Chilean women’s preferences regarding mode of delivery: which do they prefer and why?

Authors


Dr AB Caughey, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, 505 Parnassus Avenue, PO Box 0132, San Francisco, CA 94143, USA. Email abcmd@berkeley.edu

Abstract

Objective  Caesarean section rates in Chile are reported to be as high as 60% in some populations. The purpose of this study was to determine pregnant Chilean women’s preferences towards mode of delivery.

Design  Interviewer-administered cross-sectional survey.

Setting  Prenatal clinics in Santiago, Chile.

Population  Pregnant women in Santiago, Chile.

Methods  Of 180 women completing the questionnaire, 90 were interviewed at a private clinic (caesarean delivery rate 60%) and 90 were interviewed at a public clinic (cesarean delivery rate 22%). Data collected included demographics, preferred mode of delivery, and women’s attitudes towards vaginal and caesarean deliveries.

Main outcome measures  Mode of delivery preferences, perceptions of mode of delivery measured on a 1–7 Likert scale.

Results  The majority of women (77.8%) preferred vaginal delivery, 9.4% preferred caesarean section, and 12.8% had no preference. There was no statistical difference in preference between the public clinic (11% preferred caesarean) and the private clinic (8% preferred caesarean, P= 0.74). Overall, women preferring caesarean birth were slightly older than other groups (31.6 years, versus 28.4 years for women who preferred vaginal and 27.3 years for women who had no preference, P= 0.05), but there were otherwise no differences in parity, income, or education. On a scale of 1–7, women preferring caesarean birth rated vaginal birth as more painful, while women preferring vaginal birth rated it as less painful (5.8 versus 3.7, P= 0.003). Whether vaginal or caesarean, each group felt that their preferred mode of delivery was safer for their baby (P < 0.001).

Conclusions  Chilean women do not prefer caesarean section to vaginal delivery, even in a practice setting where caesarean delivery is more prevalent. Thus, women’s preferences is unlikely to be the most significant factor driving the high caesarean rates in Chile.

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