Cited by 136Maternal and Perinatal Health InterventionsReproductive Health and ContraceptionEthics and bioethics in healthcare

Choice and birth method: mixed‐method study of caesarean delivery for maternal request

Kingdon, C, Neilson, J, Singleton, V, Gyte, G, Hart, A, Gabbay, M, Lavender, T·2009·BJOG: An International Journal of Obstetrics & Gynaecology

Abstract

Objective To explore whether women view decision‐making surrounding vaginal or caesarean birth as their choice. Design Longitudinal cohort study utilising quantitative (questionnaire, routinely collected data) and qualitative (in‐depth interviews) methods simultaneously. Setting A large hospital providing National Health Service maternity care in the UK. Sample Four‐hundred and fifty‐four primigravid women. Methods Women completed up to three questionnaires between their antenatal booking appointment and delivery. Amongst these women, 153 were interviewed at least once during pregnancy (between 24 and 36 weeks) and/or after 12 moths after birth. Data were also obtained from women’s hospital delivery records. Descriptive statistical analysis was performed (survey and delivery data). Interview data were analysed using a seven‐stage sequential form of qualitative analysis. Results Whilst many women supported the principle of choice, they identified how, in practice their autonomy was limited by individual circumstance and available care provision. All women felt that concerns about their baby’s or their own health should take precedence over personal preference. Moreover, expressing a preference for either vaginal or caesarean birth was inherently problematic as choice until the time of delivery was neither static nor final. Women did not have autonomous choice over their actual birth method, but neither did they necessarily want it. Conclusions The results of this large exploratory study suggest that choice may not be the best concept through which to approach the current arrangements for birth in the UK. Moreover, they challenge the notion of choice that currently prevails in international debates about caesarean delivery for maternal request.

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Crossref · 10.1111/j.1471-0528.2009.02119.x

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Authors
Kingdon, C., Neilson, J., Singleton, V, Gyte, G., Hart, A., Gabbay, M., & Lavender, T.
Affiliations
  • University of Lancashire (GB)
  • University of Liverpool (GB)
  • Lancaster University (GB)
  • University of Manchester (GB)
Corresponding author
Kingdon, C
Venue
BJOG: An International Journal of Obstetrics & Gynaecology
Publisher
Wiley
Published
2009-05-11
Volume
116
Issue
7
Pages
886-895
ISSN
  • 0306-5456 (ISSN-L)
  • 1470-0328
  • 1471-0528
OpenAlex
W2102302915
Cited by
136
References
21
Citations by year
2026: 4 · 2025: 6 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 24 · 2019: 5 · 2018: 10 · 2017: 4 · 2016: 5 · 2015: 2 · 2014: 13 · 2013: 12 · 2012: 10
FWCI
13.03
Type
journal article
Language
en
Open access
closed
Locations
  • BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
  • CLOK (University of Central Lancashire) (acceptedVersion)
  • Lancaster EPrints (Lancaster University) (submittedVersion)
Funders
National Institute for Health and Care Research
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Keywords
birth choice, vaginal delivery, maternal autonomy, primigravida, women's preferences, obstetric decision-making, cesarean section rate
MeSH terms
Adolescent, Adult, Cesarean Section, Choice Behavior, Female, Humans, Longitudinal Studies, Parity, Pregnancy, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Surveys and Questionnaires, Patient Satisfaction, Personal Autonomy, Delivery, Obstetric, Young Adult

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