Mode of Delivery Preference Among Pregnant Nulliparous Women

Abstract

Background: Nearly a third of women in the United States deliver by cesarean at first childbirth. The extent to which women's prenatal mode of delivery preference contributes to the cesarean decision is not clear. Little research has measured pregnant nulliparous women's prelabor mode of delivery preference in relation to actual mode of delivery in the United States. Materials and Methods: A total of 3006 pregnant nulliparous women were asked about mode of delivery preference during pregnancy as part of the First Baby Study, a prospective study of women delivering in Pennsylvania hospitals, 2009-2011. Multivariable regression models were used to assess the association between women's preference for cesarean delivery and two decision stages: (1) the decision to have planned prelabor cesarean and (2) the intrapartum decision to have unplanned cesarean among those attempting vaginal delivery, adjusting for confounders. Results: Overall, 3.1% preferred cesarean delivery, 3.0% had no preference, and 93.9% preferred vaginal. Among those who preferred vaginal delivery, 4% had a planned cesarean; among those with no preference, 13.3% did; and among those who preferred cesarean, 33.7% did. In adjusted models, preference for cesarean was strongly associated with having planned prelabor cesarean (adjusted odds ratio [aOR] = 6.02; 95% confidence interval [CI] = 3.26-11.12), but was not significantly associated with unplanned cesarean among those who attempted vaginal delivery (aOR = 1.35; 95% CI = 0.77-2.38). Conclusions: Although preference for cesarean delivery among nulliparous women was uncommon, women who preferred cesarean were more likely to have planned prelabor cesarean delivery than those who preferred vaginal delivery.

Delivery Mode Preference and Associated Factors among Pregnant Mothers in Harar Regional State, Eastern Ethiopia: A Cross-Sectional Study

“…The discrepancy emerged, as our study interviewed the mothers in ANC unit, whereas the reference studies conducted in delivery units which may decrease mothers tendency to choose C/S due to fear when labor approaches. Meanwhile, comparing to our result, much lower intention to C/S was observed in University of California (1.2%), in Nerchowk, Himachal Pradesh (7%), and in State of Pennsylvania (C/S = 3:1%) [18][19][20]. Hence, mothers were surveyed in the postpartum period after they undergo C/S for their next birth preference.…”

Fear of Childbirth in Chinese Pregnant Women and Their Preferred Mode of Delivery: Validation Study of the Chinese Version of Wijma Delivery Expectancy/experience Questionnaire Version A

“…This is found to be much higher than other Western countries such as the United states of America and Norway, where only 3.5% and 3.1% nulliparous women voiced a preference for Caesarean delivery antenatally. (47,48). In contrast, up to 17% primigravida women in China wished to undergo Caesarean section for childbirth, which is more comparable to the results of our study (49).…”

Effect of sexual dysfunction on women's preference for delivery methods: a social media-based survey

“…Psychological factors underlying the preferences about the mode of delivery have been investigated in previous studies. Kjerulff et al [12] found that being depressed during pregnancy and fear of childbirth increased the odds of preferring C/S. Gamble and Creedy [13] found that anxious women were more likely to prefer C/S.…”