Caesareans by request

To describe the attitudes of nulliparas (women who have never given birth) about caesarean delivery on maternal request, and to examine their characteristics, perceptions and fears related to vaginal birth and caesarean delivery.

Cross-sectional survey.

Canadian nulliparas, 18 to 24 years of age, attending an educational institution.

A previously developed questionnaire was adapted, evaluated for validity and pretested. The questionnaire was presented in class by a research assistant. Participants placed questionnaires in a box to maintain confidentiality. The main outcome measure was participants' attitudes toward caesarean delivery on request. Descriptive, bivariate and multivariate regression statistical analyses were done.

Of 260 women invited, 140 (53.8%) participated. Participants' mean age was 20.4 years, and 95 per cent were born in Quebec. The majority (63.3%) had heard about caesarean delivery on maternal request, but only 28.6 per cent had a favourable attitude toward it. Having fears about vaginal birth (p < 0.001), thinking that caesarean delivery was less stressful than vaginal birth (p = 0.042) and that vaginal birth had more negative consequences for the mother (p = 0.014) and a positive attitude of peers (p = 0.013) were four factors associated with a favourable attitude. For this group of respondents, these four factors would successfully predict attitudes to caesarean section upon maternal request 66.5 per cent of the time.