title: Expectation and experiences of childbirth in primiparae with caesarean section.
abstract: OBJECTIVE
  The aim of this study was to examine the expectations and experiences in women undergoing a caesarean section on maternal request and compare these with women undergoing caesarean section with breech presentation as the indication and women who intended to have vaginal delivery acting as a control group. A second aim was to study whether assisted delivery and emergency caesarean section in the control group affected the birth experience.
  
  
  METHODS
  A prospective group-comparison cohort study.
  
  
  METHODS
  Danderyd Hospital, Stockholm, Sweden.
  
  
  METHODS
  First-time mothers (n= 496) were recruited to the study in week 37-39 of gestation and follow up was carried out 3 months after delivery. Comparisons were made between 'caesarean section on maternal request', 'caesarean section due to breech presentation' and 'controls planning a vaginal delivery'.
  
  
  METHODS
  The instrument used was the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ).
  
  
  METHODS
  Expectations prior to delivery and experiences at 3 months after birth.
  
  
  RESULTS
  Mothers requesting a caesarean section had more negative expectations of a vaginal delivery (P < 0.001) and 43.4% in this group showed a clinically significant fear of delivery. Mothers in the two groups expecting a vaginal delivery, but having an emergency caesarean section or an assisted vaginal delivery had more negative experiences of childbirth (P < 0.001).
  
  
  CONCLUSIONS
  Women requesting caesarean section did not always suffer from clinically significant fear of childbirth. The finding that women subjected to complicated deliveries had a negative birth experience emphasises the importance of postnatal support.
authors.affiliation: Division of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden. ingela.wiklund@bb.ptj.se
authors.forename: I
authors.initials: I
authors.lastname: Wiklund
authors.forename: G
authors.initials: G
authors.lastname: Edman
authors.forename: E-L
authors.initials: EL
authors.lastname: Ryding
authors.forename: E
authors.initials: E
authors.lastname: Andolf
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001946:Breech Presentation; D002585:Cesarean Section / Q000523:psychology*; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D004638:Emergency Treatment; D005239:Fear; D005260:Female; D006801:Humans; D010298:Parity; D017060:Patient Satisfaction; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D011446:Prospective Studies