Skip to main content

Advertisement

SpringerLink
Log in

Preferences and concerns for delivery: an antepartum survey

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Little is known regarding patient preferences for method of delivery despite concern about rising cesarean section rates. We hypothesize that the majority of pregnant women desire a vaginal birth. An anonymous survey was distributed to pregnant women assessing demographics, pregnancy history, delivery preference, and concern for outcomes. Five-hundred fifty respondents completed the survey; 43% were nulliparous. The majority preferred vaginal delivery (89.6%). Reasons included reduced recovery pain (72%), scars (68%), and bleeding (48%). Cesarean deliveries were believed to cause more maternal injuries (39%), but affect sexual function less (35%). Nulliparas were more concerned about vaginal support damage (p = .005), sexual function changes (p ≤ 0.001), and need for episiotomy (p ≤ .001). Despite this, 93% of nulliparas chose vaginal birth. Increased parity was associated with preference for cesarean delivery (r = 0.108, p = 0.013). Despite nulliparas’ concerns about complications of vaginal delivery, the majority of pregnant women would choose vaginal birth.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Minkoff H, Chervenak FA (2003) Elective primary cesarean delivery. N Engl J Med 348:946–50

    Article  PubMed  Google Scholar 

  2. Leeman L (2005) Patient-choice cesarean delivery. Am Fam Phys 72:703–705

    Google Scholar 

  3. Minkoff H, Powderly KR, Chervenak F, McCollough LB (2004) Ethical dimensions of elective primary cesarean delivery. Obstet Gynecol 103:387–392

    PubMed  Google Scholar 

  4. Handa VJ, Harvey L, Fox HE, Kjerulff KH (2004) Parity and route of delivery: does cesarean delivery reduce bladder symptoms later in life? Am J Obstet Gynecol 191:463–469

    Article  PubMed  Google Scholar 

  5. Bahl R, Strachan B, Murphy DJ (2005) Pelvic floor morbidity at 3 years after instrumental delivery and cesarean delivery in the second stage of labor and the impact of a subsequent delivery. Am J Obstet Gynecol 192:789–794

    Article  PubMed  Google Scholar 

  6. Casey B, Schaffer J, Bloom S, Heartwell S, McIntire D, Leveno K (2005) Obstetric antecedents for postpartum pelvic floor dysfunction. Am J Obstet Gynecol 192:1655–1662

    Article  PubMed  Google Scholar 

  7. Lukatcz E, Lawrence J, Contreras R, Nager C, Luber K (2006) Parity, mode of delivery, and pelvic floor disorders. Am J Obstet Gynecol 107:1252–1260

    Google Scholar 

  8. Wax JR, Cartin A, Pinette MG, Blackstone J (2004) Obstet Gynecol Surv 59:601–616

    Article  PubMed  Google Scholar 

  9. Gregory WT, Nygaard I (2004) Childbirth and pelvic floor disorders. Clin Obstet Gynecol 47:394–403

    Article  PubMed  Google Scholar 

  10. Burrows LJ, Meyn LA, Weber AM (2004) Maternal morbidity associated with vaginal versus cesarean delivery. Obstet Gynecol 103:907–912

    PubMed  Google Scholar 

  11. Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA et al (2006) Maternal morbidiity associated with multiple repeat cesarean deliveries. Obstet Gynecol 107:1226–1232

    PubMed  Google Scholar 

  12. Fogelson NS, Menard MK, Hulsey T, Ebeling M (2005) Neonatal impact of elective repeat cesarean delivery at term: a comment on patient choice cesarean delivery. Am J Obstet Gynecol 192:1433–1436

    Article  PubMed  Google Scholar 

  13. Grisaru S, Samueloff A (2004) Primary nonmedically indicated cesarean section (“Section on Request”): evidence based or modern vogue? Clin Perinatol 31:409–430

    Article  PubMed  Google Scholar 

  14. Hildingsson I, Radestad I, Rubertsson C, Waldensrom U (2002) Few women wish to be delivered by caesarean section. Br J Obstet Gynaecol 109(6):618–623

    Google Scholar 

  15. Thurman AR, Zoller JS, Swift SE (2004) Non-pregnant patients’ preference for delivery route. Int Urogynecol J Pelvic Floor Dysfunct 15:308–312

    PubMed  Google Scholar 

  16. Schindl M, Birner P, Reingrabner M, Joura E, Housslein P, Langer M (2003) Elective cesarean section vs. spontaneous delivery: a comparative study of birth experience. Acta Obstet Gynecol Scand 82:834–840

    Article  PubMed  Google Scholar 

  17. Murphy DJ, Liebling RE (2003) Cohort study of maternal views on future mode of delivery after operative delivery in the second stage of labor. Am J Obstet Gynecol 188:542–548

    Article  PubMed  Google Scholar 

  18. Kenton K, Brincat C, Mutone M, Brubaker L (2005) Repeat cesarean section and the primary elective cesarean section: recently trained obstetrician–gynecologist practice patterns and opinions. Am J Obstet Gynecol 192:1872–1876

    Article  PubMed  Google Scholar 

  19. Gonen R, Tamir A, Degani S (2002) Obstetricians’ opinions regarding patient choice in cesarean delivery. Obstet Gynecol 99:577–580

    Article  PubMed  CAS  Google Scholar 

  20. Wu JM, Hundley AF, Visco AG (2005) Elective primary cesarean delivery: attitudes of urogynecology and maternal–fetal medicine specialists. Obstet Gynecol 105:301–06

    PubMed  Google Scholar 

  21. Bettes BA, Coleman VH, Zinberg S, Spong CY, Portnoy B, DeVoto E et al (2007) Cesarean delivery on maternal request. Obstetrician–gynecologists’ knowledge, perception, and practice patterns. Obstet Gynecol 109:57–66

    PubMed  Google Scholar 

  22. American College of Obstetricians and Gynecologists Committee Opinion (2003) Surgery and patient choice: the ethics of decision making. Obstet Gynecol 102:1101–1106

    Article  Google Scholar 

Download references

Acknowledgements

A special appreciation is given to the perinatal care coordinators at the two hospitals for their efforts in survey collection.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Bethesda North Hospital, 10475 Montgomery Road Suite 4G, Cincinnati, OH, 45242, USA

    Jessica N. Bracken

  2. Hatton Institute for Research and Education, Good Samaritan Hospital, Cincinnati, OH, USA

    Vicki L. Dryfhout

  3. Office of Evaluation and Research, Medical Student Education, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Linda M. Goldenhar

  4. Division of Urogynecology and Reconstructive Pelvic Surgery, Director, Women’s Center for Specialized Care, Good Samaritan Hospital, 375 Dixmyth Ave, Seton Center, 8th floor, Cincinnati, OH, 45220, USA

    Rachel N. Pauls

Authors
  1. Jessica N. Bracken
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vicki L. Dryfhout
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda M. Goldenhar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rachel N. Pauls
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jessica N. Bracken.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bracken, J.N., Dryfhout, V.L., Goldenhar, L.M. et al. Preferences and concerns for delivery: an antepartum survey. Int Urogynecol J 19, 1527–1531 (2008). https://doi.org/10.1007/s00192-008-0680-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-008-0680-1

Keywords

Search

Navigation