Research support was provided through a Canadian Institutes of Health Research Pilot Projects grant and a Social Sciences and Humanities Research Council of Canada's Standard Research Grant, Ottawa, Ontario, Canada.
Patient-Initiated Elective Cesarean Section of Nulliparous Women in British Columbia, Canada
Article first published online: 27 JUN 2012
© 2012, Copyright the Authors, Journal compilation © 2012, Wiley Periodicals, Inc.
Volume 39, Issue 3, pages 175–182, September 2012
How to Cite
Hutton, E. K. and Kornelsen, J. (2012), Patient-Initiated Elective Cesarean Section of Nulliparous Women in British Columbia, Canada. Birth, 39: 175–182. doi: 10.1111/j.1523-536X.2012.00546.x
- Issue published online: 29 AUG 2012
- Article first published online: 27 JUN 2012
- Manuscript Accepted: 13 FEB 2012
- Canadian Institutes of Health Research
- Michael Smith Foundation for Health Research
- cesarean section;
- patient autonomy;
- patient choice;
- patient-elected cesarean section
The proportion of cesarean sections is increasing in Canada overall and in British Columbia in particular. It has been suggested that this increase is partially the result of women requesting the procedure, although the prevalence of patient-initiated elective cesarean section is unclear. The objective of this study was to examine the prevalence of probable elective cesarean and physician-suggested elective cesarean section among nulliparous women who had a cesarean section in British Columbia, Canada.
An electronic search of patient charts from seven British Columbia hospitals between June 1, 2002, and May 31, 2004, was completed and potential nulliparous women seeking elective cesarean were identified. Any women with medical factors predisposing them to a cesarean section were excluded. Identified charts were then subjected to individual chart review by two independent researchers to ensure accuracy of classification into a cohort of women with probable patient-initiated elective cesarean section.
For the study period, 10,546 nulliparous women gave birth at the seven study hospitals and 3,301 delivered by means of cesarean section. Of these 3,301 women, 36 were judged to have had a patient-initiated elective cesarean. These 36 women represented 0.34 percent of all nulliparous births and 1.09 percent of all nulliparous cesarean births. Those judged to have selected an elective cesarean were significantly older and had babies with a lower gestational age than women with a nonelective cesarean section. No significant differences between the two groups were found with respect to maternal weight, length of stay for the mother or baby, newborn birthweight, or special care nursery days.
Overall, the prevalence of nulliparous women judged to have had a patient-initiated elective cesarean was found to be low and is not likely to be substantially contributing to the rising proportion of cesarean births. (BIRTH 39:3 September 2012)