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Am J Perinatol 2015; 32(08): 741-746
DOI: 10.1055/s-0034-1395480
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

How Do Maternal Views of Delivery Outcomes Vary by Demographics and Preferred Mode of Delivery?

Teresa N. Sparks
1   Department of Obstetrics and Gynecology, University of California, San Francisco, California
2   Department of Pediatrics-Genetics, University of California, San Francisco, California
,
Amanda Yeaton-Massey
3   Department of Obstetrics and Gynecology, Stanford University, Stanford, California
,
Jesus M. Granados
4   University of California at San Francisco School of Medicine, San Francisco, California
,
Stephanie J. Handler
5   Department of Obstetrics and Gynecology, Cedars-Sanai, Los Angeles, California
,
Michelle Meyer
4   University of California at San Francisco School of Medicine, San Francisco, California
,
Aaron B. Caughey
6   Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon
› Author Affiliations
Further Information

Publication History

17 June 2014

22 September 2014

Publication Date:
17 December 2014 (online)

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Abstract

Objective To investigate how maternal views of delivery outcomes vary by demographic characteristics and preference toward mode of delivery (MOD).

Study Design Survey of 719 pregnant women in outpatient clinics at an academic institution during their third trimester. Women ranked outcomes such as vaginal delivery (VD), cesarean delivery (CD), urinary incontinence, perineal lacerations, and induction of labor (IOL) on a visual analog scale (VAS) in order of worst imaginable (0) to best possible (100) outcomes.

Results Women of all ages ranked VD as more desirable than CD. However, women ≥ 35 years of age had greater valuations of both MOD compared with women <35 years, with mean VAS scores of 88.4 versus 86.4 for VD (p < 0.001) and 61.5 versus 51.9 for CD (p < 0.001). Women with a college education or higher also rated both MOD as more desirable than women with less than a college education. Additionally, women who preferred VD rather than CD had greater valuations of perineal laceration (43.3 vs. 31.5, p = 0.001) and urinary incontinence (40.7 vs. 30.1, p = 0.002).

Conclusion Significant differences exist in women's views toward MOD and peripartum outcomes, by demographics and preferred MOD. Understanding delivery preferences better enables clinicians to counsel women about labor and management options.

Keywords

vaginal delivery - cesarean delivery - obstetrics - maternal preferences - visual analog scale
 

  • References

  • 1 Martin JA, Hamilton BE, Ventura SJ, Osterman MJK, Mathews TJ. Births: Final data for 2011. Natl Vital Stat Rep 2013; 62 (1) 1-69 , 72. Available at: http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_09.pdf . Accessed February 18, 2014
    PubMedGoogle Scholar
  • 2 Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol 2008; 199 (1) 36, e1-e5 , discussion 91–92, e7–e11
    CrossrefPubMedGoogle Scholar
  • 3 Silver RM, Landon MB, Rouse DJ , et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol 2006; 107 (6) 1226-1232
    CrossrefPubMedGoogle Scholar
  • 4 Solheim KN, Esakoff TF, Little SE, Cheng YW, Sparks TN, Caughey AB. The effect of cesarean delivery rates on the future incidence of placenta previa, placenta accreta, and maternal mortality. J Matern Fetal Neonatal Med 2011; 24 (11) 1341-1346
    CrossrefPubMedGoogle Scholar
  • 5 Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol 2012; 207 (1) 14-29
    CrossrefPubMedGoogle Scholar
  • 6 Fridman M, Korst LM, Chow J, Lawton E, Mitchell C, Gregory KD. Trends in maternal morbidity before and during pregnancy in California. Am J Public Health 2014; 104 (Suppl. 01) S49-S57
    CrossrefPubMedGoogle Scholar
  • 7 Yang YT, Mello MM, Subramanian SV, Studdert DM. Relationship between malpractice litigation pressure and rates of cesarean section and vaginal birth after cesarean section. Med Care 2009; 47 (2) 234-242
    CrossrefPubMedGoogle Scholar
  • 8 National Institutes of Health Consensus Development Conference Panel. National Institutes of Health Consensus Development conference statement: vaginal birth after cesarean: new insights March 8-10, 2010. Obstet Gynecol 2010; 115 (6) 1279-1295
    CrossrefPubMedGoogle Scholar
  • 9 Srinivas SK, Epstein AJ, Nicholson S, Herrin J, Asch DA. Improvements in US maternal obstetrical outcomes from 1992 to 2006. Med Care 2010; 48 (5) 487-493
    CrossrefPubMedGoogle Scholar
  • 10 Coleman VH, Lawrence H, Schulkin J. Rising cesarean delivery rates: the impact of cesarean delivery on maternal request. Obstet Gynecol Surv 2009; 64 (2) 115-119
    CrossrefPubMedGoogle Scholar
  • 11 Angeja AC, Washington AE, Vargas JE, Gomez R, Rojas I, Caughey AB. Chilean women's preferences regarding mode of delivery: which do they prefer and why?. BJOG 2006; 113 (11) 1253-1258
    CrossrefPubMedGoogle Scholar
  • 12 Murray SF. Relation between private health insurance and high rates of caesarean section in Chile: qualitative and quantitative study. BMJ 2000; 321 (7275) 1501-1505
    CrossrefPubMedGoogle Scholar
  • 13 Pang MW, Lee TS, Leung AK, Leung TY, Lau TK, Leung TN. A longitudinal observational study of preference for elective caesarean section among nulliparous Hong Kong Chinese women. BJOG 2007; 114 (5) 623-629
    CrossrefPubMedGoogle Scholar
  • 14 Maharlouei N, Rezaianzadeh A, Hesami E , et al. The preference of Iranian women to have normal vaginal or cesarean deliveries. J Res Med Sci 2013; 18 (11) 943-950
    PubMedGoogle Scholar
  • 15 Torloni MR, Betrán AP, Montilla P , et al. Do Italian women prefer cesarean section? Results from a survey on mode of delivery preferences. BMC Pregnancy Childbirth 2013; 13: 78
    CrossrefPubMedGoogle Scholar
  • 16 Yamasmit W, Chaithongwongwatthana S. Attitude and preference of Thai pregnant women towards mode of delivery. J Med Assoc Thai 2012; 95 (5) 619-624
    PubMedGoogle Scholar
  • 17 Karlström 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
    CrossrefPubMedGoogle Scholar
  • 18 Li WY, Liabsuetrakul T, Stray-Pedersen B. Change of childbirth preference after delivery among nulliparous Chinese women and their partners. J Obstet Gynaecol Res 2014; 40 (1) 184-191
    CrossrefPubMedGoogle Scholar
  • 19 Viswanathan M, Visco AG, Hartmann K , et al. Cesarean delivery on maternal request. Evid Rep Technol Assess (Full Rep) 2006; (133) 1-138
    PubMedGoogle Scholar
  • 20 Chen CL, Kuppermann M, Caughey AB, Zane LT. A community-based study of acne-related health preferences in adolescents. Arch Dermatol 2008; 144 (8) 988-994
    PubMedGoogle Scholar
  • 21 Schwarz EB, Smith R, Steinauer J, Reeves MF, Caughey AB. Measuring the effects of unintended pregnancy on women's quality of life. Contraception 2008; 78 (3) 204-210
    CrossrefPubMedGoogle Scholar