Original Articles

Preference and Associated Factors for Cesarean Delivery Among Pregnant Women: A Cross-Sectional Study

Abstract

Objective: A cesarean delivery is regarded as a comparatively favourable and secure approach to childbirth when contrasted with vaginal delivery. Over the past decade, its frequency has risen in both industrialized and developing nations. Maternal request for cesarean delivery has been explained for the escalating rate along with other factors like anxiety, fear of childbirth, previous cesarean delivery, previous negative vaginal birth experience, maternal age, maternal education, and socioeconomic factors. Hence, this study was undertaken to assess pregnant women's tendency to have a cesarean birth and to investigate the factors associated with the inclination for cesarean delivery.
Materials and methods: A hospital-based cross-sectional study was carried out in the Department of Obstetrics and Gynaecology of a tertiary care hospital, a systematic sampling procedure was utilized, and 368 antenatal mothers after 36 weeks of gestation, who do not have any specific medical reasons against vaginal delivery were included in the study. Data collection was done by questionnaire. The information regarding socio-demographic factors, preexisting comorbidities, current obstetric risk factors, emotional factors, previous delivery experience, and their information preference toward the mode of delivery were collected. Univariate and multivariate analysis were performed to identify the independent variables associated with preference for cesarean delivery.
Results: The preference for cesarean delivery and non-preference for cesarean delivery was 114 (30.9%) and 201 (54.6%), respectively whereas 53 (14.4%) participants remained neutral. The Chi-square analysis revealed a notable connection between the inclination towards a preference for cesarean delivery and factors such as obstetric score, parity, comorbidities, and among obstetric risk factors such as pregnancy after in-vitro fertilization (IVF), with a history of abortion, and having a prior history of cesarean delivery. Nevertheless, no meaningful association was observed between the preference for cesarean delivery and the remaining variables. On multivariate logistic analysis, independent variables like preexisting anxiety or depression, pregnancy through IVF, and having a history of previous cesarean delivery have increased the odds of preferring cesarean delivery. The independent variables like increasing gestational age, graduates, and unemployed have decreased the odds of preferring a cesarean delivery.
Conclusion: In conclusion, the prevalence of cesarean delivery is influenced by a complex interplay of medical, cultural, socioeconomic, and healthcare system factors. While cesarean delivery is essential in cases of medical necessity, efforts should be made to avoid unnecessary cesarean delivery that does not provide clear benefits over vaginal delivery. Balancing the risks and benefits of cesarean delivery and promoting evidence-based obstetric practices are crucial for ensuring optimal maternal and infant outcomes.

1. CEPAL N. The 2030 Agenda and the Sustainable Development Goals: An opportunity for Latin America and the Caribbean. Goals, Targets and Global Indicators. 2019.
2. Organization WHO. Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women: World Health Organization; 2021.
3. Vyas S, Meinhart M, Troy K, Brumbaum H, Poulton C, Stark L. The economic cost of violence against women and girls in low-and middle-income countries: a systematic review of the evidence. Trauma, Violence, & Abuse. 2023;24(1):44-55.
4. Organization WHO. Preventing violence against women: a framework for policymakers. 2019.
5. Violence against women [Internet]. 2021 [cited 15 December 2021]. Available from: https://www.who.int/news-room/fact-sheets/detail/violence-against-women.
6. Baker CK, Billhardt KA, Warren J, Rollins C, Glass NE. Domestic violence, housing instability, and homelessness: A review of housing policies and program practices for meeting the needs of survivors. Aggression and violent behavior. 2010;15(6):430-9.
7. Ford-Gilboe M, Varcoe C, Noh M, Wuest J, Hammerton J, Alhalal E, et al. Patterns and predictors of service use among women who have separated from an abusive partner. Journal of Family Violence. 2015;30(4):419-31.
8. Women U. Beijing declaration and platform for action: UNWOMEN; 1995.
9. Lyon‐Callo V. Medicalizing homelessness: the production of self‐blame and self‐governing within homeless shelters. Medical anthropology quarterly. 2000;14(3):328-45.
10. Hosseinabadi M, Amirahmadi R, Esmaeili A, Naeimi M. The Process of Violence against Women in Iran and the World: Providing Solutions to Reduce Violence based on the Experience of Countries. IAU International Journal of Social Sciences. 2021;11(4).
11. Kothari M. Promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development. 2009.
12. Gierman T, Liska A. Shelter for Women and Girls at Risk of or Survivors of Violence. Shelter Module, Canadian Network of Women’s Shelters and Transition Houses, March. 2013.
13. The 4th World Conference of Women’s Shelters. Worldwide Women’s Helplines Project reaches 61 countries. Nov 5-8, 2019. https://fourth.worldshelterconference.org/en/news/729.
14. Correia A, Melbin A. Transitional housing services for victims of domestic violence: A report from the Housing Committee of the National Task Force to End Sexual and Domestic Violence. 2005.
15. Understanding Women’s Second Stage Housing Programs in BC [Internet]. 2012 [cited 14 December 2022]. Available from: https://www.bchousing.org/publications/Understanding-Womens-Second-Stage-Housing-Programs-BC.pdf.
16. Tutty L, Bradshaw C, Hewson J, MacLaurin B, Waegemakers Schiff J, Worthington C. Risks and assets for homelessness Prevention. 2017.
17. Women U, UNFPA W, UNDP U. Essential services package for women and girls subject to violence. New York: UN Women. 2015.
18. Gierman T, Liska A, Reimer J. Shelter for Women and Girls at Risk of or Survivors of Violence. Shelter Module March 2013. Canada. https://www.endvawnow.org/uploads/modules/pdf/1363538451.pdf.
19. Mason R, Wolf M, O’Rinn S, Ene G. Making connections across silos: intimate partner violence, mental health, and substance use. BMC women's health. 2017;17(1):1-7.
20. McFarlane J, Symes L, Maddoux J, Gilroy H, Koci A. Is length of shelter stay and receipt of a protection order associated with less violence and better functioning for abused women? Outcome data 4 months after receiving services. Journal of interpersonal violence. 2014;29(15):2748-74.
21. Capezza NM, Schumacher EC, Brady BC. Trends in intimate partner violence services provided by substance abuse treatment facilities: Findings from a national sample. Journal of Family Violence. 2015;30(1):85-91.
22. Hughes J. Women’s advocates and shelter residents: Describing experiences of working and living in domestic violence shelters. Journal of interpersonal violence. 2020;35(15-16):3034-53.
23. Wathen CN, Harris RM, Ford-Gilboe M, Hansen M. What counts? A mixed-methods study to inform evaluation of shelters for abused women. Violence Against Women. 2015;21(1):125-46.
24. Quirouette M. Risks, Needs and Reality Checks: Community Work with Multiply Disadvantaged Justice Involved Individuals 2017.
25. Kulkarni S. Intersectional trauma-informed intimate partner violence (IPV) services: Narrowing the gap between IPV service delivery and survivor needs. Journal of family violence. 2019;34(1):55-64.
26. Tutty LM. Addressing the safety and trauma issues of abused women: A cross-Canada study of YWCA shelters. Journal of International Women's Studies. 2015;16(3):101-16.
27. Jonker IE, Sijbrandij M, Van Luijtelaar MJ, Cuijpers P, Wolf JR. The effectiveness of interventions during and after residence in women’s shelters: A meta-analysis. The European Journal of Public Health. 2015;25(1):15-9.
28. Weissman DM. Countering neoliberalism and aligning solidarities: Rethinking domestic violence advocacy. Sw L REv. 2015;45:915.
29. Burnett C, Ford-Gilboe M, Berman H, Wathen N, Ward-Griffin C. The day-to-day reality of delivering shelter services to women exposed to intimate partner violence in the context of system and policy demands. Journal of Social Service Research. 2016;42(4):516-32.
30. Brinegar SJ. The social construction of homeless shelters in the Phoenix area. Urban Geography. 2003;24(1):61-74.
31. Vinton L, Wilke DJ. Are collaborations enough? Professionals’ knowledge of victim services. Violence against Women. 2014;20(6):716-29.
32. Hovey A, Roberts C, Scott S, Chambers L. Understanding the landscape of substance use management practices in domestic violence shelters across ontario. Journal of family violence. 2020;35(2):191-201.
33. Demczuk I, Lévesque C, Monatasse M. Project ISHKUTEU. Domestic violence support services in response to native women’s needs. 2008.
34. Stensrud A. Toward a better understanding of the needs of shelter users. 2005.
35. Annan K, General S, Nations U. Putting it together: AIDS and the Millennium Development Goals. Geneva: United Nations; 2006.
36. Training Manual for Improving Quality Services for Victims of Domestic Violence. [Internet]. 2008. Available from: http://fileserver.wave-network.org/trainingmanuals/IMPROVE_Quality_Services_2008.pdf.
37. Kelly L. Combating violence against women: minimum standards for support services. 2008.
38. Minimum standards on shelters for abused women. [Internet]. 2001. Available from: https://www.endvawnow.org/uploads/browser/files/minimum_standards_southafrica_2001.pdf. .
39. National Service Standards for Domestic and Sexual Violence Core Standards. 2009.
40. Guidelines for the Management of Safe Shelters for GBV survivors in the English and Dutch-speaking Caribbean. [Internet]. 2021 [cited 15 December 2022]. Available from: https://caribbean.unfpa.org/en/publications/guidelines-management-safe-shelters-gbv-survivors-english-and-dutch-speaking-caribbean.
41. Kaula PM. Influence of monitoring and evaluation practices on the performance of county government projects: a case of market shelter construction projects in Kitui East Subcounty. 2020.
42. McQuigg RJ. The Istanbul convention, domestic violence and human rights: Routledge; 2017.
43. Satyen L, Supol M, Ranganathan A, Toumbourou JW. International and cross-cultural research on men’s violence against female intimate partners. The SAGE handbook of domestic violence. 2021:40-60.
44. Gregg P, Grout PA, Ratcliffe A, Smith S, Windmeijer F. How important is pro-social behaviour in the delivery of public services? Journal of public economics. 2011;95(7-8):758-66.
45. Fisher EM, Stylianou AM. To stay or to leave: Factors influencing victims’ decisions to stay or leave a domestic violence emergency shelter. Journal of Interpersonal Violence. 2019;34(4):785-811.
46. McNamara JR, Tamanini K, Pelletier-Walker S. The impact of short-term counseling at a domestic violence shelter. Research on Social Work Practice. 2008;18(2):132-6.
47. Itzhaky H, Porat AB. Battered women in shelters: Internal resources, well-being, and integration. Affilia. 2005;20(1):39-51.
48. Bennett L, Riger S, Schewe P, Howard A, Wasco S. Effectiveness of hotline, advocacy, counseling, and shelter services for victims of domestic violence: A statewide evaluation. Journal of interpersonal violence. 2004;19(7):815-29.
49. Goodman L, Epstein D. Refocusing on women: A new direction for policy and research on intimate partner violence. Journal of interpersonal Violence. 2005;20(4):479-87.
50. Yoshioka MR, Choi DY. Culture and interpersonal violence research: Paradigm shift to create a full continuum of domestic violence services. Journal of interpersonal violence. 2005;20(4):513-9.
51. Melbin A, Sullivan CM, Cain D. Transitional supportive housing programs: Battered women's perspectives and recommendations. Affilia. 2003;18(4):445-60.
52. Hart W, Vazquez I, Hedberg EC. Serving Valley Victims of Domestic Violence: Challenges and Choices: Morrison Institute for Public Policy, Arizona State University, College of …; 2014.
53. Beres MA, Crow B, Gotell L. The perils of institutionalization in neoliberal times: Results of a national survey of Canadian sexual assault and rape crisis centres. Canadian Journal of Sociology/Cahiers canadiens de sociologie. 2009;34(1):135-63.
54. Macy RJ, Ferron J, Crosby C. Partner violence and survivors' chronic health problems: informing social work practice. Social Work. 2009;54(1):29-43.
Files
IssueVol 18, No 1 (March 2024) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/jfrh.v18i1.15435
Keywords
Cesarean Section Cesarean Delivery Pregnant Women Patient Preference Obstetrics
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Begum J, Mitra S. Preference and Associated Factors for Cesarean Delivery Among Pregnant Women: A Cross-Sectional Study. J Family Reprod Health. 2024;18(1):20-29.