Requesting Cesareans Without Medical Indications: An Option Being Considered by Young Canadian Women

:  Background:  Cesarean delivery on maternal request is a worldwide growing phenomenon. The goal of this study was to describe young nulliparous women’s attitudes about cesarean delivery on maternal request. Methods:  A total of 140 nulliparous women in Canada aged between 18 and 24 years and attending school from the vocational (n = 53), college (n = 61), and university (n = 18) levels (n = 8 other) participated in the survey. The self-administered questionnaire consisted of 23 open-ended questions. The outcome measure was the participant’s attitude toward cesarean delivery on maternal request. Descriptive, bivariate, and multiple regression analyses were performed. Results:  Many of the respondents (63%) had previously heard about cesarean delivery on maternal request, and of these women 28.6 percent had a favorable attitude toward the procedure. Sociodemographic variables were not associated with participants’ attitudes toward cesarean delivery on maternal request except for place of residence and type of professional preferred for pregnancy care. Thinking that vaginal birth was more painful than cesarean delivery (p = 0.012) and had more consequences for the mother (p < 0.001) were related to a positive attitude toward cesarean delivery on maternal request. A positive attitude by peers was also associated with participants’ favorable attitude toward cesarean delivery on maternal request (p < 0.001). The overall predictive success of the model was 66.5 percent. Conclusions:  Young women are spreading the word about cesarean delivery on maternal request and may influence one another about their preferred delivery method. During prenatal visits practitioners need to address women’s fear of vaginal birth and its consequences for the mother, counseling, and women’s understanding of the consequences of cesarean delivery. This study supports the urgent need to systematically document cesarean delivery on maternal request as a medical procedure and to study its prevalence and related factors. (BIRTH 39:1 March 2012)