Liat Lerner-Geva1,2, Saralee Glasser1, Gila Levitan1, Valentina Boyko1, Abraham Golan2,3, Ron Beloosesky4, Eitan Lunenfeld5, Ariel Many2,6, Arnon Samueloff7, Eyal Schiff2,8, Ann Shoham8, Menachem Fisher9, Galit Hirsh-Yechezkel1. 1. a Women and Children's Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research Ltd , Tel Hashomer , Israel . 2. b School of Public Health, Sackler Faculty of Medicine, Tel Aviv University , Israel . 3. c Department of Obstetrics and Gynecology , Edith Wolfson Medical Center , Holon , Israel . 4. d Department of Obstetrics and Gynecology , Rambam Medical Center , Haifa , Israel . 5. e Department of Obstetrics and Gynecology , Soroka Medical Center , Beer Sheba , Israel . 6. f Maternity Department, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel . 7. g Maternity Department and Pregnancy Complications Unit, Shaare Zedek Medical Center , Jerusalem , Israel . 8. h Department of Obstetrics and Gynecology , Chaim Sheba Medical Center , Tel Hashomer , Israel . 9. i Department of Medicine in the Galil , Safed Campus, Bar Ilan University , Safed , Israel.
Abstract
OBJECTIVE: The current study aimed to evaluate the profile of women who are most likely to undergo caesarean delivery on maternal request (CDMR) and clarify their reasons for this decision. METHODS: For this multicentre case-control study, data were collected from 429 women who underwent CDMR and 429 matched controls who delivered vaginally from June, 2008 through February, 2009. Participants were interviewed by telephone regarding sociodemographic variables, health and lifestyle. RESULTS: CDMR predictors were as follows: increasing age (OR = 1.09/year; 95%CI: 1.05-1.14), family status (unmarried without a steady partner versus married - OR = 3.60; 95%CI: 1.08-11.97), decreasing level of religiosity (secular versus ultra-orthodox - OR = 11.82; 95%CI: 3.75-37.21), and never having engaged, or ceasing sports activity during pregnancy (OR = 1.79; 95%CI: 1.09-2.91 and 2.38; 95%CI: 1.28-4.43, respectively). Above average income reduced the probability of CDMR (OR = 0.56; 95%CI: 0.33-0.94). The most frequent reasons for choosing CDMR were concern for pain (21.9%), concern for their own or baby's health (20.4% and 16.5%, respectively) and emotional aspects (10.0%). CONCLUSIONS: Older, unmarried and/or secular women had increased probability of CDMR. Addressing specific concerns regarding vaginal delivery may provide the basis for a patient-oriented intervention for preventing unnecessary surgery.
OBJECTIVE: The current study aimed to evaluate the profile of women who are most likely to undergo caesarean delivery on maternal request (CDMR) and clarify their reasons for this decision. METHODS: For this multicentre case-control study, data were collected from 429 women who underwent CDMR and 429 matched controls who delivered vaginally from June, 2008 through February, 2009. Participants were interviewed by telephone regarding sociodemographic variables, health and lifestyle. RESULTS:CDMR predictors were as follows: increasing age (OR = 1.09/year; 95%CI: 1.05-1.14), family status (unmarried without a steady partner versus married - OR = 3.60; 95%CI: 1.08-11.97), decreasing level of religiosity (secular versus ultra-orthodox - OR = 11.82; 95%CI: 3.75-37.21), and never having engaged, or ceasing sports activity during pregnancy (OR = 1.79; 95%CI: 1.09-2.91 and 2.38; 95%CI: 1.28-4.43, respectively). Above average income reduced the probability of CDMR (OR = 0.56; 95%CI: 0.33-0.94). The most frequent reasons for choosing CDMR were concern for pain (21.9%), concern for their own or baby's health (20.4% and 16.5%, respectively) and emotional aspects (10.0%). CONCLUSIONS: Older, unmarried and/or secular women had increased probability of CDMR. Addressing specific concerns regarding vaginal delivery may provide the basis for a patient-oriented intervention for preventing unnecessary surgery.
Entities:
Keywords:
Caesarean section; maternal request; mode of delivery