title: Factors Associated with Preference for Vaginal Birth among Undergraduate Students from Southern Brazil.
abstract: Cesarean rates in Brazil have reached over 50 percent of all births. Multiple factors have been studied aiming to explain these rates. Mode of delivery preferences among university students may provide insights into strategies to reduce those numbers.
  
  
  
  A cross-sectional study was conducted enrolling students who attended Health Sciences and Human Sciences undergraduate programs in 2013. Participants answered a semi-structured questionnaire about which mode of delivery they considered the "best" (less risky and more beneficial) and the "preferred" mode (the one they would choose for themselves or their partners). Pearson chi-square was used to assess association among variables. Multiple regression analysis identified independent factors associated with the outcome measures.
  
  
  
  Among the 797 students who provided complete responses (76% response rate), the mean age was 22.6 years, 61.6 percent were female, 2.6 percent had previous pregnancies, and 56.7 percent were born by cesarean. Vaginal birth was chosen as the "best" mode of delivery by 91.2 percent, and the "preferred" mode by 75.5 percent of students. Being male, born vaginally, and a Health Sciences student was associated with a preference for vaginal birth. Being a Health Sciences student and born vaginally was associated with considering vaginal birth the "best" mode of delivery.
  
  
  
  Our findings indicate that the recognition of the benefits of vaginal birth do not always translate into a personal preference for vaginal birth. The student's own mode of birth was a strong predictor of their preferences for mode of delivery.
authors.affiliation: Department of Obstetrics and Gynecology, Federal University of Santa Catarina, Brazil.
authors.forename: Roxana
authors.initials: R
authors.lastname: Knobel
authors.affiliation: ANOVA Health Consulting Group, Rio de Janeiro, Brazil.
authors.forename: Maíra L S
authors.initials: ML
authors.lastname: Takemoto
authors.affiliation: Department of Medicine, Federal University of São Carlos, Brazil.
authors.forename: Carla B
authors.identifier: 0000-0002-5590-108X
authors.initials: CB
authors.lastname: Andreucci
authors.affiliation: Program to Value Basic Healthcare Professionals, Ministry of Health, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Docusse
authors.affiliation: Research and Data Resources, Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, PA, USA.
authors.forename: Danette W
authors.initials: DW
authors.lastname: McKinley
authors.affiliation: Obstetrics and Gynecology Department, School of Medical Sciences, University of Campinas (UNICAMP), Brazil.
authors.forename: Eliana
authors.initials: E
authors.lastname: Amaral
mesh_terms: D000328:Adult; D001290:Attitude; D001938:Brazil; D002585:Cesarean Section / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009321:Natural Childbirth / Q000523:psychology*; D057240:Patient Preference; D011247:Pregnancy; D013334:Students; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult
keywords: cesarean delivery; natural birth; university students