The easy option? Australian findings on mothers' perception of elective Caesarean as a birth choice after a prior Caesarean section

Abstract

As the rate of primary and repeat Caesareans around the world increases, obstetricians, midwives and primary care providers are being expected to provide counsel to women seeking information regarding birth choices for delivery after a prior emergency Caesarean. This article seeks to contribute to the knowledge on this topic by presenting research findings from a qualitative study designed to explore, from the mothers' perspective, the decision-making experience with regards to subsequent birth choice for women who have previously delivered by Caesarean section. Specifically, the findings in this article present the perspective of the mothers who opted for elective Caesarean. Eighty per cent of mothers in this study chose elective Caesarean for reasons of fear and the desire to retain some control over the birthing process. For many, this decision is made prior to or early in pregnancy without any openness to consider other possibilities. Thus, the findings strongly emphasize the importance of understanding and taking into consideration the mothers' psychosocial perspective on birth choices as a key to providing counsel and support.

Vivência do parto normal ou cesáreo: revisão integrativa sobre a percepção de mulheres

“…1619 They feel insecure and manipulated, which translates into pain, neglect and abandonment that reflects the physical, psychological or emotional violence to which they were submitted, 19 characterized by a lack of care and even by a lack of professional follow-up. 21 In regards to the negative perceptions of caesarean section, the women mentioned the pain of the postpartum period, the difficulties in recovery, 11,[23][24] the risks of surgery, 21,24 concerns about previous experiences with anesthesia, 17,21,23 higher levels of fear when compared with natural childbirth, [12][13][20][21]23 and difficulty in resuming sexual activities. 24 Women who had a cesarean section by choice or in an emergency were more unhappy when remembering the birth of their children.…”

“…It is important to highlight that the choices are based more on psychosocial aspects than on clinical advice or information about risk. 23 A cross-sectional study showed the existence of a possible association between maternal age and satisfaction with the birth experience, revealing a negative correlation (-0.21) in which the age variable varies in the opposite direction, i.e., the higher the age, the lower the satisfaction and vice versa. 12 …”

“…20,26 Positive factors regarding cesarean delivery were identified by women who have experienced this type of delivery in the past and chose to have it again. 23 They described as positive aspects of this choice that cesarean delivery is easier and faster, the surgical incision is performed on top of the already existing scar, they can set the date, there is greater control and safety for the baby, they avoid the fear of childbirth and induction, they already know what to expect of the procedure, they avoid the trauma of a new emergency cesarean section and recovery is relatively easy. It is important to highlight that the choices are based more on psychosocial aspects than on clinical advice or information about risk.…”

“…20 They highlight the importance of using qualitative research to fully understand their experience. 23 Other factors identified in studies as being of interest for further research were: the relationship between health professionals and the women they care for in childbirth, 11 psychological preparation for the emotional adaptation which occurs after childbirth 12 and attention to high-risk pregnant women or women with diagnoses of fetal abnormality or malformation. 17 …”

“…18,21,24 They can deal with the pain using non-pharmacological methods and the minimum use of medication. 10 In relation to caesarean section, the reasons to consider it the best form of childbirth are associated with: absence of labor pains, 11,13,[23][24] avoiding the fear of childbirth, 23 the speed of the procedure, 11 the possibility of having a tubal ligation at the same time, 24 safety for the baby, 11,20 having information and control over the event (when the cesarean section is planned), being an overall pleasant experience and enjoying the child with safety. 20 In two studies, high levels of satisfaction were reported by mothers who experienced cesarean section.…”