Women's perceptions of caesarean birth: a Roy international study (original) (raw)
Related papers
Women's Knowledge, Perceptions, and Potential Demand Towards Caesarean Section
2011
In today’s situation when the access to obstetric care is growing day by day there has been a concern over the rising caesarean rates over the world. A cross-sectional study was undertaken with an objective to determine the level of knowledge, attitudes, and perceptions about CS among pregnant women. All pregnant women, attending antenatal clinic, were interviewed with a structured questionnaire. Data analysis was done by using Epi info software. Of the total 247 women, participated in this study, the potential demand for CS was low and majority of women preferred vaginal delivery (91.5%). The majority of women (65.1%) were found to have very little knowledge. Overall, women preferring caesarean birth were multiparous (P<0.05), and were more likely to have had previous caesarean delivery (P<0.001), but there were otherwise no differences in age, parity, income, or education. However, most are still in favor of CS if it is necessary to protect their health or that of their infa...
Sexual & Reproductive Healthcare, 2011
The aim of this study was to compare experiences and feelings during pregnancy and childbirth in women who preferred caesarean section during pregnancy and were delivered by a planned caesarean section, and women who preferred to give birth vaginally and actually had a spontaneous vaginal birth. Design: Longitudinal cohort study where 693 women participated, 420 of whom were multiparas. Methods: Data were collected from questionnaires distributed to women during pregnancy and two months postpartum in a Mid Sweden county. Results: Women who preferred and actually were delivered by caesarean section experienced a fear of childbirth to a higher degree as compared to women with a vaginal birth. Despite a fulfilled request, women who had a caesarean section were not pleased with the decision making process. In addition, women who had a caesarean section on request were less satisfied with antenatal care and had a more negative birth experience, which made them doubt whether they would have more children. Conclusions: This study shows that a fulfilled request on mode of birth does not guarantee a positive birth experience. Antenatal information of all aspects of a caesarean section is vital for women who consider caesarean section where no medical indication is present. More research is needed about the decision making process regarding caesarean section on maternal request. Childbirth related fear is a common reason to request a caesarean birth. More knowledge about how women reason about caesarean section is required, and treatment related to fear of birth needs to be developed.
Adaptation to cesarean birth: implementation of an international multisite study
Nursing science quarterly, 2005
The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women's perceptions of and responses to cesarean birth. The need for the study arose from the concern that women's childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of study sites revealed opportunities for examination of the influence of the contextual stimuli of culture and geographic region on the women's adaptation to cesarean birth. Strategies used to foster integration of teaching, practice, and research are discussed.
Midwifery, 2011
Objective: to describe the prevalence of women's preference for caesarean section as expressed in mid pregnancy, late pregnancy and one year post partum. An additional aim was to identify associated factors and investigate reasons for the preference. Design: mixed methods. Data were collected from 2007 to 2008 through questionnaires distributed to a Swedish regional cohort of women. The survey was part of a longitudinal study of women's attitudes and beliefs related to childbirth. One open question regarding the reasons for the preferred mode of birth was analysed using content analysis. Setting: three hospitals in the county of Västernorrland in the middle of Sweden. Participants: 1506 women were recruited at the routine ultrasound screening during weeks 17 to 19 of their pregnancy. Findings: a preference for caesarean section was stated by 7.6% of women during mid pregnancy and by 7.0% in late pregnancy. One year post partum 9.8% of the women stated that they would prefer a caesarean section if they were to have another baby. This was related to their birth experience. There were more multiparous women who wished for a caesarean section. Associated factors irrespective of parity were fear of giving birth and a 'strongly disagree' response to the statement regarding that the preferred birth should be as natural as possible. Among multiparous women the strongest predictors were previous caesarean sections, particularly those that were elective, and a previous negative birth experience. Women's comments on their preferred mode of birth revealed five categories: women described caesarean section as their only option relating to obstetrical and/or medical factors; several women stated ambivalent feelings and almost as many described their previous birthing experiences as a reason to prefer a caesarean birth; childbirth-related fear and caesarean section as a safe option were the remaining categories. Key conclusions: rising caesarean section rates seem to be related to factors other than women's preferences. Ambivalence towards a way of giving birth is common during pregnancy. This should be of concern for midwives and obstetricians during antenatal care. Information and counselling should be frequent and comprehensive when a discussion on caesarean section is initiated by the pregnant woman. A negative birth experience is related to a future preference for caesarean section and this should be considered by caregivers providing intrapartum care.
Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences
PLOS ONE, 2021
Background Caesarean sections (CS) continue to increase worldwide. Multiple and complex factors are contributing to the increase, including non-clinical factors related to individual women, families and their interactions with health providers. This global qualitative evidence synthesis explores women's preferences for mode of birth and factors underlying preferences for CS. Methods Systematic database searches (MEDLINE, EMBASE, CINAHL, PsycINFO) were conducted in December 2016 and updated in May 2019 and February 2021. Studies conducted across all resource settings were eligible for inclusion, except those from China and Taiwan which have been reported in a companion publication. Phenomena of interest were opinions, views and perspectives of women regarding preferences for mode of birth, attributes of CS, societal and cultural beliefs about modes of birth, and right to choose mode of birth. Thematic synthesis of data was conducted. Confidence in findings was assessed using GRADE-CERQual. Results We included 52 studies, from 28 countries, encompassing the views and perspectives of pregnant women, non-pregnant women, women with previous CS, postpartum women, and women's partners. Most of the studies were conducted in high-income countries and published between 2011 and 2021. Factors underlying women preferences for CS had to do mainly with strong fear of pain and injuries to the mother and child during labour or birth (High confidence), uncertainty
Owning the Birth Experience: What Factors Influence Women's Vaginal Birth After Caesarean Decision?
Objective: Our quantitative analysis examined what factors influence pregnant women to choose a vaginal birth after a caesarean (VBAC). Background: There is growing concern over the high rates of caesarean section; much of the high rate is driven by repeat caesareans. A trial of labour after a previous caesarean is an option for many women increasingly supported by medical literature. Methods: Survey data from 173 pregnant women who had had only one birth by caesarean were analysed using a hierarchical binary logistic regression model. Results: Desire for the experience of a vaginal birth strongly predicted choice of VBAC; however, this relationship was dampened among women with a high (versus low) powerful others (e.g. doctors and nurses) locus of control. Prior reason for a caesarean section and practical factors also play a role. Conclusion: Women may be more likely to choose VBAC if they are encouraged to believe that they can help control the outcome, especially if their desire for a vaginal birth experience is high.
Aim. In 2008, a Western Australian maternity hospital began a next birth after caesarean (NBAC) service to improve the quality of care offered to pregnant women who had experienced a caesarean section (CS) in a previous pregnancy. The aim of this study was to evaluate the NBAC service at three time points (booking visit, 36 weeks' gestation and six weeks postnatal) to determine changes in childbirth fear, confidence, knowledge and intention to pursue a vaginal birth after caesarean (VBAC) in a current pregnancy, compared to those women receiving standard antenatal care. Method. A comparative descriptive study design was implemented following receipt of ethical approval from the study hospital. A total of 47 women who attended the NBAC service for their antenatal care and a comparison group of 45 women who attended the main hospital clinic were recruited. Descriptive statistics, chi-square and t-test analyses were used. Women provided additional qualitative comments at 36 weeks and six weeks postnatal regarding their perceptions of care, which were analysed using content analysis. Results. At recruitment, the comparison and NBAC groups were comparable for demographic variables and birth intention. Birth outcomes were not different with 15 out of 25 comparison women (60%) achieving their desired VBAC, compared to 20 out of 34 NBAC women (58.8%). At 36 weeks' gestation, NBAC women had increased knowledge of behavioural techniques to assist with labour and birth (p=0.0004) and higher self-efficacy (confidence) scores (p=0.011). There were no differences in terms of childbirth fear with both groups reporting high mean childbirth fear scores. Content analysis highlighted the positive and negative aspects of women's antenatal care experiences. Implications. Findings suggest that providing pregnant women who had experienced a previous CS with evidence-based information about birth options did increase their knowledge, confidence and satisfaction with care. Childbirth fear levels were high for both groups and midwives with appropriate skills may be ideally placed to provide counselling intervention in conjunction with antenatal care.
Women and Birth, 2017
Rates of medical interventions in childbirth have greatly increased in the Western world. Background: Women's attitudes affect their birth choices. Aim: To assess women's attitudes towards the medicalization of childbirth and their associations with women's background as well as their fear of birth and planned and unplanned modes of birth. Methods: This longitudinal observational study included 836 parous woman recruited at women's health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at <28 weeks gestation when filling in the questionnaire were asked to fill in a second one at 34weeks.Phonefollowupwasconducted34 weeks. Phone followup was conducted 34weeks.Phonefollowupwasconducted6 weeks postpartum to assess actual mode of birth. Findings: Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births. Discussion: Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned. Conclusion: Understanding women's views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth.