PL.78 Maternal Request for a Caesarean Section in the Absence of Medical Indications

Abstract

Introduction CS rates are rising worldwide. In the UK, 25% of women have a CS and 6-8% of women express a preference.1 2 NICE recently updated guidelines stating that women can request a CS after they are fully informed of the risks.2 However the evidence of risks is of a poor quality, which questions how the opinions of doctors and midwives could influence women's decisions.1 Methods A questionnaire-based study at the Sunderland Obstetric Department aimed to compare the views of pregnant women, midwives and doctors. Questionnaires used six different scenarios to ask firstly whether women should be able to request a CS and secondly the most common reason for the request. Further comparison was made between nulliparous and parous women. Data was analysed using excel. Results There were 216 pregnant women, 56 midwives and 76 doctors. All groups favoured vaginal delivery for women who have had one or no previous deliveries. Twin pregnancy was considered a more acceptable indication. Nulliparous women were more willing for CS compared with parous women. All three groups agreed that fear of childbirth was the most common reason for women with no previous deliveries (patients 84 (38%), midwives 32 (52%) and doctors 34 (44%). A higher proportion of patients and midwives, compared with doctors, considered concerns of their baby's safety (patients 78 (39%), midwives 13 (27%) and doctors 37 (47%)). Discussion Womens' anxieties of childbirth need to be explored antenatally by healthcare professionals so that an informed decision can be made regarding the best mode of delivery for them.