Mode of Delivery and Labour Analgesia: A Study of Preference in Portuguese Pregnant Women

Abstract

Background: Portugal has had one of the highest cesarean rates in Europe, possibly influenced by patient preferences. A reduction in the prevalence of these rates due to safety, quality, and concern with costs is one of the current goals of obstetric care. Fear of pain, often associated with vaginal delivery, is one of the reasons why pregnant women might prefer a cesarean section. Objective: The aim of this study was to identify the type of delivery and anaesthesia/analgesia preferred, as well as the reasons and factors associated with this preference, in a representative sample in order to identify possible modifiable factors possibly involved in increased rates. Methods: A descriptive cross-sectional study was carried out by an anonymous questionnaire to 245 pregnant women from February to April 2018. Respondents were also asked about their preference for peripartum anaesthesia/analgesia and on the sources of information that helped decide their preferences. Results: 22% of respondents would prefer an elective cesarean section. This preference was higher in women with a previous cesarean section. The preference for vaginal delivery was higher in women with more advanced pregnancies. The main reasons that led participants to prefer a vaginal delivery were the quicker postpartum recovery and not wanting to miss the first hours of their child's life. Regarding the preference for an elective cesarean section, the main reasons were fear and convenience. Most pregnant women preferred epidural analgesia. Respondents who selected their doctor (most common source) were more likely to prefer vaginal delivery. Conclusion: A minority of women showed a preference for cesarean delivery. A majority would prefer to have epidural anaesthesia. Despite the high cesarean rates, maternal desire for cesarean section is low, suggesting that this number is due to factors other than the preference of pregnant women.

Rationale of indications for caesarean delivery and associated factors among primigravidae in Tanzania

“…Other studies have reported an increase in the global CDR average from 12.4% to 18.6% and a rate of increase of 4.2% per annum. 9 , 10 Assisted reproductive technology, maternal age, maternal health condition, obstetrical complications, smoking during pregnancy, and socioeconomic status have been reported as factors contributing to increasing CDRs globally. 11 Similar experiences have been reported in sub-Saharan Africa (SSA), where only 7.3% of newborns are born via CD.…”