title: Delivery route preferences of urban women of low socioeconomic status.
abstract: OBJECTIVE
  To identify the main determinants of mode of delivery preference among urban dwelling women of lower socioeconomic status (SES).
  
  
  METHODS
  Over a 12-month period, a self-completion 36-item questionnaire was administered to a convenience sample of 308 women within the first 3 postpartum days. Non-parametric tests were used for analysis.
  
  
  RESULTS
  Study participants were mostly African American (>85%), single mothers (>75%), and unemployed (≥55%). Among the women, 85.7% had vaginal delivery (VD) and 14.3% had cesarean delivery (CD). Women who preferred CD (10%) were more likely to be concerned about a vaginal tear/episiotomy during VD, forceps, and a "big" baby compared with women who preferred VD, for whom "pushing the baby out myself" and "fear of cesarean" were the most important factors. In the final model of 7 factors, the 3 main factors found to positively impact maternal preference for CD were a vaginal cut during VD (P<0.001), higher mean BMI (P=0.001), and cesarean as the most recent delivery type (P<0.001). The total explained variance by this model was 46%.
  
  
  CONCLUSIONS
  Short-term complications of a VD, higher BMI, and a previous cesarean delivery are the most significant factors that impact the preferences of women of lower SES for future mode of delivery.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Washington Hospital Center, Washington DC 20010-2975, USA. Bela.I.Kudish@medstar.net
authors.forename: Bela
authors.initials: B
authors.lastname: Kudish
authors.forename: Shobha
authors.initials: S
authors.lastname: Mehta
authors.forename: Michael
authors.initials: M
authors.lastname: Kruger
authors.forename: Evie
authors.initials: E
authors.lastname: Russell
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sokol
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D009035:Mothers / Q000706:statistics & numerical data; D010298:Parity; D011247:Pregnancy; D015406:Single Parent / Q000706:statistics & numerical data; D012923:Social Class; D014478:Unemployment / Q000706:statistics & numerical data; D055815:Young Adult