Subscribe to RSS
DOI: 10.1055/s-0031-1280598
Maternal Goals for Childbirth Associated with Planned Vaginal and Planned Cesarean Birth
Publication History
Publication Date:
09 June 2011 (online)
![](https://www.thieme-connect.de/media/ajp/201109/lookinside/thumbnails/10.1055-s-0031-1280598-1.jpg)
ABSTRACT
We describe maternal childbirth goals among women planning either cesarean or vaginal birth. Women in the third trimester planning cesarean or vaginal birth were asked to report up to five childbirth goals. Goal achievement was assessed postpartum. Based on free-text responses, discrete goal categories were identified. Goals and goal achievement were compared between the two groups. Satisfaction was rated on a visual analogue scale and was compared with goal achievement. The sample included 163 women planning vaginal birth and 69 women planning cesarean. Twelve goal categories were identified. Only women planning vaginal birth reported a desire to achieve fulfillment related to childbirth. Women planning cesarean were less likely to express a desire to maintain control over their own responses during childbirth and more likely to report a desire to avoid complications. The 72 women who achieved all stated goals reported significantly higher mean satisfaction scores than the 94 women reporting that at least one goal was not achieved (p = 0.001). Goal achievement was higher among women planning cesarean than among those planning vaginal birth (52.2% versus 23.1%, p < 0.001). This research furthers our understanding of women's attitudes regarding cesarean childbirth and definitions of a successful birth experience.
KEYWORDS
Cesarean - vaginal birth - patient-centered goals - maternal satisfaction
REFERENCES
- 1 Penny Simkin P. Birth plans: after 25 years, women still want to be heard. Birth. 2007; 34 49-51
- 2 National Institutes of Health state-of-the-science conference statement: cesarean delivery on maternal request March 27–29, 2006. Obstet Gynecol. 2006; 107 1386-1397
- 3 Kingdon C, Neilson J, Singleton V et al.. Choice and birth method: mixed-method study of caesarean delivery for maternal request. BJOG. 2009; 116 886-895
- 4 Weaver J J, Statham H, Richards M. Are there “unnecessary” cesarean sections? Perceptions of women and obstetricians about cesarean sections for nonclinical indications. Birth. 2007; 34 32-41
- 5 Kingdon C, Baker L, Lavender T. Systematic review of nulliparous women's views of planned cesarean birth: the missing component in the debate about a term cephalic trial. Birth. 2006; 33 229-237
- 6 McCourt C, Weaver J, Statham H, Beake S, Gamble J, Creedy D K. Elective cesarean section and decision making: a critical review of the literature. Birth. 2007; 34 65-79
- 7 Gamble J, Creedy D K, McCourt C, Weaver J, Beake S. A critique of the literature on women's request for cesarean section. Birth. 2007; 34 331-340
- 8 Blomquist J L, Quiroz L H, Macmillan D, Mccullough A, Handa V L. Mothers' satisfaction with planned vaginal and planned cesarean birth. Am J Perinatol. 2011; March 4 [Epub ahead of print]
- 9 Morgan B M, Bulpitt C J, Clifton P, Lewis P J. Analgesia and satisfaction in childbirth (the Queen Charlotte's 1000 Mother Survey). Lancet. 1982; 2 808-810
- 10 Capogna G, Alahuhtat S, Celleno D et al.. Maternal expectations and experiences of labour pain and analgesia: a multicentre study of nulliparous women. Int J Obstet Anesth. 1996; 5 229-235
- 11 Hodnett E D. Pain and women's satisfaction with the experience of childbirth: a systematic review. Am J Obstet Gynecol. 2002; 186 (5, Suppl Nature) S160-S172
- 12 Wiklund I, Edman G, Andolf E. Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers. Acta Obstet Gynecol Scand. 2007; 86 451-456
- 13 Cotterill N, Norton C, Avery K N, Abrams P, Donovan J L. A patient-centered approach to developing a comprehensive symptom and quality of life assessment of anal incontinence. Dis Colon Rectum. 2008; 51 82-87
- 14 Hullfish K L, Bovbjerg V E, Steers W D. Colpocleisis for pelvic organ prolapse: patient goals, quality of life, and satisfaction. Obstet Gynecol. 2007; 110 (2 Pt 1) 341-345
- 15 Mahajan S T, Elkadry E A, Kenton K S, Shott S, Brubaker L. Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery. Am J Obstet Gynecol. 2006; 194 722-728
- 16 Hullfish K L, Bovbjerg V E, Gibson J, Steers W D. Patient-centered goals for pelvic floor dysfunction surgery: what is success, and is it achieved?. Am J Obstet Gynecol. 2002; 187 88-92
Lieschen H QuirozM.D.
Assistant Professor, Oklahoma University Health Sciences
920 SL Young Blvd., WP 2430 Oklahoma City, OK 73104
Email: lieschen-quiroz@ouhsc.edu