Women's preference on mode of delivery in Southern Italy.
BACKGROUND
Rates of cesarean section are rising worldwide and maternal requests for this kind of delivery contribute to the increase in this trend. The purpose of this study was to analyze the factors influencing maternal demand in our region and the profile of women preferring this mode of delivery.


METHODS
Six obstetricians (3 male and 3 female) were asked to give out a questionnaire to their patients with an uncomplicated pregnancy. Demographic data, obstetrical history, lifestyle, and physician-patient relationship were analyzed. Patients who would have preferred abdominal delivery were asked to report the motivations for their choice. A psychiatric evaluation, using the Hamilton Anxiety Scale and the Montgomery-Asberg Depression Rating Scale, was conducted.


RESULTS
16.9% of 390 patients enrolled preferred cesarean section. This wish was correlated with patients' age > or = 35 years (OR 2.43; p=0.0065), high level of education (OR 4.28, p=0.019), previous infertility (OR 3.91, p=0.0045), smoking (OR 4.25, p=0.0008), quality of information (OR 29.08, p=0.0013), and desire for more comprehension (OR 8.25, p=0.00001). The most frequent motivation for this choice was a safer childbirth (90.9%). No difference was found for the Hamilton scale's score, while the Montgomery-Asberg Scale showed a lower mean score for the cesarean section group (7.2+/-3.3 versus 9.4+/-7.3, p=0.0002).


CONCLUSIONS
A high rate of women wish to give birth by cesarean section. This is probably an expression of the changes in society's attitudes. However, more careful attention to the psychological aspects and more personalized information about pregnancy and delivery could reduce this maternal demand.
Mancuso
Alfredo
A
Department of Gynecological, Obstetrical Sciences and Reproductive Medicine, University of Messina, Italy. antonio.devivo@gmail.com
De Vivo
Antonio
A
Fanara
Giusi
G
Settineri
Salvatore
S
Triolo
Onofrio
O
Giacobbe
Annamaria
A
D000328:Adult; D000339:Affect; D001007:Anxiety; D002585:Cesarean Section / Q000523:psychology / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000523:psychology*; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D009035:Mothers / Q000523:psychology*; D009042:Motivation; D015999:Multivariate Analysis; D009774:Obstetrics; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011247:Pregnancy; D011795:Surveys and Questionnaires