Teresa N Sparks1, Amanda Yeaton-Massey2, Jesus M Granados3, Stephanie J Handler4, Michelle Meyer3, Aaron B Caughey5. 1. Department of Obstetrics and Gynecology, University of California, San Francisco, California. 2. Department of Obstetrics and Gynecology, Stanford University, Stanford, California. 3. University of California at San Francisco School of Medicine, San Francisco, California. 4. Department of Obstetrics and Gynecology, Cedars-Sanai, Los Angeles, California. 5. Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
Abstract
OBJECTIVE: To investigate how maternal views of delivery outcomes vary by demographic characteristics and preference toward mode of delivery (MOD). STUDY DESIGN: Survey of 719 pregnant women in outpatient clinics at an academic institution during their third trimester. Women ranked outcomes such as vaginal delivery (VD), cesarean delivery (CD), urinary incontinence, perineal lacerations, and induction of labor (IOL) on a visual analog scale (VAS) in order of worst imaginable (0) to best possible (100) outcomes. RESULTS: Women of all ages ranked VD as more desirable than CD. However, women ≥ 35 years of age had greater valuations of both MOD compared with women <35 years, with mean VAS scores of 88.4 versus 86.4 for VD (p < 0.001) and 61.5 versus 51.9 for CD (p < 0.001). Women with a college education or higher also rated both MOD as more desirable than women with less than a college education. Additionally, women who preferred VD rather than CD had greater valuations of perineal laceration (43.3 vs. 31.5, p = 0.001) and urinary incontinence (40.7 vs. 30.1, p = 0.002). CONCLUSION: Significant differences exist in women's views toward MOD and peripartum outcomes, by demographics and preferred MOD. Understanding delivery preferences better enables clinicians to counsel women about labor and management options. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
OBJECTIVE: To investigate how maternal views of delivery outcomes vary by demographic characteristics and preference toward mode of delivery (MOD). STUDY DESIGN: Survey of 719 pregnant women in outpatient clinics at an academic institution during their third trimester. Women ranked outcomes such as vaginal delivery (VD), cesarean delivery (CD), urinary incontinence, perineal lacerations, and induction of labor (IOL) on a visual analog scale (VAS) in order of worst imaginable (0) to best possible (100) outcomes. RESULTS:Women of all ages ranked VD as more desirable than CD. However, women ≥ 35 years of age had greater valuations of both MOD compared with women <35 years, with mean VAS scores of 88.4 versus 86.4 for VD (p < 0.001) and 61.5 versus 51.9 for CD (p < 0.001). Women with a college education or higher also rated both MOD as more desirable than women with less than a college education. Additionally, women who preferred VD rather than CD had greater valuations of perineal laceration (43.3 vs. 31.5, p = 0.001) and urinary incontinence (40.7 vs. 30.1, p = 0.002). CONCLUSION: Significant differences exist in women's views toward MOD and peripartum outcomes, by demographics and preferred MOD. Understanding delivery preferences better enables clinicians to counsel women about labor and management options. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: William A Grobman; Madeline M Rice; Uma M Reddy; Alan T N Tita; Robert M Silver; Gail Mallett; Kim Hill; Elizabeth A Thom; Yasser Y El-Sayed; Annette Perez-Delboy; Dwight J Rouse; George R Saade; Kim A Boggess; Suneet P Chauhan; Jay D Iams; Edward K Chien; Brian M Casey; Ronald S Gibbs; Sindhu K Srinivas; Geeta K Swamy; Hyagriv N Simhan; George A Macones Journal: N Engl J Med Date: 2018-08-09 Impact factor: 91.245