Rising caesarean section rates and factors affecting women's decision-making about mode of birth in Indonesia: a longitudinal qualitative study.
Zahroh, RI
Hazfiarini, A
Martiningtyas, MA
Ekawati, FM
Emilia, O
Cheong, M
Betran, AP
Homer, CS
Bohren, MA
- Publisher:
- BMJ PUBLISHING GROUP
- Publication Type:
- Journal Article
- Citation:
- BMJ Glob Health, 2024, 9, (6), pp. e014602
- Issue Date:
- 2024-06-18
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Full metadata record
Field | Value | Language |
---|---|---|
dc.contributor.author | Zahroh, RI | |
dc.contributor.author | Hazfiarini, A | |
dc.contributor.author | Martiningtyas, MA | |
dc.contributor.author | Ekawati, FM | |
dc.contributor.author | Emilia, O | |
dc.contributor.author | Cheong, M | |
dc.contributor.author | Betran, AP | |
dc.contributor.author | Homer, CS | |
dc.contributor.author | Bohren, MA | |
dc.date.accessioned | 2024-08-06T03:44:33Z | |
dc.date.available | 2024-05-08 | |
dc.date.available | 2024-08-06T03:44:33Z | |
dc.date.issued | 2024-06-18 | |
dc.identifier.citation | BMJ Glob Health, 2024, 9, (6), pp. e014602 | |
dc.identifier.issn | 2059-7908 | |
dc.identifier.issn | 2059-7908 | |
dc.identifier.uri | http://hdl.handle.net/10453/180157 | |
dc.description.abstract | INTRODUCTION: Caesarean section (CS) rates in Indonesia are increasing rapidly. Understanding women's preferences about mode of birth is important to help contextualise these rising rates and can help develop interventions to optimise CS. This study aimed to explore Indonesian women's preferences and decision-making about mode of birth, and how their preferences may change throughout pregnancy and birth. METHODS: We conducted a longitudinal qualitative study using in-depth interviews with 28 women accessing private and public health facilities in Jakarta, the region with the highest CS rates. Interviews were conducted two times: during the woman's third trimester of pregnancy and in the postpartum period, between October 2022 and March 2023. We used a reflexive thematic approach for analysis. RESULTS: We generated three themes: (1) preferences about the mode of birth, (2) decision-making about the mode of birth and (3) regrets about the actual mode of birth. Most women preferred vaginal birth. However, they were influenced by advertisements promoting enhanced recovery after CS (ERACS) as an 'advanced technique' of CS, promising a comfortable, painless and faster recovery birth. This messaging influenced women to perceive CS as equivalent or even superior to vaginal birth. Where women's preferences for mode of birth shifted around the time of birth, this was primarily due to the obstetricians' discretion. Women felt they did not receive adequate information from obstetricians on the benefits and risks of CS and vaginal birth and felt disappointed when their actual mode of birth was not aligned with their preferences. CONCLUSION: Our study shows that despite rising CS rates, Indonesian women prefer vaginal birth. This highlights the need for better communication strategies and evidence-based information from healthcare providers. Given the rising popularity of ERACS, more work is urgently needed to standardise and regulate its use. | |
dc.format | Electronic | |
dc.language | eng | |
dc.publisher | BMJ PUBLISHING GROUP | |
dc.relation.ispartof | BMJ Glob Health | |
dc.relation.isbasedon | 10.1136/bmjgh-2023-014602 | |
dc.rights | info:eu-repo/semantics/openAccess | |
dc.subject.classification | 4203 Health services and systems | |
dc.subject.classification | 4206 Public health | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Female | |
dc.subject.mesh | Indonesia | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Decision Making | |
dc.subject.mesh | Cesarean Section | |
dc.subject.mesh | Longitudinal Studies | |
dc.subject.mesh | Qualitative Research | |
dc.subject.mesh | Patient Preference | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Interviews as Topic | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Cesarean Section | |
dc.subject.mesh | Longitudinal Studies | |
dc.subject.mesh | Decision Making | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Qualitative Research | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Indonesia | |
dc.subject.mesh | Female | |
dc.subject.mesh | Interviews as Topic | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Patient Preference | |
dc.subject.mesh | Humans | |
dc.subject.mesh | Female | |
dc.subject.mesh | Indonesia | |
dc.subject.mesh | Pregnancy | |
dc.subject.mesh | Adult | |
dc.subject.mesh | Decision Making | |
dc.subject.mesh | Cesarean Section | |
dc.subject.mesh | Longitudinal Studies | |
dc.subject.mesh | Qualitative Research | |
dc.subject.mesh | Patient Preference | |
dc.subject.mesh | Young Adult | |
dc.subject.mesh | Interviews as Topic | |
dc.title | Rising caesarean section rates and factors affecting women's decision-making about mode of birth in Indonesia: a longitudinal qualitative study. | |
dc.type | Journal Article | |
utslib.citation.volume | 9 | |
utslib.location.activity | England | |
pubs.organisational-group | University of Technology Sydney | |
pubs.organisational-group | University of Technology Sydney/Faculty of Health | |
pubs.organisational-group | University of Technology Sydney/Strength - CHSP - Health Services and Practice | |
pubs.organisational-group | University of Technology Sydney/Strength - WHO CC | |
utslib.copyright.status | open_access | * |
dc.rights.license | This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0/ | |
dc.date.updated | 2024-08-06T03:44:30Z | |
pubs.issue | 6 | |
pubs.publication-status | Published online | |
pubs.volume | 9 | |
utslib.citation.issue | 6 |
Abstract:
INTRODUCTION: Caesarean section (CS) rates in Indonesia are increasing rapidly. Understanding women's preferences about mode of birth is important to help contextualise these rising rates and can help develop interventions to optimise CS. This study aimed to explore Indonesian women's preferences and decision-making about mode of birth, and how their preferences may change throughout pregnancy and birth. METHODS: We conducted a longitudinal qualitative study using in-depth interviews with 28 women accessing private and public health facilities in Jakarta, the region with the highest CS rates. Interviews were conducted two times: during the woman's third trimester of pregnancy and in the postpartum period, between October 2022 and March 2023. We used a reflexive thematic approach for analysis. RESULTS: We generated three themes: (1) preferences about the mode of birth, (2) decision-making about the mode of birth and (3) regrets about the actual mode of birth. Most women preferred vaginal birth. However, they were influenced by advertisements promoting enhanced recovery after CS (ERACS) as an 'advanced technique' of CS, promising a comfortable, painless and faster recovery birth. This messaging influenced women to perceive CS as equivalent or even superior to vaginal birth. Where women's preferences for mode of birth shifted around the time of birth, this was primarily due to the obstetricians' discretion. Women felt they did not receive adequate information from obstetricians on the benefits and risks of CS and vaginal birth and felt disappointed when their actual mode of birth was not aligned with their preferences. CONCLUSION: Our study shows that despite rising CS rates, Indonesian women prefer vaginal birth. This highlights the need for better communication strategies and evidence-based information from healthcare providers. Given the rising popularity of ERACS, more work is urgently needed to standardise and regulate its use.
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