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Satisfaction with Cesarean Section: Qualitative Analysis of Open-Ended Questions in a Large Postal Survey

Authors

  • Maureen Porter BSc, MSc, PhD,

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    1. 1Maureen Porter is a Research Fellow and Siladitya Bhattacharya is a Professor in the Department of Obstetrics & Gynaecology, 2Edwin van Teijlingen is a Reader in the Department of Public Health, and 3Livia Chi Ying Yip is a medical student, Department of Public Health, University of Aberdeen, Aberdeen, United Kingdom.
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  • 1 Edwin Van Teijlingen MA, MEd, PhD,

    1. 1Maureen Porter is a Research Fellow and Siladitya Bhattacharya is a Professor in the Department of Obstetrics & Gynaecology, 2Edwin van Teijlingen is a Reader in the Department of Public Health, and 3Livia Chi Ying Yip is a medical student, Department of Public Health, University of Aberdeen, Aberdeen, United Kingdom.
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  • 2 Livia Chi Ying Yip MBChB,

    1. 1Maureen Porter is a Research Fellow and Siladitya Bhattacharya is a Professor in the Department of Obstetrics & Gynaecology, 2Edwin van Teijlingen is a Reader in the Department of Public Health, and 3Livia Chi Ying Yip is a medical student, Department of Public Health, University of Aberdeen, Aberdeen, United Kingdom.
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  • and 3 Siladitya Bhattacharya MB, BS, MD 1

    1. 1Maureen Porter is a Research Fellow and Siladitya Bhattacharya is a Professor in the Department of Obstetrics & Gynaecology, 2Edwin van Teijlingen is a Reader in the Department of Public Health, and 3Livia Chi Ying Yip is a medical student, Department of Public Health, University of Aberdeen, Aberdeen, United Kingdom.
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  • The research was supported by a grant from the Chief Scientist’s Office of the Scottish Executive, Edinburgh, United Kingdom.

Maureen Porter, BSc, MSc, PhD, Department of Obstetrics & Gynaecology, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.

Abstract

ABSTRACT: Background: Cesarean section rates throughout the developed world continue to rise. Although satisfaction with cesarean section has been widely studied, relatively little is known about the causes of “distress” that may contribute to dissatisfaction. The aim of this study was to explore the factors that women identified as “distressing” so as to understand their responses to standard questions on satisfaction. Methods: A questionnaire study of 1,661 women who had delivered their first babies by cesarean section in Aberdeen, Scotland, between 1980 and 1995 elicited a 75 percent response rate and showed that 81 percent of women were satisfied with the experience. Nevertheless, 36 percent rated an aspect as distressing, and 42 percent provided written descriptions of one or more experiences that had distressed them. These responses were coded using content analysis into 5 major categories: before, during, and after the birth, psychological/general, and overall. Results: The most distressing factors were of a psychological or general nature, with 66 percent of distressed women mentioning poor communications, fears, missing out on the birth or the immediate postpartum period, or other emotions. Events happening before, during, and after the birth caused 23, 45, and 44 percent of women to be distressed, respectively. Surgical complications and infections were distressing, but anesthesia was the single factor that caused most distress, leaving 102 women (20%) with unsatisfactory memories of the birth. Conclusions: The impact of cesarean birth on women’s psychological well-being is highlighted by this study. Enhanced communication during labor and delivery, and preparation or education on issues surrounding cesarean section, can reduce distress and improve women’s satisfaction with birth. (BIRTH 34:2 June 2007)

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