Skip to main content
Log in

Involvement of first-time mothers with different levels of education in the decision-making for their delivery by a planned Caesarean section. Women’s satisfaction with information given by gynaecologists and midwives

  • Original Article
  • Published:
Journal of Public Health Aims and scope Submit manuscript

Abstract

Aims

We investigated the involvement of first-time mothers, who had a planned Caesarean section, in the decision to have a Caesarean section, taking into account their different educational levels.

Subjects and methods

A self-assessment questionnaire was sent in July 2005 to women who had undergone a Caesarean section in 2004. Participants were 2,685 members of a statutory health insurance fund who had given birth by Caesarean section (response rate: 48.0%). Included were primiparae with planned Caesarean section (n = 352).

Results

The women in this cross-sectional study felt well informed about the procedure of a section but not its consequences. They used several sources of information and were most satisfied with the information provided by doctors and midwives. Of the women in this study 20% did not have a midwife. No major differences were observed between different educational levels.

Conclusion

Although most women were satisfied with their decision, they felt that they did not receive enough information about the consequences of a Caesarean section. This information need could be met by a further involvement of midwives in maternity care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American College of Obstetricians and Gynecologists (2004) Ethics in obstetrics and gynecology, 2nd edn. American College of Obstetricians and Gynecologists, Washington DC

    Google Scholar 

  • Beisecker AE, Beisecker TD (1990) Patient information-seeking behaviors when communicating with doctors. Med Care 28:19–28

    Article  PubMed  CAS  Google Scholar 

  • BQS Bundesgeschäftsstelle Qualitätssicherung (2008) BQS Auswertung 2007 Geburtshilfe. http://www.bqs-outcome.de/2007/ergebnisse/leistungsbereiche/geburtshilfe/buaw. Accessed 22 Jul 2008

  • Charles C, Whelan T, Gafni A (1999) What do we mean by partnership in making decisions about treatment? BMJ 319:780–782

    PubMed  CAS  Google Scholar 

  • Denk CE, Kruse LL, Jain NJ (2006) Surveillance of caesarean section deliveries, New Jersey, 1999–2004. Birth 33:203–209

    Article  PubMed  Google Scholar 

  • Ende J, Kazis L, Ash A, Moskowitz MA (1989) Measuring patients’ desire for autonomy: decision making and information-seeking preferences among medical patients. J Gen Intern Med 4:23–30

    Article  PubMed  CAS  Google Scholar 

  • Enkin M, Keirse MJNC, Neilson J et al (2000) A guide to effective care in pregnancy and childbirth, 3rd edn. Oxford University Press, Oxford

    Google Scholar 

  • Fleissig A (1993) Are women given enough information by staff during labour and delivery? Midwifery 9:70–75

    Article  PubMed  CAS  Google Scholar 

  • Freda CM, Andersen HF, Damus K, Merkatz IR (1993) What pregnant women want to know: a comparison of client and provider perceptions. J Obstet Gynecol Neonatal Nurs 22:237–244

    Article  PubMed  CAS  Google Scholar 

  • Glaeske G, Janhsen K (2008) Der GEK-Arzneimittelreport 2008. Asgard, St. Augustin

    Google Scholar 

  • Graham WJ, Hundley V, McCheney AL, Hall MH, Gurney E, Milne J (1999) An investigation of women’s involvement in the decision to deliver by caesarean section. Br J Obstet Gynaecol 106:213–220

    PubMed  CAS  Google Scholar 

  • Horey D, Weaver J, Russel H (2004) Information for pregnant women about cesarean birth. Cochrane Database Syst Rev 2004, Issue 1. Art. No. CD003858. doi:10.1002/14651858.CD003858.pub2

  • Sagadyleslie M (2004) Counseling women about elective cesarean section. J Midwifery Womens Health 49:155–159

    PubMed  Google Scholar 

  • Liu S, Liston RM, Joseph KS, Heaman M, Sauve R, Kramer MS, Maternal Health Study Group of the Canadian Perinatal Surveillance System (2007) Maternal mortality and severe morbidity associated with low-risk planned cesarean delivery versus planned vaginal delivery at term. CMAJ 176:455–460

    PubMed  Google Scholar 

  • Lutz U, Kolip P (2006) Die GEK-Kaiserschnittstudie. Schriftenreihe zur Gesundheitsanalyse, Band 42. Asgard, St. Augustin

    Google Scholar 

  • McFarlin BL (2004) Elective cesarean birth: issues and ethics of an informed decision. J Midwifery Womens Health 49:421–429

    Article  PubMed  Google Scholar 

  • Menacker F, Declerq E, Macdorman MF (2006) Cesarean delivery: background, trends, and epidemiology. Semin Perinatol 30:235–241

    Article  PubMed  Google Scholar 

  • Mould TAJ, Chong S, Spencer JAD, Gallivan S (1996) Women’s involvement with the decision preceding their caesarean section and their degree of satisfaction. Br J Obstet Gynaecol 103:1074–1077

    PubMed  CAS  Google Scholar 

  • NICE - National Institute for Clinical Excellence 2004 Caesarean section. Clinical Guideline 13. http://www.nice.org.uk/page.aspx?o=113192. Accessed 20 Jul 2008

  • Niedersächsische Perinatalstatistik, Geburtskohorte 2004. Available at: http://www.zq-aekn.de

  • O’Cathain A, Thomas K, Walters SJ, Nicholl J, Kirkham M (2002) Women’s perceptions of informed choice in maternity care. Midwifery 18:136–144

    Article  PubMed  Google Scholar 

  • OECD Health Data 2006. http://www.gbe-bund.de/ -> Kaiserschnitt. Accessed 27 Jul 2008

  • Scheibler F, Janßen C, Pfaff H (2003) Shared-decision making: Ein Überblicksartikel über die internationale Forschungsliteratur. Soz Präventivmed 48:11–23

    PubMed  Google Scholar 

  • Stapleton H, Kirkham M, Thomas G (2002) Qualitative study of evidence based leaflets in maternity care. BMJ 324:639

    Article  PubMed  Google Scholar 

  • Tollånes MC, Thompson JM, Daltveit AK, Irgens LM (2007) Cesarean section and maternal education; secular trends in Norway, 1967–2004. Acta Obstet Gynecol Scand 86:840–888

    Article  PubMed  Google Scholar 

  • Turnbull DA, Wilkinson C, Yaser A, Carty V, Svigos JM, Robinson JS (1999) Women’s role and satisfaction in the decision to have a caesarean section. Med J Aust 170:580–583

    PubMed  CAS  Google Scholar 

  • Wensing M, Elwyn G, Edwards A, Vingerhoets E, Grol R (2002) Deconstructing patient centred communication and uncovering shared decision making: an observational study. BMC Med Inform Decis Mak 2:2

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The study was funded by the Gmünder Ersatzkasse, a German health insurance fund.

Conflict of interest

The authors confirm that there are no relevant associations that might pose a conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Petra Kolip.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kolip, P., Büchter, R. Involvement of first-time mothers with different levels of education in the decision-making for their delivery by a planned Caesarean section. Women’s satisfaction with information given by gynaecologists and midwives. J Public Health 17, 273–280 (2009). https://doi.org/10.1007/s10389-008-0246-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10389-008-0246-1

Keywords

Navigation