Preferences of women with low obstetric risk for cesarean or vaginal birth in Poland: Areas for intervention.
cesarean birth
preference
vaginal birth
Journal
Birth (Berkeley, Calif.)
ISSN: 1523-536X
Titre abrégé: Birth
Pays: United States
ID NLM: 8302042
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
20
01
2021
received:
06
05
2020
accepted:
26
01
2021
pubmed:
14
2
2021
medline:
26
10
2021
entrez:
13
2
2021
Statut:
ppublish
Résumé
In Poland, the rate of cesarean birth (CB) is 43%, which is much higher than the European average of 27%. Optimizing the CB birth rate is of critical importance, especially among women with low-risk pregnancies. However, the determinants of cesarean preference among low-risk women in Poland have not been well explored. This cross-sectional study included 1011 pregnant women and aimed to identify associations between selected determinants of women's preferences for CB vs. vaginal birth (VB) in Poland. A descriptive questionnaire was distributed online, and a theoretical model was validated against empirically gathered data. Group comparisons were performed using the Welch t test for continuous data or chi-square test for categorical data. All statistical analyses were performed using R (R Core Team, 2018). The mean age of women preferring CB (30.46 years) was 1.25 years higher than that of women preferring VB (29.21 years). Pregnant women who expressed a preference for CB tended to be multigravid, inhabited cities, and were characterized by higher levels of anxiety and depression. Moreover, the majority of women who underwent a previous CB asserted their intention to repeat the procedure for the current pregnancy. The primary factors that were correlated with high CB preference among the low-risk group included age, previous childbirth experiences, and anxiety. The underlying reasons that drive birth preferences remain poorly understood. However, women who have previously undergone difficult childbirth experiences and are afraid of pain require specialized care.
Sections du résumé
BACKGROUND
In Poland, the rate of cesarean birth (CB) is 43%, which is much higher than the European average of 27%. Optimizing the CB birth rate is of critical importance, especially among women with low-risk pregnancies. However, the determinants of cesarean preference among low-risk women in Poland have not been well explored.
METHODS
This cross-sectional study included 1011 pregnant women and aimed to identify associations between selected determinants of women's preferences for CB vs. vaginal birth (VB) in Poland. A descriptive questionnaire was distributed online, and a theoretical model was validated against empirically gathered data. Group comparisons were performed using the Welch t test for continuous data or chi-square test for categorical data. All statistical analyses were performed using R (R Core Team, 2018).
RESULTS
The mean age of women preferring CB (30.46 years) was 1.25 years higher than that of women preferring VB (29.21 years). Pregnant women who expressed a preference for CB tended to be multigravid, inhabited cities, and were characterized by higher levels of anxiety and depression. Moreover, the majority of women who underwent a previous CB asserted their intention to repeat the procedure for the current pregnancy.
CONCLUSIONS
The primary factors that were correlated with high CB preference among the low-risk group included age, previous childbirth experiences, and anxiety. The underlying reasons that drive birth preferences remain poorly understood. However, women who have previously undergone difficult childbirth experiences and are afraid of pain require specialized care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
265-273Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Boerma T, Ronsmans C, Melesse DY, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet. 2018;392(10155):1341-1348. https://doi.org/10.1016/S0140-6736(18)31928-7
WHO Recommendations Non-Clinical Interventions to Reduce Unnecessary Caesarean Sections. Geneva; 2018.
Betrán AP, Temmerman M, Kingdon C, et al. Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet. 2018;392(10155):1358-1368. https://doi.org/10.1016/S0140-6736(18)31927-5
Creanga AA, Bateman BT, Butwick AJ, et al. Morbidity associated with caesarean delivery in the United States: is placenta accreta an increasingly important contributor? Am J Obstet Gynecol. 2015;213(3):384.e1-384.e11. https://doi.org/10.1016/j.ajog.2015.05.002
Betran AP, Torloni MR, Zhang J, et al. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod Health. 2015;12(1):1-10. https://doi.org/10.1186/s12978-015-0043-6
Macfarlane AJ, Blondel B, Mohangoo AD, et al. Wide differences in mode of delivery within Europe: Risk-stratified analyses of aggregated routine data from the Euro-Peristat study. BJOG An Int J Obstet Gynaecol. 2016;123(4):559-568. https://doi.org/10.1111/1471-0528.13284
Potter JE, Hopkins K, Faúndes A, Perpétuo I. Women’s autonomy and scheduled caesarean sections in Brazil: A cautionary tale. Birth. 2008;35(1):33-40. https://doi.org/10.1111/j.1523-536X.2007.00209.x
Kringeland T, Daltveit AK, Møller A. What characterizes women in Norway who wish to have a caesarean section? Scand J Public Health. 2009;37(4):364-371. https://doi.org/10.1177/1403494809105027
Long Q, Kingdon C, Yang F, et al. Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for caesarean section in China: A mixed-methods systematic review. PLoS Medicine. 2018;15(10):1-25. https://doi.org/10.1371/journal.pmed.1002672
Eide KT, Morken NH, Baerøe K. Maternal reasons for requesting planned caesarean section in Norway: A qualitative study. BMC Pregnancy Childbirth. 2019;19(1):1-10. https://doi.org/10.1186/s12884-019-2250-6
Lerner-Geva L, Glasser S, Levitan G, et al. A case-control study of caesarean delivery on maternal request: who and why? J Matern Neonatal Med. 2016;29(17):2780-2785. https://doi.org/10.3109/14767058.2015.1103727
Pallasmaa N, Ekblad U, Aitokallio-Tallberg A, et al. Caesarean delivery in Finland: Maternal complications and obstetric risk factors. Acta Obstet Gynecol Scand. 2010;89(7):896-902. https://doi.org/10.3109/00016349.2010.487893
Striebich S, Mattern E, Ayerle GM. Support for pregnant women identified with fear of childbirth (FOC)/tokophobia - A systematic review of approaches and interventions. Midwifery. 2018;61(January):97-115. https://doi.org/10.1016/j.midw.2018.02.013
O’Connell MA, O’neill SM, Dempsey E, et al. Interventions for fear of childbirth (Tocophobia). Cochrane Database Syst Rev. 2019;2019(5):1-16. https://doi.org/10.1002/14651858.CD013321
Boz İ, Akgün M, Duman F. A feasibility study of a psychoeducation intervention based on Human Caring Theory in nulliparous women with fear of childbirth. J Psychosom Obstet Gynecol. 2020;8942:1-12. https://doi.org/10.1080/0167482X.2020.1752173
Demographical Atlas of Poland. Warsaw: Central Statistical Office of Poland [Internet]; 2017. https://stat.gov.pl/download/gfx/portalinformacyjny/pl/defaultaktualnosci/5501/28/1/1/atlas_demograficzny_polski.pdf. Accessed October 5, 2019.
Zeitlin J, Alexander S, Barros H, et al. Report, European Perinatal Health 2015, Core indicators of the health and care of pregnant women and babies in Europe; 2015. Available at www.europeristat.com. Accessed September 28, 2019.
Wielgos M, Bomba-Opon D, Breborowicz GH, et al. Recommendations of the Polish Society of Gynecologists and Obstetricians regarding caesarean sections. Ginekol Pol. 2018;89(11):644-657. https://doi.org/10.5603/GP.a2018.0110
Rozporządzenie Ministra Zdrowia z Dnia 16 Sierpnia 2018 r. w Sprawie Standardu Organizacyjnego Opieki Okołoporodowej (The Regulation of the Minister of Health of 16 August 2018 on the Organisational Standard of Perinatal Care) Poland; 2019:1-21.
Raport z Monitoringu Oddziałów Położniczych. Medykalizacja Porodu w Polsce (Report from Maternity Wards Monitoring. Medicalisation of Births in Poland) in Polish. Warszawa (Warsaw); 2017. https://doi.org/10.4467/20842627OZ.11.015.0552
Sowada C, Sagan A. Health systems in transition Poland health system review. 2019;21(1):1-193. Available at www.healthobservatory.eu
Opieka Okołoporodowa Na Oddziałach Położniczych (Perinatal Care at Maternity Wards) in Polish. Warszawa (Warsaw); 2015.
Podwińska E, Janosz I, Bodzek P, Brenk A, Olejek A. Opinie kobiet dotyczące możliwości wyboru cięcia cesarskiego na życzenie oraz roli anestezjologa podczas porodu. Ginekol i Poloznictwo. 2015;37(3):33-36.
Opiyo N, Kingdon C, Oladapo OT, et al. Non-clinical interventions to reduce unnecessary caesarean sections: Who recommendations. Bull World Health Organ. 2020;98(1):66-68. https://doi.org/10.2471/BLT.19.236729
Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory; 1970. Available at https://ubir.buffalo.edu/xmlui/handle/10477/2895. Accessed January 9, 2019.
Sosnowski T, Wrześniewski K, Jaworowska AFD. STAI - Inwentarz Stanu i Cechy Lęku STAI. Warszawa: Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego; 2011.
Schulz U, Schwarzer R. Soziale Unterstützung bei der Krankheitsbewältigung: Die Berliner Social Support Skalen (BSSS). [Social Support in Coping with Illness: The Berlin Social Support Scales (BSSS).]. Diagnostica. 2003;49(2):73-82. https://doi.org/10.1026//0012-1924.49.2.73
Luszczynska A, Kowalska M, Mazurkiewicz M. Sr.Berlin Social Support Scales (Bsss): Polish Version Of Bsss And Preliminary Results On Its Psychometric Properties. Stud Psychol. 2006;44(3):17-27.
Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
Beck AT. Charakterystyka psychometryczna polskiej adaptacji Kwestionariusza Depresji BDI-II Aarona T. Becka (Psychometric Properties of the Polish Version of the Aaron T. Beck’s Depression Inventory BDI-II); 2019.
Schantz C, de Loenzien M, Goyet S, Ravit M, Dancoisne A, Dumont A. How is women’s demand for caesarean section measured? A systematic literature review. PLoS One. 2019;14(3):1-14. https://doi.org/10.1371/journal.pone.0213352
Gebuza G, Kaźmierczak M, Gierszewska M, Mieczkowska E, Banaszkiewicz M, Wróbel-bania A. Lęk przed porodem w III trymestrze ciąży i jego powiązania ze stanem noworodka. Med Og Nauk Zdr. 2015;21(1):39-44. https://doi.org/10.5604/20834543.1142357
Bayrampour H, Ali E, McNeil DA, Benzies K, MacQueen G, Tough S. Pregnancy-related anxiety: A concept analysis. Int J Nurs Stud. 2016;55:115-130. https://doi.org/10.1016/j.ijnurstu.2015.10.023
Fontein-Kuipers Y, Ausems M, Budé L, Van Limbeek E, De Vries R, Nieuwenhuijze M. Factors influencing maternal distress among Dutch women with a healthy pregnancy. Women Birth. 2015;28(3):e36-e43. https://doi.org/10.1016/j.wombi.2015.02.002
Westerneng M, Witteveen AB, Warmelink JC, Spelten E. ScienceDirect Pregnancy-specific anxiety and its association with background characteristics and health-related behaviors in a low-risk population. Compr Psychiatry. 2017;75:6-13. https://doi.org/10.1016/j.comppsych.2017.02.002
Huizink AC, Mulder EJH, Robles De Medina PG, Visser GHA, Buitelaar JK. Is pregnancy anxiety a distinctive syndrome? Early Hum Dev. 2004;79(2):81-91. https://doi.org/10.1016/j.earlhumdev.2004.04.014
Laursen M, Johansen C, Hedegaard M. Fear of childbirth and risk for birth complications in nulliparous women in the Danish National Birth Cohort. BJOG An Int J Obstet Gynaecol. 2009;116(10):1350-1355. https://doi.org/10.1111/j.1471-0528.2009.02250.x
Ryding EL, Lukasse M, Van PAS, et al. Fear of childbirth and risk of caesarean delivery: A cohort study in six European countries. Birth. 2015;42(1):48-55. https://doi.org/10.1111/birt.12147
Sydsjö G, Blomberg M, Palmquist S, Angerbjörn L, Bladh M, Josefsson A. Effects of continuous midwifery labour support for women with severe fear of childbirth. BMC Pregnancy Childbirth. 2015;15(1):1-5. https://doi.org/10.1186/s12884-015-0548-6
Koelewijn JM, Sluijs AM, Vrijkotte TGM. Possible relationship between general and pregnancy-related anxiety during the first half of pregnancy and the birth process: A prospective cohort study. BMJ Open. 2017;7(5):1-12. https://doi.org/10.1136/bmjopen-2016-013413
Baranowska B, Doroszewska A, Kubicka-Kraszyńska U, et al. Is there respectful maternity care in Poland? Women’s views about care during labor and birth. BMC Preg Childbirth. 2019;19(1):1-9. https://doi.org/10.1186/s12884-019-2675-y
Coates D, Thirukumar P, Henry A. Women’s experiences and satisfaction with having a caesarean birth: An integrative review. Birth. 2020;47(2):169-182. https://doi.org/10.1111/birt.12478