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Elective Caesarean section on maternal request in Germany: factors affecting decision making concerning mode of delivery

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate sociopsychological factors of women undergoing a caesarean section on maternal request (CSMR).

Methods

Twenty-eight women who underwent CSMR and 29 women with vaginal delivery (VD) filled in standardized questionnaires concerning psychological burden (SCL-R 90), fear of childbirth (W-DEQ, STAI), personality structure (HEXACO-Pi-R) and social support (F-SozU) as well as one questionnaire assessing potential factors influencing their mode of delivery.

Results

Women with CSMR were older (36.5 ± 5.4 vs. 30.6 ± 5.2 years; p < 0.001) and suffered more from fear of childbirth (W-DEQ 4.3 ± 0.8 vs. 3.7 ± 1.2; p = 0.041), concerns for their child (W-DEQ 2.0 ± 1.5 vs. 1.3 ± 0.7; p = 0.026) and appraised the birth less negative (W-DEQ 2.0 ± 0.7 vs. 2.7 ± 1.1; p = 0.008). The majority of parturients had chosen their preferred mode of delivery before pregnancy (CS 61% vs. VD 82%, p = 0.328). In the decision-making process for the mode of delivery, the advice of the partner (85 and 90%) played an important role. 82% of the women who delivered via CSMR did not regret the decision for this mode of delivery.

Conclusion

Women who underwent CS had higher fear of childbirth and appraised the birth less negative. The majority did not regret the decision for the CS and would even choose this mode of delivery for their next pregnancy. Although the partner and the physician seem to be important in the decision process for of the mode of delivery, reasons for the choice for CSMR appear to be multifactorial.

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Author contributions

PS: data collection, data analysis and manuscript writing; SB: manuscript editing; SL: data analysis and manuscript editing; CS: project development; MS: Project development; and BTP: development, data analysis and manuscript writing.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Paul Philipp Stützer, Sebastian Berlit, Marc Sütterlin & Benjamin Tuschy

  2. Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Stefanie Lis

  3. Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

    Christian Schmahl

  4. Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada

    Christian Schmahl

Authors
  1. Paul Philipp Stützer
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  2. Sebastian Berlit
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  3. Stefanie Lis
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  4. Christian Schmahl
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  5. Marc Sütterlin
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  6. Benjamin Tuschy
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Corresponding author

Correspondence to Benjamin Tuschy.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Committee II of the Medical Faculty Mannheim, Heidelberg University (2013-588N-MA).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Research involving human and animal rights

No animals were involved.

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Stützer, P.P., Berlit, S., Lis, S. et al. Elective Caesarean section on maternal request in Germany: factors affecting decision making concerning mode of delivery. Arch Gynecol Obstet 295, 1151–1156 (2017). https://doi.org/10.1007/s00404-017-4349-1

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  • DOI: https://doi.org/10.1007/s00404-017-4349-1

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