Background: Global access to social media has supposedly changed women’s awareness about the pharmacological and alternative methods of pain relief during vaginal delivery. The purpose of the study was to analyze changes in women’s preference and opinion about different forms of labor analgesia over the past decade. Materials and methods: The study was designed as an anonymous survey with questions about women’s knowledge and preference of different forms of pain relief in labor. The survey was conducted in 2010 and 2020, with data collected from 1175 women in 2010 and 1033 in 2020. Results: There were no differences between 2010 and 2020 in the proportion of women who wanted to receive analgesia in labor, at, respectively 67.9% of women in 2010 and 73.9% in 2020. About 50% of women chose epidural analgesia as the only efficacious method of pain relief in labor both in 2010 and 2020. There were no differences between the two time-points in the distribution of chosen methods of pain relief. In total, 92.3% of women in 2010 and 94.9% in 2020 thought that they should have the possibility of independent choice of analgesia method before the delivery (p < 0.04). Conclusions: A high proportion of Polish women choose EDA over other pharmacological and nonpharmacological methods of pain relief in labor, and this preference has not changed over the last decade. Increasing women’s knowledge about different methods of intrapartum pain relief may lead to wider use of nonpharmacological methods of pain relief.

Background and Objectives: The maternal preference of mode of delivery is an important problem in respect of patient’s autonomy and shared decision-making. The objective of the study was to obtain information about women’s preferences of the mode of delivery and knowledge about the cesarean section and its’ consequences. Materials and Methods: The study was based on a survey filled in by 1175 women in 2010 and 1033 women in 2020. Respondents were asked about their preference of mode of delivery, possible factors influencing their decision and their knowledge about risks and benefits of cesarean section. Results: There was a significant increase in the rate of women who declared cesarean section as their preferred mode of delivery, from 43.97% in 2010 to 56.03% in 2020 (p < 0.05). In 2010 26.51% of women thought that choice of mode of delivery should be their autonomic decision, 46.36% preferred decision-sharing with their obstetrician, 25.64% thought that cesarean section should be performed for medical indications only (respectively 34.86%, 44.45% and 19.38% in 2020). Conclusions: There has been a significant increase in the rate of Polish women who prefer cesarean delivery over the last decade, as well as in the rate of women who consider the mode of delivery as their autonomic decision.

Background and Objectives: Shared-decision making has become an important trend in the problem of women’s preference for the way of delivery. There are different factors influencing women, including obstetric history, culture, religion, family and social influences. Materials and Methods: The study was designed as an online survey with the aim of acquiring information about women’s knowledge, opinions and preferences about the mode of delivery and the decision-making process. Data were collected from 1175 women in 2010 and 1033 in 2020. Results: A significant increase in the proportion of women who prefer vaginal delivery (VD) was found to be present with an increasing level of education, with the lowest rate in the group with primary education (66.0% in 2010 and 33.3% in 2020) and highest with medical education—86.3% in 2010 and 69.3% in 2020 (p < 0.05). This trend existed both in 2010 and 2020; however, the proportion of women who preferred VD has decreased over the last decade in all groups, and even two-fold in the primary education group. No significant correlation was found between a history of previous delivery and the preference of the way of delivery, decision-making or paid cesarean delivery on maternal request (CDMR). A history of VD significantly reduced the preference for having a cesarean delivery, with only 6.9% of women in 2010 with a history of VD, and 8.9% in 2020 having preferred a cesarean delivery. In 2010, 34.9% of women with a history of cesarean section (CS) only, compared to 6.9% of women with a history VD only, had preference for CS with, respectively, 36.4% vs. 5.8% in 2020. Conclusions: As the proportion of women who prefer cesarean delivery has significantly increased over the last decade, we should emphasize the importance of educating women about the advantages and disadvantages of vaginal and cesarean delivery. The patient’s preference should always be discussed with the obstetrician and the medical indications explained.

Background. urinary incontinence is defined as any involuntary loss of urine. the tVt (tension-free Vaginal tape) operation is a treatment for stress urinary incontinence introduced in poland in the year 2000. there are few studies evaluating the long-term effectiveness of tVt in polish women. Objectives. to evaluate the long-term effectiveness of tVt in the treatment of stress urinary incontinence in women. Material and methods. 40 women operated on in the period 1999-2004 were recalled 12.6 ± 1.2 years after tVt for a follow-up study. 85 vs 15% of women were operated on due to primary vs recurrent stress incontinence, respectively. 20 vs 80% of the patients had mixed vs pure stress urinary incontinence, respectively. the effectiveness of tVt operations was assessed objectively on the basis of a cough test, and subjectively on improvement after treatment according to the patientsʼ answers (yes/no), pgi-i, psQ and Vas ("0" was the total absence of improvement after surgery, "100" -total improvement). Results. the cough test was negative in 85% of cases. subjectively, 85% of women declared improvement after tVt. Based on pgi-i -77.5% of them maintained improvement after surgery. Based on psQ -70% of the women assessed control of urinary incontinence after surgery as better, 72.5% were satisfied with the results of the operation, and 77.5% of them would recommend tVt to other women. Based on Vas, total improvement was noted by 12.5% of women, 60% of women rated improvement "50-99", and total lack of improvement was noted by 20% of the women. Conclusions. tVt seems to be an effective form of treatment for urinary incontinence in women 12 years after surgery. Key words: urinary incontinence, mid-urethral sling, tVt, effectiveness. Broś-Konopielko M, Chmielewski g, Jodzis a, teliga-Czajkowska J, Czajkowski K. long-term effectiveness of tension-free Vaginal tape (tVt) procedure -twelve years after surgery.