Abstract
Objective: This study explores the basic demographic characteristics of expectant mothers in the context of their intentions regarding mode of delivery, in particular, the preference for caesarean delivery, and analyzes the social and psychological factors that influence delivery preference. Method: A cross-sectional survey of pregnant women was conducted during June to August in 2015. This study adopted a stratified sampling method, and 16 representative hospitals in five provinces of China were included. Results: 1755 and 590 of expectant mothers in their first and second pregnancies, respectively, were enrolled in this study. 354 (15.10%) intended to deliver by caesarean section and 585 (24.95%) participants were uncertain prior to delivery. 156 (8.89%) of expectant mothers in their first pregnancy and 198 (33.56%) expectant mothers in their second pregnancy intended to deliver by caesarean section. Ordinal logistic regression analysis found that nationality, parity, trimester of pregnancy, and advanced maternal age were factors associated with intention to deliver by caesarean (ordered logistic regression/three-level caesarean delivery intention criterion; odds ratios p < 0.05). Conclusions: 8.89% of first pregnancy expectant mothers and 33.56% of second pregnancy expectant mothers intended to deliver by caesarean section. Any intervention program to reduce the rate of Caesarean delivery should focus on the Han population, older pregnant women, and expectant mothers in their second pregnancy, at an early gestation.
Highlights
In 1985, the World Health Organization declared in Fortaleza, Brazil, that “There is no justification for any region to have a caesarean section rate higher than 10%–15%” [1]
156 (8.9%) expectant mothers in their first pregnancy and 198 (33.6%) expectant mothers in their second pregnancy intended to deliver by CS. 346 (15.4%) Han nationality and 8 (8.6%) minority nationality intended to deliver by CS. 42 (14.3%) in the first trimester of pregnancy and 97 (13.8%)
In the ordinal logistic regression analysis model, this study found that compared with expectant mothers in their first pregnancy, expectant mothers in their second pregnancy were more likely to have
Summary
In 1985, the World Health Organization declared in Fortaleza, Brazil, that “There is no justification for any region to have a caesarean section rate higher than 10%–15%” [1]. In middle/low-income countries, the optimal caesarean section (CS) rate is influenced by preferences regarding delivery, available medical services, family income, and the health care professionals’ qualifications, as well as parents’ education level. The increased preference for CS is likely to be influenced by multiple additional factors, such as the financial status, underlying diseases, level of education, family/social environment, reproductive knowledge, media reports, feedback from social circles and medical staff, as well as the previous delivery experience [13]. As for the primipara, the increase may be related to differences in clinical decision making or maternal request Other reasons, such as anxiety, various pregnancy complications, a painful previous childbirth experience, as well as the neonatal morbidities caused by the vaginal delivery, may influence a choice to opt for CS [17]. We compared the delivery preferences of women in their first and second pregnancies and analyze socioeconomic factors that impact on delivery preference
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