Attitudes to cesarean delivery: the view of cesarean section mothers

This study analyses the attitudes to cesarean section of women who have undergone a section. The subjects of the study are differentiated into primiparous and multiparous women and women with planned and intrapartum sections.

A total of 2 685 women from a statutory health insurance fund who had given birth by cesarean section in the year 2004 were questioned (response rate: 48%; n=1,339). A written questionnaire was used to assess the reasons for cesarean section as well as to explore the three following attitude areas: the right to choose the mode of delivery, safety and childbirth risks, lifestyle factors.

771 women (57.6%) were primiparous, 560 women (41.8%) were multiparous, 8 women (0.6%) did not answer the question about previous births. 346 had a repeat section, 53 had been delivered once (3 twice) with a vacuum extractor or forceps. In 733 women (54.7%) a planned cesarean section was performed, 606 women (45.3%) had an intrapartum cesarean section. Two-thirds (61.1%) agreed with statements that emphasised the woman's right to choose the mode of delivery. Another two thirds (68.9%) stated that cesarean sections should be reserved for emergency situations and that women should always try to deliver vaginally. In relation to operation risks and the safety of cesarean sections, the women had varying opinions. The answers to the lifestyle questions were also quite varied. Women with planned sections emphasised a woman's right to choose more strongly than women with intrapartum cesarean delivery and assessed the risks to be lower. There was almost no difference between primiparous and multiparous women in all three attitude areas.

The results clearly show the ambivalent situation in which women find themselves. Although they are aware of the social changes in obstetrics, they still do not consider a cesarean section as an option for themselves unless indicated.