Cesarean section on maternal request: reasons for the request, self‐estimated health, expectations, experience of birth and signs of depression among first‐time mothers

Abstract

The knowledge gained from this study may help in understanding why some women prefer to give birth with elective cesarean section. It also elucidates the need for awareness of professional support during vaginal birth.

The Cesarean Decision Survey

“…Many of the reasons for the cesarean surgery that were reported by the women were not an accepted reason (ACOG, 2005); however, they were medical in nature and thus the cesarean was perceived by the women to be necessary. A perceived reason of safety for the baby was similar to previous reports (Arthur & Payne, 2005;Fenwick et al, 2010;Weaver & Statham, 2005;Wiklund et al, 2007). Another similarity to prior research was the use of friends/family and the Internet as sources of information (Lagan et al, 2010;Munro et al, 2009).…”

“…The notion that a vaginal birth is scary and dangerous and a cesarean surgery is safe and controllable were revealed as common themes for motivating factors (Arthur & Payne, 2005;Fenwick, Staff, Gamble, Creedy, & Bayes, 2010;Weaver & Statham, 2005;Wiklund, Edman, & Andolf, 2007). Arthur and Payne (2005) conducted an interpretive phenomenological study of five women who had requested a cesarean surgery.…”

“…Several themes emerged from the data analysis about why the women chose to have a cesarean surgery: "vaginal birth as hazardous," "safety of the unborn child," and "the right to choose" (Arthur & Payne, 2005). Wiklund et al (2007) conducted a survey of 357 women and found women were afraid of lack of labor support, loss of control, and fetal injury or death. Similar findings of fear were also confirmed by Weaver and Statham (2005) in a qualitative study.…”

Clinical aspects of childbirth-related anxiety

“…Our results showed that this applied to only a fraction (3.1%) of all pregnant women (2.2% of nulliparous and 4.0% of parous). This is supported by the strong correlation between a severe FOC and a request for CS as seen in our results (p<0.0001), and is in line with the results in previous studies conducted both in Sweden (Wiklund, Edman, & Andolf 2007;Salomonsson et al 2013) and in a multi-centre study conducted in five European countries (Ryding et al 2015).…”

Treatment of nulliparous women with severe fear of childbirth via the Internet: a feasibility study

“…Women with severe FOC are often vigilant for signals of danger, and often find that their suspicions are verified, creating a vicious cycle of adverse expectations and negative experiences [2][3][4]. FOC is thought to explain, to some extent, the increasing number of caesarean sections (CS) based on maternal requests during the last decade [5][6][7][8].…”