Caesarean section delivery from maternal perspective: An exploratory study in Jordan

Abstract

Caesarean section (CS) is one of the most commonly performed abdominal surgeries in women during recent decades. 1,2 The rate of CS varies between countries and medical facilities but continues to rise all over the world. 1,2 It is thought that some pregnant women ask for CS delivery even when there is no medical indication, where many pregnant females prefer the CS procedure because of their fear of labour pain, which is the most common reason for avoiding spontaneous vaginal delivery. 3 Despite medical advances and increasing access to improved obstetric care across the globe, CS deliveries are still more risky for both mother and baby. The literature has identified that CS causes increased risk of maternal and neonatal morbidity and mortality. 2,4 The World Health Organization (WHO) focuses on the fact that performing CS without a medical purpose could put the mother and her baby at risk of short-and long-term complications. 2 Those include the risk of death, blood transfusion, hysterectomy and risks related to the stay in an intensive care unit (ICU). 5 Furthermore, the lack of labour in elective CS delivery increases the risk of neonatal mortality, prolonged ICU stay 4 and extremely elevated costs. 6 In 1985, based on evidence at that time, WHO put an optimal rate for CS of 10%-15%, 7 but in 2015, WHO replaced this rate and stated that

Attitudes of midwives and obstetricians towards midwives practiced roles in hospitals: A national study in Jordan

“…7 There is a great conflict to determine roles for both midwives and obstetricians, but generally, most guidelines indicate that midwives should always refer to obstetricians to determine, for example who should attend giving birth, a midwife or a physician. 8,9 Obstetricians consider that power and authority inequalities are the usual and compulsory rules during practice, 10 as they perceive themselves as the only decisionmakers and describe themselves as the end of line, where midwives will eventually return to. 10 In addition, obstetricians put professional midwives with the untrained traditional birth attended at the same level, which strongly reflects obstetricians' lack of clear understandings and appreciations of midwifery-led models.…”

“…In contrast, the medical‐led model considers labour a mechanical process once it begins it should progress steadily in which labour pain is a pathological problem that needs anaesthesia and intervention 7 . There is a great conflict to determine roles for both midwives and obstetricians, but generally, most guidelines indicate that midwives should always refer to obstetricians to determine, for example who should attend giving birth, a midwife or a physician 8,9 . Obstetricians consider that power and authority inequalities are the usual and compulsory rules during practice, 10 as they perceive themselves as the only decision‐makers and describe themselves as the end of line , where midwives will eventually return to 10 …”