decisions about their upcoming delivery.   Participation may not benefit you personally. The educational information may be helpful to you.
V.        Voluntary Participation and Withdrawal:
Participation in research is voluntary.  You have the right not to be in the study.  If you decide to be in the study and change your mind, you have the right to drop out at any time.  You may skip questions or stop participating at any time.  Whatever you decide, you will not lose any benefits to which you are otherwise entitled.
VI.       Confidentiality:
We will keep your records private to the extent allowed by law.  We will use a study number rather than your email information on study records. No other personal identification will be obtained. Only the research team will have access to the information you provide.  The data will be stored in the researcher’s office on a secure server. The identification code key will be stored in a password and fire-wall protected computer. You will not be identified personally.  However, it is important to notify you that no internet systems are 100% safe or secure.
VII.     Contact Persons:
Contact Mrs. Deborah MacMillan (478) 747-0986 ( if you have questions about this study.  If you have questions or concern about your rights as a participant in this research study, you may contact Susan Vogtner in the Office of Research Integrity at (404) 413-3513 or 

  1. Copy of Consent Form to Participant

You may print a copy of this consent form for your records by clicking the print icon.  If you are willing to volunteer, please indicate your consent by entering your email address and today’s date in the space provided. After completing this click the submit button below.