Cesarean section or normal vaginal delivery: A cross-sectional study of attitude of medical students

Childbirth is regarded as an important life event for women, and growing numbers of them are making the choice to give birth by cesarean delivery. Increasing rate of births by cesarean section is an issue of concern in many countries. In order to reduce the rates of unnecessary cesarean sections, it is essential to acquire information of the reasons that motivate physicians to carry out cesarean sections rather than vaginal deliveries. The objective of present study is to evaluate whether the education process for undergraduate medical students affects their decision-making.

The present study was cross-sectional and questionnaire based. A total of 292 students participated in the study. Out of which, 150 were first-year students and 142 were doing internship in Maharashtra Institute of Medical Education and Research (MIMER), Talegaon Dabhade, Maharashtra, India. The study was conducted in the months of June and July 2019. Data was collected with the help of person to person interview of all the participants who satisfied the inclusion criteria after obtaining their informed consent. The data was entered by using Microsoft Excel 2007 and was analyzed using Epi Info version 3.3.2. The data was tabulated and analyzed according to responses which were given by the respondents.

A total of 292 students answered the questionnaire. Age of participants varied between 19 and 23 years. 130 males and 162 females were the subjects, out of which 40 students declared fear of labor. Most of the students preferred vaginal delivery over cesarean sections in all the four scenarios. The difference of opinion was significant in case of an uneventful pregnancy and normal pregnancy under their care. For general population as healthcare manager this difference of opinion was not significant. In case of one's own or partner's delivery, internship students preferred cesarean section but this difference was statistically non-significant.

Most of the students would recommend vaginal delivery because this form of delivery has fewer risks as compared to cesarean section. Majority of students chose vaginal delivery for the birth of their own child; however, a higher number of interns as compared to first year students preferred cesarean section. Pain associated with vaginal delivery was the most common reason given for choosing cesarean section. The student's preference for childbirth changed in due course of graduation toward cesarean section. This indicates a probable effect of medical education on permissive culture of cesarean section as a mode of delivery.