Does Obesity Influence Women's Decision Making about the Mode of Delivery?

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Public Health

Background:

• Rising rates of cesarean deliveries (CDs) globally.
• Increasing incidence of cesarean delivery on maternal request (CDMR) and private sector CDs.
• Factors influencing maternal delivery preferences and shared decision-making (SDM) are complex.

Purpose of the Study:

• To investigate the influence of maternal Body Mass Index (BMI) on delivery mode preferences.
• To assess the impact of BMI on opinions regarding CDMR without medical indications.
• To evaluate the relationship between BMI and views on shared decision-making (SDM) in delivery choices.

Main Methods:

• An online survey distributed to 1040 women.
• Questionnaire assessed delivery preferences, CDMR opinions, and SDM perspectives.
• Statistical analysis compared outcomes across different BMI categories (≤25, >25, ≤30, >30 kg/m²).

Main Results:

• No significant differences in preferred delivery mode, SDM opinions, or CDMR preference were found between BMI groups (≤25 vs >25 kg/m² and ≤30 vs >30 kg/m²).
• Over 85% of women preferring CD desired CDMR, irrespective of BMI category.
• The sample size for women with morbid obesity (BMI ≥35 kg/m²) was insufficient for significant conclusions.

Conclusions:

• Maternal overweight and obesity do not appear to influence delivery mode preferences or attitudes towards CDMR without medical indications.
• Further research is needed with larger sample sizes for women with morbid obesity.
• Understanding factors driving CDMR and SDM remains crucial amidst rising cesarean rates.