Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study

Autores
Mazzoni, Agustina; Althabe, Fernando; Gutierrez, Laura; Gibbons, Luz; Liu, Nancy H.; Bonotti, Ana María; Izbizky, Gustavo H.; Ferrary, Marta; Viergue, Nora; Vigil, Silvia I.; Zalazar Denett, Gabriela; Belizan, Jose
Año de publicación
2016
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women’s preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. Methods A prospective cohort study was conducted in two public and three private hospitals in Buenos Aires, Argentina. 382 nulliparous pregnant women (183 from the private sector and 199 from the public sector) aged 18 to 35 years, with single pregnancies over 32 weeks of gestational age were enrolled during antenatal care visits between October 2010 and September 2011. We excluded women with pregnancies resulting from assisted fertility, women with known pre-existing major diseases or, with pregnancy complications, or with a medical indication of elective cesarean section. We used two different approaches to assess women’s preferences: a survey using a tailored questionnaire, and a discrete choice experiment. Results Only 8 and 6 % of the healthy nulliparous women in the public and private sectors, respectively, expressed a preference for caesarean section. Fear of pain and safety were the most frequently expressed reasons for preferring caesarean section. When reasons for delivery mode were assessed by a discrete choice experiment, women placed the most emphasis on sex after childbirth. Of women who expressed their preference for vaginal delivery, 34 and 40 % ended their pregnancies by caesarean section in public and private hospitals, respectively. Conclusions The preference for caesarean section is low among healthy nulliparous women in Buenos Aires. The reasons why these women had a rate of more than 35 % caesarean sections are unlikely related to their preferences for mode of delivery.
Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Liu, Nancy H.. UCSF General Internal Medicine; Estados Unidos
Fil: Bonotti, Ana María. Ministerio de Salud de la Nación; Argentina
Fil: Izbizky, Gustavo H.. Hospital Italiano; Argentina
Fil: Ferrary, Marta. Hospital Magdalena; Argentina
Fil: Viergue, Nora. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; Argentina
Fil: Vigil, Silvia I.. Hospital Británico de Buenos Aires; Argentina
Fil: Zalazar Denett, Gabriela. Hospital Materno Infantil Dr. Carlos Gianantonio; Argentina
Fil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Materia
Caesarean section
Childbirth
Choice
Obstetric
Preference
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/43857
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/43857
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort studyMazzoni, AgustinaAlthabe, FernandoGutierrez, LauraGibbons, LuzLiu, Nancy H.Bonotti, Ana MaríaIzbizky, Gustavo H.Ferrary, MartaViergue, NoraVigil, Silvia I.Zalazar Denett, GabrielaBelizan, JoseCaesarean sectionChildbirthChoiceObstetricPreferencehttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women’s preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. Methods A prospective cohort study was conducted in two public and three private hospitals in Buenos Aires, Argentina. 382 nulliparous pregnant women (183 from the private sector and 199 from the public sector) aged 18 to 35 years, with single pregnancies over 32 weeks of gestational age were enrolled during antenatal care visits between October 2010 and September 2011. We excluded women with pregnancies resulting from assisted fertility, women with known pre-existing major diseases or, with pregnancy complications, or with a medical indication of elective cesarean section. We used two different approaches to assess women’s preferences: a survey using a tailored questionnaire, and a discrete choice experiment. Results Only 8 and 6 % of the healthy nulliparous women in the public and private sectors, respectively, expressed a preference for caesarean section. Fear of pain and safety were the most frequently expressed reasons for preferring caesarean section. When reasons for delivery mode were assessed by a discrete choice experiment, women placed the most emphasis on sex after childbirth. Of women who expressed their preference for vaginal delivery, 34 and 40 % ended their pregnancies by caesarean section in public and private hospitals, respectively. Conclusions The preference for caesarean section is low among healthy nulliparous women in Buenos Aires. The reasons why these women had a rate of more than 35 % caesarean sections are unlikely related to their preferences for mode of delivery.Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Liu, Nancy H.. UCSF General Internal Medicine; Estados UnidosFil: Bonotti, Ana María. Ministerio de Salud de la Nación; ArgentinaFil: Izbizky, Gustavo H.. Hospital Italiano; ArgentinaFil: Ferrary, Marta. Hospital Magdalena; ArgentinaFil: Viergue, Nora. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; ArgentinaFil: Vigil, Silvia I.. Hospital Británico de Buenos Aires; ArgentinaFil: Zalazar Denett, Gabriela. Hospital Materno Infantil Dr. Carlos Gianantonio; ArgentinaFil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaBioMed Central2016-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/43857Mazzoni, Agustina; Althabe, Fernando; Gutierrez, Laura; Gibbons, Luz; Liu, Nancy H.; et al.; Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study; BioMed Central; BMC Pregnancy and Childbirth; 16; 1; 2-20161471-23930968-8080CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1186/s12884-016-0824-0info:eu-repo/semantics/altIdentifier/url/https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0824-0info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:36:11Zoai:ri.conicet.gov.ar:11336/43857instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:36:12.24CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
title Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
spellingShingle Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
Mazzoni, Agustina
Caesarean section
Childbirth
Choice
Obstetric
Preference
title_short Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
title_full Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
title_fullStr Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
title_full_unstemmed Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
title_sort Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study
dc.creator.none.fl_str_mv Mazzoni, Agustina
Althabe, Fernando
Gutierrez, Laura
Gibbons, Luz
Liu, Nancy H.
Bonotti, Ana María
Izbizky, Gustavo H.
Ferrary, Marta
Viergue, Nora
Vigil, Silvia I.
Zalazar Denett, Gabriela
Belizan, Jose
author Mazzoni, Agustina
author_facet Mazzoni, Agustina
Althabe, Fernando
Gutierrez, Laura
Gibbons, Luz
Liu, Nancy H.
Bonotti, Ana María
Izbizky, Gustavo H.
Ferrary, Marta
Viergue, Nora
Vigil, Silvia I.
Zalazar Denett, Gabriela
Belizan, Jose
author_role author
author2 Althabe, Fernando
Gutierrez, Laura
Gibbons, Luz
Liu, Nancy H.
Bonotti, Ana María
Izbizky, Gustavo H.
Ferrary, Marta
Viergue, Nora
Vigil, Silvia I.
Zalazar Denett, Gabriela
Belizan, Jose
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Caesarean section
Childbirth
Choice
Obstetric
Preference
topic Caesarean section
Childbirth
Choice
Obstetric
Preference
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women’s preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. Methods A prospective cohort study was conducted in two public and three private hospitals in Buenos Aires, Argentina. 382 nulliparous pregnant women (183 from the private sector and 199 from the public sector) aged 18 to 35 years, with single pregnancies over 32 weeks of gestational age were enrolled during antenatal care visits between October 2010 and September 2011. We excluded women with pregnancies resulting from assisted fertility, women with known pre-existing major diseases or, with pregnancy complications, or with a medical indication of elective cesarean section. We used two different approaches to assess women’s preferences: a survey using a tailored questionnaire, and a discrete choice experiment. Results Only 8 and 6 % of the healthy nulliparous women in the public and private sectors, respectively, expressed a preference for caesarean section. Fear of pain and safety were the most frequently expressed reasons for preferring caesarean section. When reasons for delivery mode were assessed by a discrete choice experiment, women placed the most emphasis on sex after childbirth. Of women who expressed their preference for vaginal delivery, 34 and 40 % ended their pregnancies by caesarean section in public and private hospitals, respectively. Conclusions The preference for caesarean section is low among healthy nulliparous women in Buenos Aires. The reasons why these women had a rate of more than 35 % caesarean sections are unlikely related to their preferences for mode of delivery.
Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Liu, Nancy H.. UCSF General Internal Medicine; Estados Unidos
Fil: Bonotti, Ana María. Ministerio de Salud de la Nación; Argentina
Fil: Izbizky, Gustavo H.. Hospital Italiano; Argentina
Fil: Ferrary, Marta. Hospital Magdalena; Argentina
Fil: Viergue, Nora. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; Argentina
Fil: Vigil, Silvia I.. Hospital Británico de Buenos Aires; Argentina
Fil: Zalazar Denett, Gabriela. Hospital Materno Infantil Dr. Carlos Gianantonio; Argentina
Fil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
description Background Rates of caesarean section have steadily increased in most middle- and high-income countries over the last few decades without medical justification. Maternal request is one of the frequently cited non-medical factors contributing to this trend. The objectives of this study were to assess pregnant women’s preferences regarding mode of delivery and to compare actual caesarean section rates in the public and private sectors. Methods A prospective cohort study was conducted in two public and three private hospitals in Buenos Aires, Argentina. 382 nulliparous pregnant women (183 from the private sector and 199 from the public sector) aged 18 to 35 years, with single pregnancies over 32 weeks of gestational age were enrolled during antenatal care visits between October 2010 and September 2011. We excluded women with pregnancies resulting from assisted fertility, women with known pre-existing major diseases or, with pregnancy complications, or with a medical indication of elective cesarean section. We used two different approaches to assess women’s preferences: a survey using a tailored questionnaire, and a discrete choice experiment. Results Only 8 and 6 % of the healthy nulliparous women in the public and private sectors, respectively, expressed a preference for caesarean section. Fear of pain and safety were the most frequently expressed reasons for preferring caesarean section. When reasons for delivery mode were assessed by a discrete choice experiment, women placed the most emphasis on sex after childbirth. Of women who expressed their preference for vaginal delivery, 34 and 40 % ended their pregnancies by caesarean section in public and private hospitals, respectively. Conclusions The preference for caesarean section is low among healthy nulliparous women in Buenos Aires. The reasons why these women had a rate of more than 35 % caesarean sections are unlikely related to their preferences for mode of delivery.
publishDate 2016
dc.date.none.fl_str_mv 2016-02
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/43857
Mazzoni, Agustina; Althabe, Fernando; Gutierrez, Laura; Gibbons, Luz; Liu, Nancy H.; et al.; Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study; BioMed Central; BMC Pregnancy and Childbirth; 16; 1; 2-2016
1471-2393
0968-8080
CONICET Digital
CONICET
url http://hdl.handle.net/11336/43857
identifier_str_mv Mazzoni, Agustina; Althabe, Fernando; Gutierrez, Laura; Gibbons, Luz; Liu, Nancy H.; et al.; Women’s preferences and mode of delivery in public and private hospitals: a prospective cohort study; BioMed Central; BMC Pregnancy and Childbirth; 16; 1; 2-2016
1471-2393
0968-8080
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1186/s12884-016-0824-0
info:eu-repo/semantics/altIdentifier/url/https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0824-0
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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