Monday, November 3, 2008

Swedish women choosing cesarean delivery

A new study from the Karolinska Institutet in Sweden set out to examine public attitudes to the act of choosing a cesarean delivery in preference to vaginal delivery. Out of the 1,066 women who responded, "two-thirds stated that a cesarean should be decided on for medical reasons and by a doctor. One-third considered that a woman, without persuasion, should decide herself about mode of delivery and should be free to choose a cesarean."

"These respondents used arguments such as women's rights, bodily integrity and childbirth fear. The results were associated with low trust in health care, women being young or middle aged, urban living and having no children. Low trust in health care was associated with experiences of insecurity, vulnerability and perceived maltreatment."

What does this mean for Sweden's future maternity care?
The study authors (Ulf Houmlgberg, Niels Lynoumle and Marianne Wulff) predict that antenatal care will encounter "more parents asking for a cesarean [in the future], and demanding that health professionals provide an ethically appropriate informed consent process."

They conclude: "Considering the risk of violating young women's trust if not respecting her wish, it seems reasonable that making decisions whether or not to perform a cesarean is part of shared decision making."

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