Abstract
Objective: This study aimed to determine the knowledge and attitudes of pregnant Thai women regarding modes of birth. Methods: A cross-sectional study was conducted at Songklanagarind Hospital. A total of 605 women with a singleton pregnancy and gestational age >20 weeks who attended an antenatal clinic from September 2018 to June 2019 were recruited. Women having a history of cesarean section, or any condition associated with indications for cesarean section, having a fetus with an obvious anomaly, could not read or write in the Thai language, or could not complete the questionnaire were excluded. Their knowledge and attitudes regarding modes of birth were evaluated through self-administered questionnaires. Results: Most women (69.4%) had poor knowledge scores (<5), with a median score of 3 (range, 0-9). Only 14.5% of women knew about serious complications of cesarean section in future pregnancies(placental adherence). Multivariate logistic regression analysis showed that factors associated with adequate knowledge scores (>5) were high educational levels (OR 2.06; 95% CI 1.23-3.47), high incomes (OR 1.96; 95%CI 1.32-2.90), and multiparity(OR 1.73; 95%CI 1.18-2.52). Most women had positive attitudes towards vaginal birth. Only 10.2% of women had a preference for cesarean birth. Factors associated with the preference for cesarean birth were advanced maternal age (OR 3.10; 95%CI 1.72-5.60), having an underlying disease (OR 3.61; 95% CI 1.79-7.25), and poor knowledge scores (OR 2.43; 95% CI 1.21-4.91). Conclusion: Most pregnant Thai women had poor knowledge of the modes of birth. However, the majority of women had positive attitudes towards vaginal birth.
Highlights
According to the latest data from 121 countries, the overall cesarean section rates increased from 6.7% in 1990 to 19.1% in 2014 [1]
Obstetrics and Gynecology) increased from 34.4% in 2001 to 55.3% in 2017, which is higher than the 10-15% rate recommended by the World Health Organization (WHO) [3]
We invited all pregnant women, who attended the antenatal clinic at Songklanagarind Hospital, a university hospital that serves as a tertiary referral center in Southern Thailand, from September 2018 to June 2019, to participate in this study
Summary
According to the latest data from 121 countries, the overall cesarean section rates increased from 6.7% in 1990 to 19.1% in 2014 [1]. Based on the data from a World Health Organization (WHO) global survey, the overall cesarean section rate from 2007 to 2008 in Thailand was 34.1% [2]. At our institution in Southern Thailand, the cesarean section rate (retrieved from the database of the Medical Statistics Unit of the Department of Obstetrics and Gynecology) increased from 34.4% in 2001 to 55.3% in 2017, which is higher than the 10-15% rate recommended by the WHO [3]. Several factors have contributed to the increased cesarean section rates for both medically and non-medically indicated reasons.
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