title: Process of decision-making regarding the mode of birth in Brazil: from the initial preference of women to the final mode of birth.
abstract: The purpose of this article is to describe the factors cited for the preference for type of birth in early pregnancy and reconstruct the decision process by type of birth in Brazil. Data from a national hospital-based cohort with 23,940 postpartum women, held in 2011-2012, were analyzed according to source of funding for birth and parity, using the χ2 test. The initial preference for cesarean delivery was 27.6%, ranging from 15.4% (primiparous public sector) to 73.2% (multiparous women with previous cesarean private sector). The main reason for the choice of vaginal delivery was the best recovery of this type of birth (68.5%) and for the choice of cesarean, the fear of pain (46.6%). Positive experience with vaginal delivery (28.7%), cesarean delivery (24.5%) and perform female sterilization (32.3%) were cited by multiparous. Women from private sector presented 87.5% caesarean, with increased decision for cesarean birth in end of gestation, independent of diagnosis of complications. In both sectors, the proportion of caesarean section was much higher than desired by women.
authors.affiliation: Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors.forename: Rosa Maria Soares Madeira
authors.initials: RM
authors.lastname: Domingues
authors.affiliation: Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors.forename: Marcos Augusto Bastos
authors.initials: MA
authors.lastname: Dias
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Nakamura-Pereira
authors.affiliation: Agência Nacional de Saúde Suplementar, Rio de Janeiro, Brasil.
authors.forename: Jacqueline Alves
authors.initials: JA
authors.lastname: Torres
authors.affiliation: Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil.
authors.forename: Eleonora
authors.initials: E
authors.lastname: d'Orsi
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors.forename: Ana Paula Esteves
authors.initials: AP
authors.lastname: Pereira
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors.forename: Arthur Orlando Correa
authors.initials: AO
authors.lastname: Schilithz
authors.affiliation: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
authors.forename: Maria do
authors.initials: Md
authors.lastname: Carmo Leal
mesh_terms: D000328:Adult; D001938:Brazil; D002585:Cesarean Section / Q000706:statistics & numerical data*; D002755:Choice Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D009321:Natural Childbirth / Q000706:statistics & numerical data*; D011247:Pregnancy; D011295:Prenatal Care; D012959:Socioeconomic Factors; D055815:Young Adult