658: Is shift work or self-reported short sleep duration during pregnancy associated with adverse pregnancy outcomes?

Abstract

In 2012, a public tertiary care hospital in Houston, TX promoted its TOLAC services on social media, resulting in a surge of self-referrals. In 2018, an electronic survey was distributed by email to 200 women who had previously contacted the hospital regarding TOLAC and posted on 2 local social media TOLAC sites. Women were asked to participate if they ever sought TOLAC in the Houston area. Data were analyzed for trends in patient experience seeking TOLAC and comparisons were made based on number of prior cesarean deliveries (CD) and race/ethnicity. RESULTS: The survey was open for responses for 1 month, with 128 completed surveys by the end of the study time period. Of the respondents, most (64%) had 1 prior CD and identified as White (63%). 60% of all women reported contacting >3 providers before finding one that offered TOLAC, with no difference reported for women with 1 vs 2 prior CD (p¼.2). Most women (52%) reported their experience seeking TOLAC to be difficult (5 on Likert scale 1-5), with more difficulty noted by those with 2 vs 1 prior CD, but not statistically significant (p ¼ .06). White women were more likely to report an easier experience seeking TOLAC (Likert 1-4) compared to Black/African women (p¼.04). Of all respondents, 37% attempted TOLAC at the reference hospital. Of those, 70% sought care specifically for TOLAC and only 4% had received care at the hospital previously; 26% were referred by a friend, family, or obstetric provider; 70% were referred through social media information. Black/African women (p¼.02) and Hispanics (p¼.0001) were more likely to have delivered at the reference hospital than White women. CONCLUSION: Our results suggest that women seeking TOLAC have trouble finding providers who offer the service. This may be especially true for Black/African and Hispanic women and women with >1 prior CD. Women may utilize social media forums for resources and recommendations and such platforms may represent an underutilized opportunity to identify regional TOLAC services.