期刊论文详细信息
BMC Pregnancy and Childbirth
Do Italian women prefer cesarean section? Results from a survey on mode of delivery preferences
Mario Merialdi1  Gian Paolo Donzelli2  Francesca Merzagora5  Fernando Althabe3  Agustina Mazzoni3  Armando Seuc1  Elisa Scolaro1  Pilar Montilla5  Ana Pilar Betrán1  Maria Regina Torloni4 
[1]Department of Reproductive Health and Research, World Health Organization, 20, via Appia CH-1211, Geneva, Switzerland
[2]Meyer Children Hospital, University of Florence, Italy, Viale Gaetano Pieraccini, Florence, 24 50141, Italy
[3]Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina, Dr. Emilio Ravignani 2024, Buenos Aires, C1414CPV, Argentina
[4]Obstetrics Department, São Paulo Federal University, São Paulo, Brazil, Rua Borges Lagoa 564, conj. 63, São Paulo, SP, CEP 04038-000, Brazil
[5]O.N.Da, Osservatorio Nazionale sulla salute della Donna, Milan, Italy, Foro Buonaparte, Milan, 48 2012, Italy
关键词: Women;    Public opinion;    Vaginal birth after cesarean;    Cesarean section;    Obstetric;    Delivery;    Health surveys;   
Others  :  1138122
DOI  :  10.1186/1471-2393-13-78
 received in 2012-08-12, accepted in 2013-03-19,  发布年份 2013
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【 摘 要 】

Background

About 20 million cesareans occur each year in the world and rates have steadily increased in almost all middle- and high-income countries over the last decades. Maternal request is often argued as one of the key forces driving this increase. Italy has the highest cesarean rate of Europe, yet there are no national surveys on the views of Italian women about their preferences on route of delivery. This study aimed to assess Italian women´s preference for mode of delivery, as well as reasons and factors associated with this preference, in a nationally representative sample of women.

Methods

This cross sectional survey was conducted between December 2010-March 2011. An anonymous structured questionnaire asked participants what was their preferred mode of delivery and explored the reasons for this preference by assessing their agreement to a series of statements. Participants were also asked to what extent their preference was influenced by a series of possible sources. The 1st phase of the study was carried out among readers of a popular Italian women´s magazine (Io Donna). In a 2nd phase, the study was complemented by a structured telephone interview.

Results

A total of 1000 Italian women participated in the survey and 80% declared they would prefer to deliver vaginally if they could opt. The preference for vaginal delivery was significantly higher among older (84.7%), more educated (87.6%), multiparous women (82.3%) and especially among those without any previous cesareans (94.2%). The main reasons for preferring a vaginal delivery were not wanting to be separated from the baby during the first hours of life, a shorter hospital stay and a faster postpartum recovery. The main reasons for preferring a cesarean were fear of pain, convenience to schedule the delivery and because it was perceived as being less traumatic for the baby. The source which most influenced the preference of these Italian women was their obstetrician, followed by friends or relatives.

Conclusion

Four in five Italian women would prefer to deliver vaginally if they could opt. Factors associated with a higher preference for cesarean delivery were youth, nulliparity, lower education and a previous cesarean.

【 授权许可】

   
2013 Torloni et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Betran AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van LP: Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol 2007, 21(2):98-113.
  • [2]World Health Organization: Facts and Figures from the World Health Report. 2005. http://www.who.int/whr/2005/media_centre/facts_en.pdf webcite
  • [3]ACOG: ACOG Committee Opinion No. 394, December 2007. Cesarean delivery on maternal request. Obstet Gynecol 2007, 110(6):1501.
  • [4]Althabe F, Sosa C, Belizan JM, Gibbons L, Jacquerioz F, Bergel E: Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth 2006, 33(4):270-277.
  • [5]Belizan JM, Cafferata ML, Althabe F, Buekens P: Risks of patient choice cesarean. Birth 2006, 33(2):167-169.
  • [6]Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A: Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet 2006, 367(9525):1819-1829.
  • [7]Gibbons L, Belizan JM, Lauer JA, Betran AP, Merialdi M, Althabe F: Inequities in the use of cesarean section deliveries in the world. Am J Obstet Gynecol 2012, 206(4):331-19.
  • [8]Dubourg D, Richard F, Van LW, De BV: Need for caesarean sections in west Africa. Lancet 2002, 359(9310):974-975.
  • [9]Brazilian Ministry of Health: Pesquisa Nacional de Demografía e Saúde da Criança e da Mulher. Ministério da Saúde. 2008. Available from: URL: http://bvsms.saude.gov.br/bvs/pnds/index.php webcite
  • [10]Hopkins K: Are Brazilian women really choosing to deliver by cesarean? Soc Sci Med 2000, 51(5):725-740.
  • [11]Italian Ministry of Health: Ministero della Salute. SDO. Anno 2011; 2011.
  • [12]Cohain JS: Documented causes of unneCesareans. Midwifery Today Int Midwife 2009, 63(92):18-19.
  • [13]Graham WJ, Hundley V, McCheyne AL, Hall MH, Gurney E, Milne J: An investigation of women's involvement in the decision to deliver by caesarean section. Br J Obstet Gynaecol 1999, 106(3):213-220.
  • [14]Jackson NV, Irvine LM: The influence of maternal request on the elective caesarean section rate. J Obstet Gynaecol 1998, 18(2):115-119.
  • [15]Mould TA, Chong S, Spencer JA, Gallivan S: Women's involvement with the decision preceding their caesarean section and their degree of satisfaction. Br J Obstet Gynaecol 1996, 103(11):1074-1077.
  • [16]Usha Kiran TS, Jayawickrama NS: Who is responsible for the rising caesarean section rate? J Obstet Gynaecol 2002, 22(4):363-365.
  • [17]Wilkinson C, McIlwaine G, Boulton-Jones C, Cole S: Is a rising caesarean section rate inevitable? Br J Obstet Gynaecol 1998, 105(1):45-52.
  • [18]Karlstrom A, Nystedt A, Johansson M, Hildingsson I: Behind the myth–few women prefer caesarean section in the absence of medical or obstetrical factors. Midwifery 2011, 27(5):620-627.
  • [19]Mazzoni A, Althabe F, Liu NH, Bonotti AM, Gibbons L, Sanchez AJ: Women's preference for caesarean section: a systematic review and meta-analysis of observational studies. BJOG 2011, 118(4):391-399.
  • [20]McCourt C, Weaver J, Statham H, Beake S, Gamble J, Creedy DK: Elective cesarean section and decision making: a critical review of the literature. Birth 2007, 34(1):65-79.
  • [21]Tranquilli AL, Giannubilo SR: Cesarean delivery on maternal request in Italy. Int J Gynaecol Obstet 2004, 84(2):169-170.
  • [22]Edwards GJ, Davies NJ: Elective caesarean section–the patient's choice? J Obstet Gynaecol 2001, 21(2):128-129.
  • [23]Geary M, Fanagan M, Boylan P: Maternal satisfaction with management in labour and preference for mode of delivery. J Perinat Med 1997, 25(5):433-439.
  • [24]Hildingsson I, Radestad I, Rubertsson C, Waldenstrom U: Few women wish to be delivered by caesarean section. BJOG 2002, 109(6):618-623.
  • [25]Johanson RB, El-Timini S, Rigby C, Young P, Jones P: Caesarean section by choice could fulfil the inverse care law. Eur J Obstet Gynecol Reprod Biol 2001, 97(1):20-22.
  • [26]Murphy DJ, Liebling RE: Cohort study of maternal views on future mode of delivery after operative delivery in the second stage of labor. Am J Obstet Gynecol 2003, 188(2):542-548.
  • [27]Rouhe H, Salmela-Aro K, Halmesmaki E, Saisto T: Fear of childbirth according to parity, gestational age, and obstetric history. BJOG 2009, 116(1):67-73.
  • [28]Weaver JJ, Statham H, Richards M: Are there "unnecessary" cesarean sections? Perceptions of women and obstetricians about cesarean sections for nonclinical indications. Birth 2007, 34(1):32-41.
  • [29]Wiklund I, Edman G, Ryding EL, Andolf E: Expectation and experiences of childbirth in primiparae with caesarean section. BJOG 2008, 115(3):324-331.
  • [30]Donati S, Grandolfo ME, Andreozzi S: Do Italian mothers prefer cesarean delivery? Birth 2003, 30(2):89-93.
  • [31]Mancuso A, De VA, Fanara G, Settineri S, Triolo O, Giacobbe A: Women's preference on mode of delivery in Southern Italy. Acta Obstet Gynecol Scand 2006, 85(6):694-699.
  • [32]National Institute of Statistics: Archivio statistiche in breve: anni 2004–2005. Istituto Nazionale di Statistica. 2006. Available from: URL: http://www.istat.it/it/ webcite
  • [33]Corriere della Sera: Corriere della Sera Media Details. RCS Pubblicità; 2012. Available from: URL: http://www.rcspubblicita.it/site/en/home/media/newspapers/corriere-della-sera.html webcite
  • [34]ICC/ESOMAR Code on Market and Social Research: ICC/ESOMAR. 2008. Available from: URL: http://www.esomar.org/uploads/public/knowledge-and-standards/codes-and-guidelines/ICCESOMAR_Code_English_.pdf webcite
  • [35]de Leeuw ED: To Mix or Not to Mix Data Collection Modes in Surveys. JOS 2005, 21(2):233-255.
  • [36]Italian Ministry of Health: Ministero della Salute Certificato di assistenza al parto (CeDAP). Analisi dell'evento nascita: Anno 2009; 2010.
  • [37]Lumbiganon P, Laopaiboon M, Gulmezoglu AM, Souza JP, Taneepanichskul S, Ruyan P: Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet 2010, 375(9713):490-499.
  • [38]Karlstrom A, Radestad I, Eriksson C, Rubertsson C, Nystedt A, Hildingsson I: Cesarean section without medical reason, 1997 to 2006: a Swedish register study. Birth 2010, 37(1):11-20.
  • [39]Robson SJ, Tan WS, Adeyemi A, Dear KB: Estimating the rate of cesarean section by maternal request: anonymous survey of obstetricians in Australia. Birth 2009, 36(3):208-212.
  • [40]Fenwick J, Gamble J, Hauck Y: Reframing birth: a consequence of cesarean section. J Adv Nurs 2006, 56(2):121-130.
  • [41]Hall WA, Hauck YL, Carty EM, Hutton EK, Fenwick J, Stoll K: Childbirth fear, anxiety, fatigue, and sleep deprivation in pregnant women. J Obstet Gynecol Neonatal Nurs 2009, 38(5):567-576.
  • [42]Saisto T, Halmesmaki E: Fear of childbirth: a neglected dilemma. Acta Obstet Gynecol Scand 2003, 82(3):201-208.
  • [43]Waldenstrom U, Hildingsson I, Ryding EL: Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG 2006, 113(6):638-646.
  • [44]Wax JR, Cartin A, Pinette MG, Blackstone J: Patient choice cesarean: an evidence-based review. Obstet Gynecol Surv 2004, 59(8):601-616.
  • [45]Nieminen K, Stephansson O, Ryding EL: Women's fear of childbirth and preference for cesarean section–a cross-sectional study at various stages of pregnancy in Sweden. Acta Obstet Gynecol Scand 2009, 88(7):807-813.
  • [46]Fenwick J, Staff L, Gamble J, Creedy DK, Bayes S: Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery 2010, 26(4):394-400.
  • [47]Minkoff H, Chervenak FA: Elective primary cesarean delivery. N Engl J Med 2003, 348(10):946-950.
  • [48]Behruzi R, Hatem M, Fraser W, Goulet L, Ii M, Misago C: Facilitators and barriers in the humanization of childbirth practice in Japan. BMC Pregnancy Childbirth 2010, 10:25. BioMed Central Full Text
  • [49]Misago C, Umenai T, Onuki D, Haneda K, Wagner M: Humanised maternity care. Lancet 1999, 354(9187):1391-1392.
  • [50]Rilby L, Jansson S, Lindblom B, Martensson LB: A qualitative study of women's feelings about future childbirth: dread and delight. J Midwifery Womens Health 2012, 57(2):120-125.
  • [51]Wagner M: Fish can't see water: the need to humanize birth. Int J Gynaecol Obstet 2001, 75(Suppl 1):S25-S37.
  • [52]Torloni MR, Daher S, Betran AP, Widmer M, Montilla P, Souza JP: Portrayal of caesarean section in Brazilian women's magazines: 20 year review. BMJ 2011, 342:d276.
  • [53]Dobson R: Caesarean section rate in England and Wales hits 21. BMJ 2001, 323(7319):951.
  • [54]Kwee A, Cohlen BJ, Kanhai HH, Bruinse HW, Visser GH: Caesarean section on request: a survey in The Netherlands. Eur J Obstet Gynecol Reprod Biol 2004, 113(2):186-190.
  • [55]Langer A, Villar J: Promoting evidence based practice in maternal care. BMJ 2002, 324(7343):928-929.
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