Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand

Suwanrath, Chitkasaem; Chunuan, Sopen; Matemanosak, Phawat; Pinjaroen, Sutham

doi:10.1186/s12884-020-03525-3

Cited by 42 publications

(46 citation statements)

References 16 publications

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“…Some women experienced strong fear of pain and injuries to the mother and child during labor and birth [ 24 , 29 , 30 , 33 , 36 , 41 , 49 , 50 , 52 , 55 , 58 – 61 , 65 , 67 – 72 , 74 ]. It was described consistently as a reason for CS on maternal request.…”

Section: Resultsmentioning

confidence: 99%

“…Finding 1: Deep rooted fears regarding vaginal birth (High confidence). Some women experienced strong fear of pain and injuries to the mother and child during labor and birth [24,29,30,33,36,41,49,50,52,55,[58][59][60][61]65,[67][68][69][70][71][72]74]. It was described consistently as a reason for CS on maternal request.…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

“…The possibility to plan day and time was described hinged on qualities associated with organization and control over the timing of the birth [23,34,39,40,42,61,67,70,74]. This is related with the idea of CS as a more civilized way to give birth [23,25,40,[42][43][44]50,59,62,63].…”

Section: Plos Onementioning

confidence: 99%

“…Also, women who preferred elective CS, reported to have constructed their decision in the best interests of the baby, largely because of what they conceived as safety associated with technologically advanced surgical birth and less trauma for the baby [23,29,31,33,35,36,[41][42][43][44][45]48,[53][54][55]57,[62][63][64][65]70,74].…”

Section: Plos Onementioning

confidence: 99%

“…[23,24,27,33,41,43,44,50,51,54,55,58,63,65,67,69,74] High-income 28[25,26,[28][29][30]32,[34][35][36][37][38][39][40]42,45,46,48,49,52,56,57,59,60,62,64,66,68,72,75] Setting Facility based 35 [25,27-29,31,32,34-36,38,39,41-43,48,50,51,54-56,58-61,65,67-70,72,74,76] c Pregnant women 32 [23,25,28,29,32,34,36-44,46,51,53-56,58-62,64,67,68,70,72,74] Non-pregnant women 18 [23,27,29,33,49-53,57,62,63,65,66,69,71-73] Women with previous CS 20 [26,31-35,37,39,47-51,57,60,65,69,71-73] a Fourteen studies used more than one of the listed data collection methods [24,28,30,35,39,40,47,50,58,60,66,67,70]. b Includes data collection through open-ended questions in a written survey [48], field notes [28], diaries [35,36] and internet blog [64].…”

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confidence: 99%

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Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences

Colomar¹,

Opiyo

Kingdon

et al. 2021

PLoS ONE

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Background Caesarean sections (CS) continue to increase worldwide. Multiple and complex factors are contributing to the increase, including non-clinical factors related to individual women, families and their interactions with health providers. This global qualitative evidence synthesis explores women’s preferences for mode of birth and factors underlying preferences for CS. Methods Systematic database searches (MEDLINE, EMBASE, CINAHL, PsycINFO) were conducted in December 2016 and updated in May 2019 and February 2021. Studies conducted across all resource settings were eligible for inclusion, except those from China and Taiwan which have been reported in a companion publication. Phenomena of interest were opinions, views and perspectives of women regarding preferences for mode of birth, attributes of CS, societal and cultural beliefs about modes of birth, and right to choose mode of birth. Thematic synthesis of data was conducted. Confidence in findings was assessed using GRADE-CERQual. Results We included 52 studies, from 28 countries, encompassing the views and perspectives of pregnant women, non-pregnant women, women with previous CS, postpartum women, and women’s partners. Most of the studies were conducted in high-income countries and published between 2011 and 2021. Factors underlying women preferences for CS had to do mainly with strong fear of pain and injuries to the mother and child during labour or birth (High confidence), uncertainty regarding vaginal birth (High confidence), and positive views or perceived advantages of CS (High confidence). Women who preferred CS expressed resoluteness about it, but there were also many women who had a clear preference for vaginal birth and those who even developed strategies to keep their birth plans in environments that were not supportive of vaginal births (High confidence). The findings also identified that social, cultural and personal factors as well as attributes related to health systems impact on the reasons underlying women preferences for various modes of birth (High confidence). Conclusions A wide variety of factors underlie women’s preferences for CS in the absence of medical indications. Major factors contributing to perceptions of CS as preferable include fear of pain, uncertainty with vaginal birth and positive views on CS. Interventions need to address these factors to reduce unnecessary CS.

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Section: Resultsmentioning

confidence: 99%

Section: Summary Of Main Findingsmentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

mentioning

confidence: 99%

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Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences

Colomar¹,

Opiyo

Kingdon

et al. 2021

PLoS ONE

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Low-Value Surgical Procedures in Low- and Middle-Income Countries

Albarqouni,

Abukmail,

MohammedAli

et al. 2023

JAMA Netw Open

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ImportanceOveruse of surgical procedures is increasing around the world and harms both individuals and health care systems by using resources that could otherwise be allocated to addressing the underuse of effective health care interventions. In low- and middle-income countries (LMICs), there is some limited country-specific evidence showing that overuse of surgical procedures is increasing, at least for certain procedures.ObjectivesTo assess factors associated with, extent and consequences of, and potential solutions for low-value surgical procedures in LMICs.Evidence ReviewWe searched 4 electronic databases (PubMed, Embase, PsycINFO, and Global Index Medicus) for studies published from database inception until April 27, 2022, with no restrictions on date or language. A combination of MeSH terms and free-text words about the overuse of surgical procedures was used. Studies examining the problem of overuse of surgical procedures in LMICs were included and categorized by major focus: the extent of overuse, associated factors, consequences, and solutions.FindingsOf 4276 unique records identified, 133 studies across 63 countries were included, reporting on more than 9.1 million surgical procedures (median per study, 894 [IQR, 97-4259]) and with more than 11.4 million participants (median per study, 989 [IQR, 257-6857]). Fourteen studies (10.5%) were multinational. Of the 119 studies (89.5%) originating from single countries, 69 (58.0%) were from upper-middle–income countries and 30 (25.2%) were from East Asia and the Pacific. Of the 42 studies (31.6%) reporting extent of overuse of surgical procedures, most (36 [85.7%]) reported on unnecessary cesarean delivery, with estimated rates in LMICs ranging from 12% to 81%. Evidence on other surgical procedures was limited and included abdominal and percutaneous cardiovascular surgical procedures. Consequences of low-value surgical procedures included harms and costs, such as an estimated US $3.29 billion annual cost of unnecessary cesarean deliveries in China. Associated factors included private financing, and solutions included social media campaigns and multifaceted interventions such as audits, feedback, and reminders.Conclusions and RelevanceThis systematic review found growing evidence of overuse of surgical procedures in LMICs, which may generate significant harm and waste of limited resources; the majority of studies reporting overuse were about unnecessary cesarean delivery. Therefore, a better understanding of the problems in other surgical procedures and a robust evaluation of solutions are needed.

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Maternal age and adverse pregnancy outcomes among Meitei women of Manipur, Northeast India: A cross‐sectional study

Devi,

Singh

2023

American J Hum Biol

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ObjectiveThe study examines the outcomes of pregnancies conceived at advanced maternal age (AMA) and maternal complications after childbirth among Meitei women of Northeast India.MethodA total of 760 women participants were included in this study and compared among women aged ≥35 years, with a reference group of women aged 20–34 years. Data on obstetric characteristics were collected after obtaining consent. The data were compared using chi‐square analysis, and the results were adjusted using a logistic regression model. Decision trees were developed to predict the potential variables associated with preterm delivery and postpartum complication.ResultsIn the study, 18.95% of AMA women experienced one or more adverse pregnancy outcomes (APOs). Women with AMA are at significantly increased risk of placenta previa (adjusted odds ratio [AOR] = 4.89, 95% confidence interval [CI]: 2.78–8.57), induction of labor (AOR = 3.69, 95%CI: 2.48–5.50), and caesarean section (AOR = 3.42, 95%CI: 2.28–5.12). Moreover, AMA women have a 1.86–2.76 AOR for developing gestational diabetes, pregnancy‐induced hypertension, urinary tract infections, preterm delivery, and postpartum complications. Decision tree analysis revealed that AMA and urban residence independently predict preterm delivery and postpartum complications.ConclusionThe study's findings confirm the adverse impact of AMA on pregnancy outcomes and postpartum complications. Such issues should be addressed, and counseling on the risk of AMA should be provided, particularly for those in the high‐risk group. Further prospective studies are needed to understand other potential risk factors of APOs and the impact of AMA complications to prevent the associated burden.

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Why do pregnant women prefer cesarean birth? A qualitative study in a tertiary care center in Southern Thailand

Cited by 42 publications

References 16 publications

Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences

Do women prefer caesarean sections? A qualitative evidence synthesis of their views and experiences

Low-Value Surgical Procedures in Low- and Middle-Income Countries

Maternal age and adverse pregnancy outcomes among Meitei women of Manipur, Northeast India: A cross‐sectional study

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