Women’s caesarean section preferences: A multicountry cross-sectional survey in low- and middle-income countries

Objective To measure the proportion of women's preferences for CS in hospitals with high caesarean section rates and to identify related factors. Design A cross-sectional hospital-based postpartum survey was conducted. We used multilevel multivariate logistic regression and probit models to ana...

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Detalles Bibliográficos
Autores: Etcheverry, Camille, Betrán, Ana Pilar, de Loenzien, Myriam, Kaboré, Charles, Lumbiganon, Pisake, Carroli, Guillermo, Nhu Hung Mac, Quoc, Gialdini, Celina, Dumont, Alexandre, QUALI-DEC Research Group
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Ramon Llull (URL)
Repositorio:DAU Arxiu Digital de la Universitat Ramon Llull
OAI Identifier:oai:dau.url.edu:20.500.14342/5323
Acceso en línea:http://hdl.handle.net/20.500.14342/5323
https://doi.org/10.1016/j.midw.2024.103979
Access Level:acceso abierto
Palabra clave:Cesària (Operació)
Preferències de les dones
Naixement
Països de renda baixa i mitjana
Descripción
Sumario:Objective To measure the proportion of women's preferences for CS in hospitals with high caesarean section rates and to identify related factors. Design A cross-sectional hospital-based postpartum survey was conducted. We used multilevel multivariate logistic regression and probit models to analyse the association between women's caesarean section preferences and maternal characteristics. Probit models take into account selection bias while excluding women who had no preference. Setting Thirty-two hospitals in Argentina, Thailand, Vietnam and Burkina Faso were selected. Participants A total of 1,979 post-partum women with no potential medical need for caesarean section were included among a representative sample of women who delivered at each of the participating facilities during the data collection period. Findings The overall caesarean section rate was 23.3 %. Among women who declared a preference in late pregnancy, 9 % preferred caesarean section, ranging from 1.8 % in Burkina Faso to 17.8 % in Thailand. Primiparous women were more likely to prefer a caesarean section than multiparous women (β=+0.16 [+0.01; +0.31]; p = 0.04). Among women who preferred caesarean section, doctors were frequently cited as the main influencers, and “avoid pain in labour” was the most common perceived benefit of caesarean section. Key conclusions Our results suggest that a high proportion of women prefer vaginal birth and highlight that the preference for caesarean section is linked to women's fear of pain and the influence of doctors. These results can inform the development of interventions aimed at supporting women and their preferences, providing them with evidence-based information and changing doctors' behaviour in order to reduce the number of unnecessary caesarean sections.