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

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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

DOI 10.1111/j.1471-0528.2009.02119.x

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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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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
ORCID: Kingdon, C
Singleton, V
Gyte, G
Gabbay, M
Lavender, T
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
DOI: 10.1111/j.1471-0528.2009.02119.x
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
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
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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Choice and birth method: mixed‐method study of caesarean delivery for maternal request

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