Preferences and concerns for delivery: an antepartum survey

Bracken, Jessica; Dryfhout, Vicki; Goldenhar, Linda M.; Pauls, Rachel N.

doi:10.1007/s00192-008-0680-1

Cited by 28 publications

(24 citation statements)

References 22 publications

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“…Vaginal delivery was viewed as normal, healthy, and a natural rite of passage from womanhood to motherhood. Contrary to reports suggesting that women fear pain associated with childbirth [9-12,14,15,19] pain associated with VD was viewed in a positive light. In contrast, women viewed CS as a medical decision and often defer decisions to medical staff in the presence of medical indications for CS.…”

Section: Discussionmentioning

confidence: 69%

“…Preferences are influenced by culture, knowledge of risk and benefits, and personal and social factors. Reasons for women’s preferences range from perceived ease of recovery and need to return to family responsibilities to concerns about the safety of the baby [9-15]. Until a standardized assessment is available, our understanding of the role of women’s preferences is limited.…”

Section: Introductionmentioning

confidence: 99%

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Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study

et al. 2013

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BackgroundOver the last three decades, cesarean section (CS) rates have been rising around the world despite no associated improvement in maternal and perinatal mortality and morbidity. The role of women’s preferences for mode of delivery in contributing to the high CS rate remains controversial; however these preferences are difficult to assess, as they are influenced by culture, knowledge of risk and benefits, and personal and social factors. In this qualitative study, our objective was to understand women’s preferences and motivational factors for mode of delivery. This information will inform the development and design of an assessment aimed at understanding the role of the women’s preferences for mode of delivery.MethodsWe conducted 4 focus group discussions (FGDs) and 12 in-depth interviews with pregnant women in Buenos Aires, Argentina in 4 large non-public and public hospitals. Our sample included 29 nulliparous pregnant women aged 18–35 years old, with single pregnancies over 32 weeks of gestational age, without pregnancies resulting from assisted fertility, without known pre-existing medical illness or diseases diagnosed during pregnancy, without an indication of elective cesarean section, and who are not health professionals. FGDs and interviews followed a pre-designed guide based on the health belief model and social cognitive theory of health decisions and behaviors.ResultsMost of the women preferred vaginal delivery (VD) due to cultural, personal, and social factors. VD was viewed as normal, healthy, and a natural rite of passage from womanhood to motherhood. Pain associated with vaginal delivery was viewed positively. In contrast, women viewed CS as a medical decision and often deferred decisions to medical staff in the presence of medical indication.ConclusionsThese findings converge with quantitative and qualitative studies showing that women prefer towards VD for various cultural, personal and social reasons. Actual CS rates appear to diverge from women’s preferences and reasons are discussed.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study

et al. 2013

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“…35 Several studies have pointed to an increased short-term risk of postpartum sexual dysfunction, particularly after vaginal delivery, 12,14 episiotomy, 16,19 or perineal trauma during delivery. 16-18 In our study, women with a history of operative vaginal delivery reported lower interest in sex, which could be related to residual delivery-rated pain or pelvic floor dysfunction; 36,37 however, operative vaginal delivery was not a predictor of frequency of sexual activity, sexual satisfaction, or other sexual problems.…”

Section: Discussionmentioning

confidence: 99%

Childbirth and Female Sexual Function Later in Life

Fehniger

Brown

Creasman

et al. 2013

Obstetrics &Amp; Gynecology

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Objective To examine relationships between parity, mode of delivery, and other parturition-related factors with women's sexual function later in life. Methods Self-administered questionnaires examined sexual desire, activity, satisfaction, and problems in a multiethnic cohort of women aged 40 years and older with at least one past childbirth event. Trained abstractors obtained information on parity, mode of delivery, and other parturition-related factors from archived records. Multivariable regression models examined associations with sexual function, controlling for age, race or ethnicity, partner status, diabetes, and general health. Results Among 1,094 participants, mean (±SD) age was 56.3 (±8.7) years, 568 (43%) were racial or ethnic minorities (214 Black, 171 Asian, and 183 Latina), and 963 (88%) were multiparous. Fifty-six percent (n=601) reported low sexual desire ; 53% (n=577) reported less than monthly sexual activity, and 43% (n=399) reported low overall sexual satisfaction. Greater parity was not associated with increased risk of reporting low sexual desire (adjusted odds ratio [AOR]=1.08, CI=0.96-1.21 per each birth), less than monthly sexual activity (AOR=1.05, CI=0.93-1.20 per each birth), or low sexual satisfaction (AOR=0.96, CI=0.85-1.09 per each birth). Compared to vaginal delivery alone, women with a history of cesarean delivery were not significantly more likely to report low desire (AOR=0.71, CI=0.34-1.47), less than monthly sexual activity (AOR=1.03, CI=0.46-2.32), or low sexual satisfaction (AOR=0.57, CI=0.26-1.22). Women with a history of operative-assisted delivery were more likely to report low desire (AOR=1.38, CI=1.04-1.83). Conclusions Among women with at least one childbirth event, parity and mode of delivery are not major determinants of sexual desire, activity, or satisfaction later in life.

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“…21 In some Latin American countries, including Brazil, the incidence of cesarean sections is as high as 80% in private care and leads to persistent concern within the healthcare system. 22 Introduction of a test that could predict the likelihood that a lesion would not occur might allow the expectant mother to be more comfortable and "secure" in opting for vaginal delivery.…”

Section: Discussionmentioning

confidence: 99%

Determination of a cutoff value for pelvic floor distensibility using the Epi-no balloon to predict perineal integrity in vaginal delivery: ROC curve analysis. Prospective observational single cohort study

et al. 2015

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CONTEXT AND OBJECTIVE: Several risk factors are involved in perineal lacerations during vaginal delivery. However, little is known about the influence of perineal distensibility as a protective factor. The aim here was to determine a cutoff value for pelvic floor distensibility measured using the Epi-no balloon, which could be used as a predictive factor for perineal integrity in vaginal delivery. DESIGN AND SETTING: Prospective observational single cohort study conducted in a maternity hospital. METHODS: A convenience sample of 227 consecutive at-term parturients was used. All women had a single fetus in the vertex presentation, with up to 9.0 cm of dilation. The maximum dilation of the Epi-no balloon was measured using a tape measure after it had been inflated inside the vagina up to the parturients' maximum tolerance. The receiver operating characteristic (ROC) curve was used to obtain the Epi-no circumference measurement with best sensitivity and specificity. RESULTS: Among the 161 patients who were included in the study, 50.9% underwent episiotomy, 21.8% presented lacerations and 27.3% retained an intact perineum. Age > 25.9 years; number of pregnancies > 3.4; number of deliveries > 2.2 and circumference measured by Epi-no > 21.4 cm were all directly correlated with an intact perineum. Circumference measurements using the Epi-no balloon that were greater than 20.8 cm showed sensitivity and specificity of 70.5% and 66.7% (area under curve = 0.713), respectively, as a predictive factor for an intact perineum in vaginal delivery. CONCLUSION: Circumferences greater than 20.8 cm achieved using the Epi-no balloon are a predictive factor for perineal integrity in parturients.

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Preferences and concerns for delivery: an antepartum survey

Cited by 28 publications

References 22 publications

Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study

Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study

Childbirth and Female Sexual Function Later in Life

Determination of a cutoff value for pelvic floor distensibility using the Epi-no balloon to predict perineal integrity in vaginal delivery: ROC curve analysis. Prospective observational single cohort study

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