Pregnant women value safety over choice
Wed April 22nd, 2009
The vast majority of pregnant women put safety above personal choice when it comes to birth method, British researchers said today.
Choice has been established as a central theme in maternity care policy in the UK, with current guidelines highlighting the role of women's preferences, say Dr Carol Kingdon, of the University of Central Lancashire, UK, and colleagues.
Rates of caesarean sections are rising, and "caesarean delivery on maternal request" rather than medical necessity, is thought to be the main reason.
In a new study, the researchers followed 454 women from first antenatal booking appointment to 12 months after birth, to explore their views and experiences of NHS maternity care.
While most women felt that vaginal birth was preferable, they accepted that their actual birth would be determined by: health concerns and the circumstances of their pregnancy, the position of the baby, the course of their labour, and the practices of midwives and obstetricians involved.
These key findings are published in BJOG: An International Journal of Obstetrics and Gynaecology. The team also found that desire for a caesarean declined during pregnancy - "preference is neither static nor final".
Dr Kingdon suggests that "choice may not be the best way to understand women's decision-making about birth method", because the findings "challenge prevailing notions about caesarean delivery on maternal request".
She said: "This study has highlighted that whilst many women supported the principle of choice, few women may have any real choice about how they give birth in NHS maternity hospitals. "All women felt that medical concerns should take precedence over personal preferences and recognised how any choice expressed can change as pregnancy progresses."
Kingdon, C. et al. Choice and birth method: mixed-method study of caesarean delivery for maternal request. BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 116, April 22, 2009, pp. 1-10.
Tags: UK News | Women’s Health & Gynaecology | Nursing & Midwifery | NHS | Childbirth and Pregnancy
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