Women’s experiences of decision-making and beliefs in relation to planned caesarean section: A survey study

Coates, D; Donnolley, N; Thirukumar, P; Lainchbury, A; Spear, V; Henry, A

Women’s experiences of decision-making and beliefs in relation to planned caesarean section: A survey study

Coates, D

Donnolley, N Thirukumar, P Lainchbury, A Spear, V Henry, A

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Publisher:: Wiley
Publication Type:: Journal Article
Citation:: Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020
Issue Date:: 2020-01-01

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Field	Value	Language
dc.contributor.author	Coates, D https://orcid.org/0000-0002-4463-7615
dc.contributor.author	Donnolley, N
dc.contributor.author	Thirukumar, P
dc.contributor.author	Lainchbury, A
dc.contributor.author	Spear, V
dc.contributor.author	Henry, A
dc.date.accessioned	2020-10-02T00:44:08Z
dc.date.available	2020-10-02T00:44:08Z
dc.date.issued	2020-01-01
dc.identifier.citation	Australian and New Zealand Journal of Obstetrics and Gynaecology, 2020
dc.identifier.issn	0004-8666
dc.identifier.issn	1479-828X
dc.identifier.uri	http://hdl.handle.net/10453/142998
dc.description.abstract	© 2020 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: The caesarean section (CS) rate is over 25% in many high-income countries, with a substantial minority of CSs occurring in women with low-risk pregnancies. CS decision-making is influenced by clinician and patient beliefs and preferences, and clinical guidelines increasingly stipulate the importance of shared decision-making (SDM). To what extent SDM occurs in practice is unclear. Aims: To identify women’s birth preferences and SDM experience regarding planned CS. Material and Methods: Survey of women at eight Sydney hospitals booked for planned CS. Demographic data, initial mode of birth preferences, reason for CS, and experiences of SDM were elicited using questions with multiple choice lists, Likert scales, and open-ended responses. Quantitative data were analysed using descriptive statistics and qualitative data using content analysis. Responses of women who perceived their CS as 'requested' vs 'recommended' were compared. Results: Of 151 respondents, repeat CS (48%) and breech presentation (14%) were the most common indications. Only 32% stated that at the beginning of pregnancy they had a definite preference for spontaneous labour and birth. Key reasons for wanting planned CS were to avoid another emergency CS, prior positive CS experience, and logistical planning. Although 15% of women felt pressured (or were unsure) about their CS decision, the majority reported positive experiences, with over 90% indicating they were informed about CS benefits and risks, had adequate information, and understood information provided. Conclusions: The majority (85%) of women appeared satisfied with the decision-making process, regardless of whether they perceived their CS as requested or recommended.
dc.language	en
dc.publisher	Wiley
dc.relation.ispartof	Australian and New Zealand Journal of Obstetrics and Gynaecology
dc.relation.isbasedon	10.1111/ajo.13255
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.title	Women’s experiences of decision-making and beliefs in relation to planned caesarean section: A survey study
dc.type	Journal Article
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	open_access	*
utslib.copyright.embargo	2022-02-01T00:00:00+1000Z
dc.date.updated	2020-10-02T00:43:43Z
pubs.publication-status	Published

Abstract:

© 2020 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Background: The caesarean section (CS) rate is over 25% in many high-income countries, with a substantial minority of CSs occurring in women with low-risk pregnancies. CS decision-making is influenced by clinician and patient beliefs and preferences, and clinical guidelines increasingly stipulate the importance of shared decision-making (SDM). To what extent SDM occurs in practice is unclear. Aims: To identify women’s birth preferences and SDM experience regarding planned CS. Material and Methods: Survey of women at eight Sydney hospitals booked for planned CS. Demographic data, initial mode of birth preferences, reason for CS, and experiences of SDM were elicited using questions with multiple choice lists, Likert scales, and open-ended responses. Quantitative data were analysed using descriptive statistics and qualitative data using content analysis. Responses of women who perceived their CS as 'requested' vs 'recommended' were compared. Results: Of 151 respondents, repeat CS (48%) and breech presentation (14%) were the most common indications. Only 32% stated that at the beginning of pregnancy they had a definite preference for spontaneous labour and birth. Key reasons for wanting planned CS were to avoid another emergency CS, prior positive CS experience, and logistical planning. Although 15% of women felt pressured (or were unsure) about their CS decision, the majority reported positive experiences, with over 90% indicating they were informed about CS benefits and risks, had adequate information, and understood information provided. Conclusions: The majority (85%) of women appeared satisfied with the decision-making process, regardless of whether they perceived their CS as requested or recommended.

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http://hdl.handle.net/10453/142998