Pregnant women's preference for cesarean section and subsequent mode of birth - a six-country cohort study.

• Published in: Journal of Psychosomatic Obstetrics & Gynecology
• Main Authors: Ryding, Elsa Lena, Lukasse, Mirjam, Kristjansdottir, Hildur, Steingrimsdottir, Thora, Schei, Berit
• Other Authors: 1 Karolinska Inst, Div Obstet & Gynecol, Dept Womens & Childrens Hlth, S-17176 Stockholm, Sweden 2 Oslo & Akershus Univ Coll Appl Sci, Dept Hlth Nutr & Management, Oslo, Norway 3 Landspitali Univ Hosp, Fac Nursing, Dept Midwifery, Reykjavik, Iceland Organization-Enhanced Name(s) Landspitali National University Hospital 4 Landspitali Univ Hosp, Dept Obstet & Gynecol, Reykjavik, Iceland Organization-Enhanced Name(s) Landspitali National University Hospital 5 Norwegian Univ Sci & Technol, Dept Publ Hlth & Gen Practice, N-7034 Trondheim, Norway 6 St Olavs Univ Hosp, Dept Obstet & Gynecol, Trondheim, Norway
• Format: Article in Journal/Newspaper
• Language: English
• Published: Taylor & Francis Ltd 2016
• Subjects: Keisaraskurðir; Tíðni; OAG12; Cesarean Section; Cohort Studies; Norway; Iceland
• Online Access: http://hdl.handle.net/2336/617962; https://doi.org/10.1080/0167482X.2016.1181055

To access publisher's full text version of this article click on the hyperlink at the bottom of the page The rate of cesarean section (CS) for non-medical reasons has risen and it is a concern for health care. Women's preferences may vary across countries for psychosocial or obstetric reasons. A prospective cohort study of 6549 women in routine antenatal care giving birth in Belgium, Iceland, Denmark, Estonia, Norway or Sweden. Preference for mode of birth was self-reported in mid-pregnancy. Birth outcome data were collected from hospital records. A CS was preferred by 3.5% of primiparous women and 8.7% of the multiparous women. Preference for CS was associated with severe fear of childbirth (FOC), with a negative birth experience in multiparous women and with depressive symptoms in the primiparous. Women were somewhat more prone to prefer a cesarean in Iceland, odd ratio (OR) 1.70 (1.02-2.83), adjusted for age, education, depression, FOC, history of abuse, previous cesarean and negative birth experience. Out of the 404 women who preferred CS during pregnancy, 286 (70.8%) delivered by CS, mostly for a medical indication. A total of 9% of the cesareans in the cohort had a non-medical indication only. Women's preference for CS often seems to be due to health concerns. Both medical and psychological factors need to be addressed in antenatal counseling. Obstetricians need to convey accurately to women the risks and benefits of CS in her specific case. Maternity professionals should identify and explore psychosocial reasons for women's preferences. Daphne II Program, European Commission for Freedom, Security, and Justice, Brussels, Belgium JLS/2006/DAP-1/242/W30-CE-0120887/00o87 Norwegian Research Council 204292