title: [Fear-driven cesarean section on request].
abstract: Traditionally, women gave birth surrounded by other, experienced women. Modern women not only require continuous support during labor, but they also want to have a part in decision-taking. That is why some of them, regardless of how much or how little medical knowledge they have, want to decide about the way of birth on their own. The aim of this study was to find the underlying cause of the growing percentage of cesarean sections and cesarean sections on request and to find an answer to the question of what can be done to reduce that number.
  
  
  METHODS
  A survey was conducted among 100 nulliparas between 38 and 40 week of pregnancy who were determined to give birth in a natural way, and among 50 nulliparas, in the same gestational age, who requested cesarean section.
  
  
  RESULTS
  The analysis of our survey shows that request for cesarean section in 12% of cases resulted from fear of labor pain, more than before were declared 2%. After they were informed about methods of reducing labor pain and guaranteed that those methods would be available, as many as 52% of pregnant women who had previously requested cesarean section changed their mind and wanted to give birth in a natural way (this could reduce cesarean section rate about 52%, p<0.05), and 42% (of the total) wanted to have epidural anesthesia.
  
  
  CONCLUSIONS
  Better access of pregnant women to information about pharmacological and non-pharmacological methods of reducing labor pain, coupled with the availability of those methods, can reduce the number of cesarean sections on request even by half. In the group of pregnant women determined to have cesarean section, one in four would give it up if they had access to epidural anesthesia, and one in ten if they had access to non-pharmacological methods of reducing labor pain (mainly acupuncture).
authors.affiliation: First Chair and Department of Gynecology and Obstetrics, Medical University of Wroclaw, Poland. mproust@wp.pl
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Pawelec
authors.forename: Jolanta
authors.initials: J
authors.lastname: Pietras
authors.forename: Andrzej
authors.initials: A
authors.lastname: Karmowski
authors.forename: Bogusław
authors.initials: B
authors.lastname: Pałczyński
authors.forename: Mikołaj
authors.initials: M
authors.lastname: Karmowski
authors.forename: Tytus
authors.initials: T
authors.lastname: Nowak
mesh_terms: D015670:Acupuncture Therapy / Q000706:statistics & numerical data; D000328:Adult; D000767:Anesthesia, Epidural / Q000706:statistics & numerical data; D000773:Anesthesia, Obstetrical / Q000379:methods / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000523:psychology* / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000523:psychology / Q000706:statistics & numerical data*; D005239:Fear / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D048949:Labor Pain / Q000523:psychology*; D036801:Parturition / Q000523:psychology*; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy