Breast feeding after caesarean delivery on maternal request: protocol of a systematic review and meta-analysis

Abstract

IntroductionCaesarean delivery under maternal request (CDMR) is a major factor contributing to the rising global rates of caesarean section (CS) procedure. The choice of CDMR without medical indications could provide a sense of assured safety by avoiding the experiences and complications of vaginal birth, and the risks related to an emergency CS. However, it might adversely influence women’s breast feeding patterns and produce a long-lasting impact on maternal and neonatal health. This study aims to systematically review the current evidence relating to the effects of intentions of performing CDMR on breast feeding.Methods and analysisA comprehensive literature search will be performed in three English-language electronic databases, major clinical study registries and other sources for original studies reporting the breast feeding outcomes after a planned CDMR or vaginal delivery. The three databases Medline, Embase and the Cochrane Central Register of Controlled Trials will be searched via Ovid from inception to February 2020. Randomised controlled trials (RCTs), pseudo-RCTs, cohort studies and case–control studies on this topic will be included. Participants in the experimental or case group should meet the Robson criteria of classes 2B or 4B and have experienced planned CS undertaken for no maternal or foetal indication, whereas participants in the control group have undergone scheduled vaginal delivery. All kinds of breast feeding outcomes will be included. Meta-analyses will be attempted to provide an estimate of the pooled effect and will be stratified by different study designs. A qualitative description will be provided if quantitative synthesis proves to be fruitless.Ethics and disseminationThis study is a secondary literature review that does not need ethical approval. No primary data will be collected from the participants. Findings of this study will be presented at scientific conferences and be published in scientific journals.PROSPERO registration numberCRD42020160303.

Rural–urban disparities in caesarean deliveries in sub-Saharan Africa: a multivariate non-linear decomposition modelling of Demographic and Health Survey data

“…Globally, the rate of caesarean deliveries has increased significantly from approximately 16.0 million (12.1% of all births) in the year 2000 to 29.7 million (21.1% of all births) in 2015 [8]. The increase in caesarean deliveries has largely been attributed to the growing rate of childbirths occurring at healthcare facilities due to improved access and the increasing trend of maternal requests for caesarean deliveries [6,[9][10][11]. The increasing trend of maternal requests for caesarean deliveries has become a global concern due to its exposure of women to short and long-term risk for maternal health complications [11,12].…”

“…The increase in caesarean deliveries has largely been attributed to the growing rate of childbirths occurring at healthcare facilities due to improved access and the increasing trend of maternal requests for caesarean deliveries [6,[9][10][11]. The increasing trend of maternal requests for caesarean deliveries has become a global concern due to its exposure of women to short and long-term risk for maternal health complications [11,12].…”

CAESAREAN DELIVERY ON MATERNAL REQUEST: the perspective of the postpartum women

“…Studies show that children born by C-section have a greater chance of developing asthma, type 1 diabetes, obesity and other autoimmune childhood diseases (18). Also, after a C-section, women are at risk of abnormal placentation and placenta accreta, premature placental abruption, miscarriage and stillbirth in subsequent pregnancies (19), late initiation of breastfeeding (13,18,20), higher prevalence of postpartum and urinary infections, anaesthetic complications, headache, surgical complications, but also, lower risk of anaemia, short-term urinary incontinence, and haemorrhoids (21).…”