Maternal request for cesarian birth without medical indication in a group of healthy women: A qualitative study in Jordan

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ObjectiveTo explore women's reasons for requesting an elective cesarian birth without medical indication and to describe the factors that affect their decision to choose a cesarian birth. DesignA descriptive qualitative content analysis approach was used for the gathering and analysis of data. Interviews were held with 35 first-time mothers. The participants were recruited by using a purposive sampling method. Interviews were begun with the same question which sked about women's reasons for requesting cesarian birth without medical indication. Other questions were used to facilitate the interview and elicit the factors that led this group of first-time Jordanian mothers to choose a cesarian birth. SettingA private hospital in Amman, the capital of Jordan, was selected as the location for the data gathering process. Data collection and analysis were conducted concurrently and interviews were discontinued when data saturation was reached. ParticipantsThe participants consisted of 35 first-time mothers recruited by using a purposive sampling method. FindingsSocio-demographic, economic status, and childbirth culture played an important role in influencing women's requests for an elective cesarian. Women made their decision based on the lived negative experience of other women and were driven and supported by their social network. Five themes that reflected the reasons for elective cesarian birth without medical indication were identified: (1) fear of vaginal birth process, (2) concerns about future sexual life, (3) need for humanized birth, (4) personal reasons, and (5) decision-making process. Conclusions and implicationsThe women's reasons for choosing cesarian birth without medical indication and the factors influencing the women's decision-making process were complex and interrelated and reflect a lack of appropriate informed choice about elective cesarian. The findings therefore suggest that healthcare policy makers need to attend to the reasons and the factors that influence women's decision-making about cesarian birth in order to promote the trend of women having a vaginal birth. Evidence-based knowledge and strategies to reduce elective caesareans should be disseminated to healthcare providers in maternity settings. Future explorations of this issue should address obstetricians’ and midwives’ views and attitudes about cesarian birth without medical indication.