A STUDY ON PATIENTS PERSPECTIVE ON PERSONALIZED DECISION-MAKING OPTIONS ABOUT MODE OF DELIVERY: A CROSS SECTIONAL STUDY

Shamrao R. Wakode and Ritu A. Damahe*

ABSTRACT

Background:Although vaginal delivery remains most common delivery mode, overall cesarean rate reached 32.8% in 2010. Cause for this is multi-factorial and decision to deliver by cesarean section depends on variety of factors. Though it‟s safety in present era is proved. However cesarian sections should be done only for indicated cases. As a malpractice many cesarians done either unindicted or on patients demand. Hence present study undertaken to review patients opinion about various modes of delivery. Aims and Objectives: To study preferences and influencing factors for elective caesarean section or normal vaginal delivery among antenatal mothers. Methods: Prospective observational study in tertiary care centre of 360 term antenatal women was conducted. Patients were evaluated with respect to age, education, gravida, socioeconomic status, previous cesarean section were interviewed and questionnaire was provided. Results: We found 87% women preferred vaginal delivery while 13 % preferred cesarean section. We found socioeconomical status, gravida, previous mode of delivery and complications in previous delivery are the main determining factors for choosing mode of delivery. Majority who preferred vaginal delivery as it is natural process, short hospital stay, fear of surgery, prolonged bed rest after operative. Few preferred section due to fear of labour pain, fear of injury. Conclusion: After assessing knowledge, attitudes and preferences regarding mode of delivery, study concludes that majority of women irrespective of gravida, parity, previous obstetric history prefer vaginal delivery as compared to cesarean section. Factors like history of previous cesarean section, economical status, counselling in antenatal clinics and knowledge provided by husband and relatives may influence in making decisions. From specialist obstetricians view preference should be given to vaginal delivery.

Keywords: Mode of delivery, Attitude, Preferences, Knowledge.