Preferences of women with low obstetric risk for cesarean or vaginal birth in Poland: Areas for intervention

Birth. 2021 Jun;48(2):265-273. doi: 10.1111/birt.12537. Epub 2021 Feb 12.

Abstract

Background: In Poland, the rate of cesarean birth (CB) is 43%, which is much higher than the European average of 27%. Optimizing the CB birth rate is of critical importance, especially among women with low-risk pregnancies. However, the determinants of cesarean preference among low-risk women in Poland have not been well explored.

Methods: This cross-sectional study included 1011 pregnant women and aimed to identify associations between selected determinants of women's preferences for CB vs. vaginal birth (VB) in Poland. A descriptive questionnaire was distributed online, and a theoretical model was validated against empirically gathered data. Group comparisons were performed using the Welch t test for continuous data or chi-square test for categorical data. All statistical analyses were performed using R (R Core Team, 2018).

Results: The mean age of women preferring CB (30.46 years) was 1.25 years higher than that of women preferring VB (29.21 years). Pregnant women who expressed a preference for CB tended to be multigravid, inhabited cities, and were characterized by higher levels of anxiety and depression. Moreover, the majority of women who underwent a previous CB asserted their intention to repeat the procedure for the current pregnancy.

Conclusions: The primary factors that were correlated with high CB preference among the low-risk group included age, previous childbirth experiences, and anxiety. The underlying reasons that drive birth preferences remain poorly understood. However, women who have previously undergone difficult childbirth experiences and are afraid of pain require specialized care.

Keywords: cesarean birth; preference; vaginal birth.

MeSH terms

  • Adult
  • Cesarean Section*
  • Cross-Sectional Studies
  • Delivery, Obstetric
  • Female
  • Humans
  • Parturition*
  • Poland
  • Pregnancy