Obstetrical Providers’ Preferred Mode of Delivery and Attitude Toward Nonmedically Indicated Caesarean Sections: A Cross-Sectional Study

Rivo, Julie; Amyx, Melissa; Pingray, Verónica; Casale, Roberto; Fiorillo, Angel; Krupitzki, Hugo; Malamud, Julio; Mendilaharzu, M; Medina, Maritza L. Morales; Pino, Alicia; Ribola, L.; Schvartzman, Javier Alfonso; Tartalo, G.M.; Trasmonte, M; Varela, S; Althabe, Fernando; Belizán, José M.

doi:10.1097/01.aoa.0000557662.10281.6c

Cited by 3 publications

(4 citation statements)

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“…The role of care providers in facilitating or influencing a woman's preferred mode of deliv ery also warrants examination. Although care providers are sup portive of a woman's right to choose CDMR, 25,26,48 surveys show variable willingness to comply with such requests. In our study, care from an obstetrician was a significant determi nant of CDMR, suggesting that women who plan CDMR are more likely to seek out care from an obstetrician and that women preferring vaginal deliveries are more likely to seek antenatal care from a midwife.…”

Section: Discussionmentioning

confidence: 99%

“…However, obstetrical care providers often accede to patient preferences, given the ethical imperative of patient auton omy. [23][24][25][26][27] Contemporary, highquality observational studies leveraging robust populationbased data are required. Our objective was to evaluate the trends, determinants and out comes of CDMR compared with planned vaginal delivery using an intenttotreat approach.…”

Section: Methodsmentioning

confidence: 99%

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Birth outcomes following cesarean delivery on maternal request: a population-based cohort study

Guo

Murphy

Erwin

et al. 2021

CMAJ

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esarean delivery is the most common inpatient surgical procedure in North America, 1,2 where rates often exceed World Health Organization recommendations (10%-15% of deliveries). 3 Given the financial and resource implications of cesarean deliveries on health care systems, the contribution of cesarean deliveries on maternal request (CDMR) to rising cesar ean section rates is of ongoing interest. Women may prefer CDMR for many reasons, including scheduling convenience, anxiety regarding labour pain, perceptions that the quality of obstetrical care is better for women who have cesarean deliver ies, and concerns about possible urinary incontinence and sexual dysfunction after vaginal delivery. [4][5][6][7] Challenges in characteriz ing the epidemiology of CDMR include the lack of internation ally accepted case definitions and inconsistencies in docu mentation that hinder meaningful comparisons across jurisdictions. [8][9][10][11] In Canada, the prevalence of CDMR has been estimated at 2% of cesarean deliveries, 12 but robust contem porary data are lacking.The benefits of vaginal delivery are well known and include a lower risk of transient tachypnea of the newborn, newborn exposure to the vaginal microbiome, shorter mater nal hospital stays and lower risk of complications associated

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Birth outcomes following cesarean delivery on maternal request: a population-based cohort study

Guo

Murphy

Erwin

et al. 2021

CMAJ

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“…It is known that many of the women in this cohort deliver in a public hospital, so it is possible that the 'other' delivery location represents a private facility. Private facilities have higher cesarean birth rates and more likelihood of elective cesarean birth, which is analogous to pre-labor cesarean birth in the case of women with a history of prior cesarean [13].…”

Section: Discussionmentioning

confidence: 99%

The association of timing of repeat cesarean with outcomes among a cohort of Guatemalan women with a history of prior cesarean birth

Harrison

Garcés

Figueroa

et al. 2021

BMC Pregnancy Childbirth

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Background The objective of this analysis was to observe whether maternal and perinatal/neonatal outcomes of birth vary by timing of repeat cesarean among women with a history of one prior cesarean birth in a Guatemalan cohort. Methods This secondary analysis was conducted using data from a prospective study conducted in communities in Chimaltenango, Guatemala through the Global Network for Women’s and Children’s Health Research. Results Between January 2017 and April 2020, 26,465 women delivered; 3,143 (11.9%) of those women had a singleton gestation and a history of prior cesarean delivery. 2,210 (79.9%) women with a history of prior cesarean birth had data available on mode of delivery and gave birth by repeat cesarean; 1312 (59.4%) were pre-labor cesareans while 896 (40.5%) were intrapartum cesarean births. Risk factors associated with an increased risk of intrapartum cesarean birth included hospital delivery as compared to “other” location (ARR 1.6 [1.2,2.1]) and dysfunctional labor (ARR 1.6 [1.4,1.9]). Variables associated with a reduced risk of intrapartum cesarean birth were hypertensive disease (ARR 0.7 [0.6,0.9]), schooling (ARR 0.9 [0.8,0.9]), and increasing age, which was associated with a very slight reduction in the outcome (ARR 0.99 [0.98,0.99]). Maternal and neonatal outcomes did not vary by type of cesarean birth. Conclusion Outcomes of cesarean birth do not seem to vary by timing of repeat cesarean birth, with hypertensive disease increasing the likelihood of pre-labor cesarean. This information might be useful in counseling women that outcomes after failed trial of labor do not appear worse than those after pre-labor cesarean birth.

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“…While the women are not healthy and some are very ill, its advised by leading cardiac societies to offer vaginal mode of delivery to these women [2][3][4][5][6] . This is a problematic issue because nations around the globe have a rising caesarean section rate in the healthy pregnant population due to myriad of reasons 8,9 which is needs a collaborative effort on its own to scale down. There is also a lack of robust randomized trials or evidence based care for these patients which also high lights the need for more studies.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Clinical Approach to the Form of Delivery During Pregnancy in Patients With Cardiac Disease; A Review of the Effects of Practice Change by Concurring to International Guidelines

Khalil

Akhtar

2021

PAFMJ

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Objective: To assess if adherence to international guidelines for pregnant cardiac patients’ mode of delivery is achievable with available local resources. Study Design: Prospective quasi experimental descriptive study. Place and Duration of Study: All Pregnant patients with cardiac disease reporting to Armed Forces Institute of Cardiac Disease/National Institute of Heart Disease (AFIC/NIHD) who were admitted for and were delivered from Oct 2009 to Sep 2011 were included in the study. Methodology: International guidelines and recommendations for mode of delivery for cardiac patients with pregnancy were followed for patients. Caesarean sections were reserved only for obstetrical reasons and absolute cardiac indications. The patients with first trimester miscarriage were not included. Data was collected on a personal computer Microsoft excel sheet. Frequency was calculated from the data entered. The reduction in caesarean section rate and increase in vaginal delivery rate as per guidelines without an increase in maternal mortality, was the main outcome. Results: Total of 221 patients were delivered in the 2 year period between October 2009 to September 2011 at AFIC/NIHD. The caesarean section rate the year before 2008-2009 had been 48.6%. After the change in practice by concurring to international guidelines, the caesarean section rate for the 2 year period dropped to 26.7%. The hospital maternal deaths were 5. This was slightly better to the year 2008-2009 which had 3 maternal deaths. Conclusion: It’s possible to adhere to international recommendations and protocols for pregnant cardiac patients and achieve internationally comparable outcome in terms of mode of delivery without increasing current institutional maternal mortality rate with local hospital resources.

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Obstetrical Providers’ Preferred Mode of Delivery and Attitude Toward Nonmedically Indicated Caesarean Sections: A Cross-Sectional Study

Cited by 3 publications

References 0 publications

Birth outcomes following cesarean delivery on maternal request: a population-based cohort study

Birth outcomes following cesarean delivery on maternal request: a population-based cohort study

The association of timing of repeat cesarean with outcomes among a cohort of Guatemalan women with a history of prior cesarean birth

Optimizing Clinical Approach to the Form of Delivery During Pregnancy in Patients With Cardiac Disease; A Review of the Effects of Practice Change by Concurring to International Guidelines

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