title: 'My pain was stronger than my happiness': experiences of caesarean births from Lebanon.
abstract: OBJECTIVE
  the rising trends in caesarean section have been partially attributed to women's requests. Many studies in developed and very few in developing countries have attempted to understand this phenomenon. This qualitative study explores experiences of women having caesarean section on demand in a middle-income country with a private health-care system.
  
  
  METHODS
  an inductive qualitative design, using face-to-face semi-structured interviews.
  
  
  METHODS
  women were identified and recruited through a perinatal database and selected obstetricians' clinics in the Greater Beirut area in Lebanon.
  
  
  METHODS
  a purposive sample of women who had a caesarean childbirth within the four months preceding the interview, were visited for an interview at home using a semi-structured interview guide. Thematic content analysis was conducted on a sub-sample of 22 women who requested a caesarean birth.
  
  
  RESULTS
  lack of information about caesarean sections fosters women's fear from labour pain and acts as the main impetus for women to consider caesareans as the pain free alternative. Findings reveal health-care providers' role in reinforcing beliefs about caesarean sections being the way for pain free deliveries by overestimating the safety of the procedure and disregarding postpartum health issues.
  
  
  CONCLUSIONS
  caesarean birth is presented to women as a safe option for 'pain free' childbirth. This needs to be considered within the cultural context of understanding safety and pain as well as the dynamics of power in maternity care. Health-care professionals need to explore these dimensions and promote women's informed choice as well as encouraging the normality of birth.
authors: Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Riad El Solh 1107 2020, PO Box 11-0236, Lebanon. Electronic address: tk00@aub.edu.lb.
authors: Tamar
authors: T
authors: Kabakian-Khasholian
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D002585:Cesarean Section / Q000523:psychology*; D002755:Choice Behavior; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007861:Lebanon; D008880:Midwifery / Q000379:methods / Q000592:standards; D058748:Pain Perception; D057240:Patient Preference / Q000523:psychology*; D011247:Pregnancy; D064186:Prenatal Education; D036301:Qualitative Research; D012959:Socioeconomic Factors
keywords: Caesarean birth; Caesarean on demand; Childbirth; Postpartum health