Reasons for elective cesarean section on maternal request: a systematic review

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Surgical Outcomes

Background:

• Increasing rates of cesarean delivery without clear medical indications.
• Growing trend of maternal requests for elective cesarean sections.
• Need to understand the underlying reasons for these requests.

Purpose of the Study:

• To systematically review and identify the reasons behind maternal requests for elective cesarean sections.
• To explore both psychological and demographic factors influencing these decisions.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Web of Science databases.
• Inclusion of 28 studies meeting predefined criteria.
• Quality assessment using the Newcastle-Ottawa Scale.
• No meta-analysis due to data heterogeneity.

Main Results:

• Common reasons include fear of labor pain, childbirth, fetal injury/death, and previous adverse delivery experiences.
• Other factors cited: fear of trauma, physician suggestion, birth timing, and perceived lack of support.
• Demographic factors: advanced maternal age, parity, occupation, education, and maternal obesity.

Conclusions:

• Findings highlight the need for comprehensive programs to address maternal concerns and reduce unnecessary cesarean deliveries.
• Interventions focused on health promotion can improve vaginal birth rates.
• Addressing patient fears and providing adequate support are crucial for informed decision-making.