Maternal perspective on requesting elective caesarean birth

Abstract

Objective: This study was conducted to explore the underline factors for requesting elective cesarean section without an obstetric indication in primigravida.

Methods: A qualitative case study was conducted in Obstetrics & Gynaecology department at Central Park Hospital from September 2023 to February 2024. The study participants were primigravidas who presented after 37 weeks of gestation and requested for cesarean section without any medical indication. Semi-structured interviews were taken from fifteen participants for an in-depth analysis of the causes of elective cesarean section. Thematic analysis was done using NVivo 14.

Results: The analysis of the reasons given by women to seek cesarean section led to the identification of four main themes. Traumatic birth experiences of near relatives and friends emerged as a main reason that resulted in fear of childbirth. Psychological fear related to labor pains and vaginal examination were yet another reason. Behaviour control expressed as visual impaction, ashamed of exposure and lithotomy positioning were described by few of participants. Most respondents reported more than one reasons for requesting cesarean section.

Conclusion: We found that CDMR in primigravidas is multifactorial and had personal, behavioural and social contexts. Listening to horrific birth stories from surroundings was most pronounced factor that created a negative impression of vaginal delivery on first-time mothers and generated self-perceived harm which led to multi-faceted fear regarding birth process.