Why women request cesarean section without medical indication?

Dursun, Polat; Yanık, Filiz Bilgin; Zeyneloglu, Hulusi Bulent; Başer, Eralp; Kuşçu, Esra; Ayhan, Ali

doi:10.3109/14767058.2010.531327

Cited by 51 publications

(61 citation statements)

References 20 publications

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“…33 This indicates a lack of information available to pregnant women, because a number of studies have shown that infants born by caesarean section are exposed to more risks compared with those born vaginally. A recent review summarises short-term as well as longer-term effects of delivery by prelabour caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish case–control study

Karlström

Lindgren

Hildingsson

2013

BJOG

134

109

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Objective To compare maternal complications and infant outcomes for women undergoing elective caesarean sections based on a maternal request and without recorded medical indication with those of women who underwent spontaneous onset of labour with the intention to have a vaginal birth.Design Retrospective register study.Setting Sweden; Medical Birth Register used for data collection.Methods A case-control study of 5877 birth records of women undergoing caesarean sections without medical indication and a control group of 13 774 women undergoing births through spontaneous onset of labour. The control group was further divided into women who actually had a vaginal birth and women who ended up with an emergency caesarean section.Results Maternal complications occurred more frequently among women undergoing caesarean section with odds ratios (OR) for bleeding complications of 2.5 (95% CI 2.1-3.0) in the elective caesarean group and 2.0 (95% CI 1.5-2.6) in the emergency caesarean group. The OR for infections was 2.6 in both groups. Breastfeeding complications were most common in women having an elective caesarean section: 6.8 (95% CI 3.2-14.5). Infant outcomes showed a higher incidence of respiratory distress with an OR of 2.7 (95% CI 1.8-3.9) in the elective caesarean section group compared with infants born by emergency caesarean section. The risk of hypoglycaemia was at least twice as high for infants in the caesarean group.Conclusions Caesarean sections without medical indication as well as emergency caesarean sections were associated with higher risks for maternal and infant morbidity.

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Section: Discussionmentioning

confidence: 99%

Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish case–control study

Karlström

Lindgren

Hildingsson

2013

BJOG

134

109

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“…56,57 Furthermore, another study reported that almost half of women thought a cesarean delivery without medical indication should be performed upon request, despite minimal knowledge about the risks and benefits of one. 58 We advocate policies and strategies that support informed and shared decision-making for women, their families, and clinicians. Nevertheless, there are instances where the spontaneous onset of labor occurs before 39 weeks or planned birth is unavoidable, and it is important that appropriate interventions and support in early childhood are developed and provided for these potentially vulnerable children.…”

Section: Discussionmentioning

confidence: 99%

Planned Birth Before 39 Weeks and Child Development: A Population-Based Study

et al. 2016

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To investigate the association of gestational age and mode of birth with early child development. METHODS:Population-based record linkage cohort study was conducted among 153 730 liveborn infants of ≥32 weeks' gestation with developmental assessments at school age, in New South Wales, Australia, 2002 to 2007. Children were assessed in 5 domains: physical health and well-being, language and cognition, social competence, emotional maturity, and general knowledge and communication. Children scoring in the bottom 10% of national domains were considered developmentally vulnerable, and children developmentally vulnerable for ≥2 domains were classified as developmentally high risk (DHR), the primary outcome. Robust multivariable Poisson models were used to obtain individual and combined adjusted relative risks (aRRs) of gestational age and mode of birth for DHR children.RESULTS: Overall, 9.6% of children were DHR. The aRR (95% confidence interval) of being DHR increased with decreasing gestational age (referent: 40 weeks); 32 to 33 weeks 1.25 (1.08-1.44), 34 to 36 weeks 1.26 (1.18-1.34), 37 weeks 1.17 (1.10-1.25), 38 weeks 1.06 (1.01-1.10), 39 weeks 0.98 (0.94-1.02), ≥41 weeks 0.99 (0.94-1.03), and for labor induction or prelabor cesarean delivery (planned birth; referent: vaginal birth after spontaneous labor), 1.07 (1.04-1.11). The combined aRR for planned birth was 1.26 (1.18-1.34) at 37 weeks and 1.13 (1.08-1.19) at 38 weeks.CONCLUSIONS: Early (at <39 weeks) planned birth is associated with an elevated risk of poor child development at school age. The timing of planned birth is modifiable, and strategies to inform more judicious decision-making are needed to ensure optimal child health and development.

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“…We also found that an increased preference for cesarean delivery was associated with an increased level of education, perhaps due to increased knowledge about the risks and benefits of each mode of delivery. However, previous results showing a relationship between level of education and choice of cesarean delivery in the absence of any medical indication found that most of these women did not have detailed knowledge about the benefits and risks of these modes of delivery [13].…”

Section: Discussionmentioning

confidence: 77%

Vaginal Birth or Cesarean Section: Recommendations of Women Who Delivered Via Both Methods

Guldeniz¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Hem vajinal doğum hem de sezaryen ile doğum yapmış kadınların hangi doğum şeklini önerdikleri ve bu önerilerin sebeplerinin belirlenmesi. Gereç ve Yöntem: Çalışmaya hem vajinal doğum hem de sezaryen ile doğum yapmış olan ve ortalama yaşları 42.1 ±7.6 olan toplam 204 kadın dahil edildi. Vajinal ve sezaryen doğum ile ilgili deneyimlerini sorgulayan bir anket hazırlandı. Bulgular: Sezaryen endikasyonları, anne tercihi (40) ve obstetrik endikasyonlardı (164). İkiyüzdört kadından 129'u (% 63.2), diğer kadınlara vajinal doğum önermiştir. Vajinal doğum eylemi sırasında zor doğum yaşayan katılımcılar, vajinal doğumu "kolay" olarak kabul edenlere göre daha fazla sezaryen öner-mişlerdir (%65.4'e karşılık %10.4, p <0.01). Eğitim düzeyi (p = 0.011) yüksel-dikçe sezaryen önerisi verilmesi de anlamlı ölçüde artmaktadır. Vajinal doğu-mu önerenlerin belirttikleri en sık neden postpartum rahatlık(% 64.3), sezaryen önerenlerin belirttikleri en sık neden ise eylemin kolayca sonlanmasıdır. (% 53.3). Obstetrik endikasyonlar nedeni ile sezaryen doğum yapan kadınla-rın çoğunluğu (% 69.6) vajinal doğumu önermiştir, oysa ki anne tercihi nedeni ile sezaryen doğum yapan kadınların büyük kısmı (% 62.5) sezaryen doğumu önermiştir. Tartışma: Her iki yöntem ile doğum yapmış kadınlar arasında vajinal doğum önerenler % 63.2 oranındadır, en sık neden postpartum konfordur. Sezaryen önerenler, vajinal doğum esnasındaki ağrıya göre daha kolay tolere edilmesi nedeniyle bu tavsiyede bulunmuşlardır.Anahtar Kelimeler Doğum Şekilleri; Sezaryen; Vajinal Doğum; Hasta Önerileri Abstract Aim: To determine which method is recommended by women who have delivered via both methods and their reasons for this recommendation. Material and Method: The study included 204 women, mean age was 42±7.6 years with history of both vaginal and cesarean delivery. A questionnaire was prepared about experiences with vaginal and caesarean delivery. Results: Reasons for cesarean section were maternal preference (40), and obstetric indications (164). Of the 204 women, 129 (63.2%) recommended vaginal delivery to other women. More participants who experienced difficult labor during vaginal delivery recommended cesarean delivery than those who considered their vaginal delivery "easy" (65.4% vs.10.4%, p<0.01). Recommendation of cesarean section increased significantly with the level of education (p=0.011). The most frequent reason for recommend vaginal delivery was postpartum comfort (64.3%), for recommend cesarean delivery were easy labor (53.3%). Most women who delivered via cesarean section due to obstetric indications (69.6%) recommended vaginal route, whereas most who chose cesarean delivery (62.5%) recommended cesarean section. Discussion: Among women who had delivered via both methods, 63.2% of those recommended vaginal delivery due to primarily postpartum comfort. Patients who recommend cesarean section regarded it as easier primarily because of pain during vaginal delivery.

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Why women request cesarean section without medical indication?

Abstract: Although majority of the women had wrong idea or no idea about the risks and benefits of CD, nearly half of them indicated that women can always demand CDMR. This study shows that basal knowledge of the women should be improved by education.

Cited by 51 publications

References 20 publications

Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish case–control study

Maternal and infant outcome after caesarean section without recorded medical indication: findings from a Swedish case–control study

Planned Birth Before 39 Weeks and Child Development: A Population-Based Study

Vaginal Birth or Cesarean Section: Recommendations of Women Who Delivered Via Both Methods

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