Cesarean Delivery at Maternal Request in a Rural Medical College Hospital

Abstract

Background: The aim of the study was to find out the reasons behind women preferring cesarean section (CS) in the absence of obstetric and medical indications.

Methods: This was a prospective study among women who came for delivery at R.L. Jalappa Hospital and Research Center, Kolar, a tertiary level teaching hospital. All women who underwent cesarean delivery for maternal request were included in this study.

Results: The total number of deliveries during the study period (1.5 years) was 3,639. There were 1,877 (52%) vaginal deliveries and 1,762 (48%) CSs. Among 1,762 cesarean deliveries, 44 (2.5%) had maternal request as their indication. Majority (54.5%) of them were in the age group of 20 - 25 years. Multigravida opted for CS more than primigravida (30 versus 14). Most (61.3%) of them have finished their primary school. Majority of them (56.8%) were in class IV socioeconomic status of Kuppuswamys scale. The various reasons for women requesting cesarean delivery were refusal of vagina birth after cesarean section (VBAC), simultaneous tubectomy, painless delivery, prolonged infertility, afraid of neonatal outcome and astrological concerns.

Conclusion: Many of the women opted for cesarean delivery in our study for preventable reasons like painless labor and simultaneous tubectomy which would have been avoided by prior counseling starting from antenatal period and by providing labor analgesia. Proper education of the patient and personal involvement of the treating obstetrician in counseling the patient and her supporters can reduce cesarean delivery for maternal request.




J Clin Gynecol Obstet. 2016;5(2):64-67
doi: http://dx.doi.org/10.14740/jcgo290w

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