An investigation of women's involvement in the decision to deliver by caesarean section

Abstract

Objective To assess the degree and nature of women's involvement in the decision to deliver by caeDesign Observational study. SettingThe maternity unit in a large teaching hospital.Sample One hundred and sixty-six women undergoing caesarean section.Methods Interviews with the women on the third or fourth day postpartum, questionnaires sent to the women at 6 weeks and at 12 weeks postpartum, and extraction of information from the women's medical records. Main outcome measuresWomen's knowledge, satisfaction, and involvement in making the decision concerning their caesarean section. ResultsThe majority of the women were satisfied with the information they received during pregnancy on caesarean section and with their involvement in making the decision, but the proportions were significantly higher for elective than emergency sections. For 7% of the women, maternal preference for caesarean section was a direct factor in making the decision. Just over half of the 166 women reported that they were not debriefed on the reasons for their caesarean section before their discharge from hospital. Almost a third of the women undergoing emergency caesarean section expressed negative feelings towards their delivery, compared with 13% of those undergoing elective caesarean sections. ConclusionWomen are not a homogeneous group in terms of their requirements for information, nor their desire to be involved in the decision on mode of delivery. Health professionals need to be responsive to this variability and to agree on standards for communicating with women during pregnancy about the possibility of operative delivery and for debriefing women after caesarean section.sarean section, and women's satisfaction with this involvement.

Involvement of first-time mothers with different levels of education in the decision-making for their delivery by a planned Caesarean section. Women’s satisfaction with information given by gynaecologists and midwives

“…The findings correspond with other studies, e.g. that of Graham et al (1999), who were able to demonstrate that 71% of women who had undergone elective Caesarean sections judged the information they had received about Caesarean section during their pregnancy to be adequate. Two aspects of our findings are a As a detailed analysis shows most of the missing answers can be interpreted as "wasn't important at all" a Satisfaction in school grades: 1 = Very good through to 6 = unsatisfactory: lower values indicate a greater degree of satisfaction striking: first, the women questioned were more satisfied with the information they received about the actual process of Caesarean section than they were with the information they were given about the post-operative consequences.…”

“…Against this backdrop, we need to consider how women are involved in the decision to have a Cesarean section. As studies from the USA and UK show, many women feel that they do not receive sufficient information from maternity caregivers to enable them to participate in childbirth decisions (Turnbull et al 1999;Fleissig 1995), even though women who are involved in the decision to have an elective Caesarean section appear to be significantly happier than those women who feel they have not been involved (Graham et al 1999). In Germany, women are usually kept informed by their local gynaecologists, midwives who take care of them during the pregnancy and, to a lesser degree, doctors and midwives in hospital.…”

Involvement of Women with the Decision of Caesarean Section and their Degree of Satisfaction for Post-operative Care and Pain Management

“…Mould and colleagues found that women going for elective caesarean delivery had a 93% satisfaction score for involvement in decision making while those going for emergency delivery had a 69% satisfaction rating [30]. Graham and Hundley also had similar results [22]. Turnbull and colleagues reported a 90.9% satisfaction with the decision to have a caesarean delivery [31].…”

“…This level of satisfaction is accepted in comparison with other similar research. In other studies, the level of informational satisfaction was high [20][21][22].…”

Minding the shop: The case of obstetrics conferences

“…National Institutes of Health (NIH), 2006), several studies have found that this ideal is not carried out in practice. For example, both Graham et al (1999) and Turnbull et al (1999) found that about one-fifth of women who gave birth via elective cesarean section reported that they were not involved in the decision.…”