title: Patterns and Associated Factors of Caesarean Delivery Intention among Expectant Mothers in China: Implications from the Implementation of China's New National Two-Child Policy.
abstract: This study explores the basic demographic characteristics of expectant mothers in the context of their intentions regarding mode of delivery, in particular, the preference for caesarean delivery, and analyzes the social and psychological factors that influence delivery preference.
  
  
  
  A cross-sectional survey of pregnant women was conducted during June to August in 2015. This study adopted a stratified sampling method, and 16 representative hospitals in five provinces of China were included.
  
  
  
  1755 and 590 of expectant mothers in their first and second pregnancies, respectively, were enrolled in this study. 354 (15.10%) intended to deliver by caesarean section and 585 (24.95%) participants were uncertain prior to delivery. 156 (8.89%) of expectant mothers in their first pregnancy and 198 (33.56%) expectant mothers in their second pregnancy intended to deliver by caesarean section. Ordinal logistic regression analysis found that nationality, parity, trimester of pregnancy, and advanced maternal age were factors associated with intention to deliver by caesarean (ordered logistic regression/three-level caesarean delivery intention criterion; odds ratios p < 0.05).
  
  
  
  8.89% of first pregnancy expectant mothers and 33.56% of second pregnancy expectant mothers intended to deliver by caesarean section. Any intervention program to reduce the rate of Caesarean delivery should focus on the Han population, older pregnant women, and expectant mothers in their second pregnancy, at an early gestation.
authors.affiliation: The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. llian_w@163.com.|Department of Reproduction Health and Infertility, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. llian_w@163.com.|Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing 400016, China. llian_w@163.com.
authors.forename: Lianlian
authors.initials: L
authors.lastname: Wang
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China. xianglong1989@126.com.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China. xianglong1989@126.com.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China. xianglong1989@126.com.
authors.forename: Xianglong
authors.initials: X
authors.lastname: Xu
authors.affiliation: Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing 400016, China. philip.baker@leicester.ac.uk.|College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester 3182, UK. philip.baker@leicester.ac.uk.
authors.forename: Philip
authors.initials: P
authors.lastname: Baker
authors.affiliation: The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. chaotongcqmu@163.com.|Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing 400016, China. chaotongcqmu@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Tong
authors.affiliation: Research Center for Public Health, School of Medicine, Tsinghua University, Beijing 100062, China. lzhang20@mail.tsinghua.edu.cn.|Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3182, Australia. lzhang20@mail.tsinghua.edu.cn.|School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne 3053, Australia. lzhang20@mail.tsinghua.edu.cn.|Melbourne Sexual Health Centre, Alfred Health, Melbourne 3053, Australia. lzhang20@mail.tsinghua.edu.cn.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: The Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China. qihongbo@sina.com.|Canada-China-New Zealand Joint Laboratory of Maternal and Fetal Medicine, Chongqing Medical University, Chongqing 400016, China. qihongbo@sina.com.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Qi
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China. zhaoyong@cqmu.edu.cn.|Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing 400016, China. zhaoyong@cqmu.edu.cn.|The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing 400016, China. zhaoyong@cqmu.edu.cn.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000523:psychology / Q000706:statistics & numerical data*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008423:Maternal Age; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011640:Public Policy
keywords: China; caesarean delivery intention; expectant mothers; two-child policy