Previous birth experience and birth anxiety: predictors of caesarean section on demand?
OBJECTIVE
The purpose of this study was to investigate pregnant women's intentions for opting for caesarean section (CS), their experiences regarding previous births and their expectations for subsequent delivery. Our objectives were to identify medical and psychological predictors pertaining to the decision for CS on demand.


METHODS
The cross-sectional survey was conducted at two study centres over a three-month period including German speaking women at any time of pregnancy and consisted of an anonymous structured questionnaire. Logistic regression was computed to investigate the predictive value of medical variables, birth experience and birth anxiety on the demand for CS.


RESULTS
Nineteen of 201 participants preferred to deliver by CS on demand and 15 felt uncertain about their decision. How the preceding delivery had been experienced was significantly better in the vaginal delivery (VD)-group (women not considering CS on demand) than in the CS-group (good experience in 81.7% and 52.0% respectively, p = 0.007). A negative previous birth experience and a preceding CS were predictors for the wish to deliver by CS.


CONCLUSIONS
As negative birth experience predicts the wish for a CS, specific supportive care during first pregnancy could play a pivotal role in making this decision.
Tschudin
Sibil
S
Department of Obstetrics and Gynecology, University of Basel, CH-4031 Basel, Switzerland. stschudin@uhbs.ch
Alder
Judith
J
Hendriksen
Stephanie
S
Bitzer
Johannes
J
Popp
Karoline Aebi
KA
Zanetti
Rosanna
R
Hösli
Irene
I
Holzgreve
Wolfgang
W
Geissbühler
Verena
V
D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D002585:Cesarean Section / Q000523:psychology*; D003430:Cross-Sectional Studies; D003469:Culture; D003657:Decision Making; D005239:Fear; D005260:Female; D006801:Humans; D033182:Intention; D048949:Labor Pain / Q000523:psychology; D007744:Obstetric Labor Complications / Q000523:psychology; D010298:Parity; D036801:Parturition / Q000523:psychology*; D017060:Patient Satisfaction; D011247:Pregnancy / Q000523:psychology*; D011594:Psychometrics; D011613:Psychotherapy; D011795:Surveys and Questionnaires; D013557:Switzerland; D055815:Young Adult