Changes in attitudes toward cesarean birth

To compare the findings of three studies of women's responses to planned and unplanned cesarean birth.

Descriptive.

Private obstetric practices, childbirth education classes, and hospital postpartum units.

Study 1: 24 women who had cesarean deliveries between 1973 and 1980; Study 2: 15 women who delivered in 1981-82; Study 3: 173 women who delivered in 1989-90.

Qualitative data were obtained by an investigator-developed open-ended questionnaire that was mailed to participants after cesarean delivery.

The findings from the three studies indicate that the dominant responses to cesarean birth are happiness and excitement about the newborn, accompanied by disappointment about having to have a cesarean delivery. The women in Study 1 expressed the highest proportion of ineffective responses and the lowest proportion of adaptive responses (p = .003), whereas the women in Studies 2 and 3 expressed approximately equal percentages of adaptive and ineffective responses. Women who had unplanned cesarean deliveries had a lower percentage of adaptive responses and a higher percentage of ineffective responses than those who had planned cesarean deliveries (p < .05). Women who had regional anesthesia had more adaptive responses than those who had general anesthesia (p = .0217).

The findings suggest that women who deliver by cesarean section require continued attention and sensitive care that takes into account their special needs for information, for the presence of their partners throughout the birth experience, and for sustained contact with their newborn.