Maternal perspective on requesting elective caesarean birth

Area of Science:

• Obstetrics and Gynecology
• Maternal Health
• Qualitative Research

Background:

• Elective caesarean section requests without medical indication are increasing in primigravidas.
• Understanding the complex motivations behind these requests is crucial for patient counseling and care.

Purpose of the Study:

• To explore the underlying factors influencing primigravidas' requests for elective caesarean section without obstetric indications.
• To identify the primary themes and contextual elements contributing to this decision.

Main Methods:

• A qualitative case study design was employed.
• Semi-structured interviews were conducted with 15 primigravidas requesting caesarean section without indication.
• Thematic analysis was performed using NVivo 14 software.

Main Results:

• Four main themes emerged: psychological fear, negative birth experiences, behavioral control, and maternal firmness.
• Traumatic birth stories from relatives/friends and fear of labor pain were significant drivers.
• Concerns regarding vaginal examination, witnessing labor distress, and positioning also contributed.

Conclusions:

• Requests for caesarean delivery without medical indication (CDMR) in primigravidas are multifactorial, encompassing personal, behavioral, and social contexts.
• Exposure to negative birth narratives significantly shapes first-time mothers' fear of vaginal delivery and perceived harm.
• Addressing these deep-seated fears and perceptions is essential for informed birth choices.