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Women’s preference for caesarean section: a systematic review and meta-analysis of observational studies: Women’s preference for caesarean section: systematic review

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Mazzoni, A, Althabe, F, Liu, NH, Bonotti, AM, Gibbons, L, Sánchez, AJ, Belizán, JM·2011·BJOG: An International Journal of Obstetrics & Gynaecology
DOI 10.1111/j.1471-0528.2010.02793.xPMC PMC3312015
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Abstract

BACKGROUND: The striking increase in caesarean section rates in middle- and high-income countries has been partly attributed to maternal request. We conducted a systematic review and meta-analysis of women's preferences for caesarean section. OBJECTIVES: To review the published literature on women's preferences for caesarean section. SEARCH STRATEGY: A systematic search of MEDLINE, EMBASE, LILACS and PsychINFO was performed. References of all included articles were examined. SELECTION CRITERIA: We included studies that quantitatively evaluated women's preferences for caesarean section in any country. We excluded articles assessing health providers' preferences and qualitative studies. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened abstracts of all identified citations, selected potentially eligible studies, and assessed their full-text versions. We conducted a meta-analysis of proportions, and a meta-regression analysis to determine variables significantly associated with caesarean section preference. MAIN RESULTS: Thirty-eight studies were included (n = 19,403). The overall pooled preference for caesarean section was 15.6% (95% CI 12.5-18.9). Higher preference for caesarean section was reported in women with a previous caesarean section versus women without a previous caesarean section (29.4%; 95% CI 24.4-34.8 versus 10.1%; 95% CI 7.5-13.1), and those living in a middle-income country versus a high-income country (22.1%; 95% CI 17.6-26.9 versus 11.8%; 95% CI 8.9-15.1). AUTHORS' CONCLUSIONS: Only a minority of women in a wide variety of countries expressed a preference for caesarean delivery. Further research is needed to better estimate the contribution of women's demand to the rising caesarean section rates.

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  • The success rate for spontaneous vaginal delivery after a trial of labor in women with a previous cesarean section is 60-80%.

    “the success rate for spontaneous vaginal delivery is 60–80%.”

    From Preference and determinants of delivery mode in pregnant women with one cesarean scar: a cross-sectional study in two urban Ugandan public hospitals (2025) · cites this paper as [16]

    The Abstract’s Main Results report preferences for caesarean section, and the Discussion reports a 22–90% range for preference for a trial of labour after a previous caesarean. Neither reports the success rate of spontaneous vaginal delivery. Searches for a 60–80% success rate and for successful vaginal birth after caesarean found no passage addressing the claim. (LLM, conf=0.76)

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Authors
Mazzoni, A., Althabe, F., Liu, N., Bonotti, A., Gibbons, L., Sánchez, A., & Belizán, J.
Affiliations
  • Instituto de Efectividad Clínica y Sanitaria (AR)
  • University of Nebraska–Lincoln (US)
  • Ministerio de Salud (AR)
Corresponding author
Mazzoni, A
ORCID
Venue
BJOG: An International Journal of Obstetrics & Gynaecology
Publisher
Wiley
Published
2010-12-07
Volume
118
Issue
4
Pages
391-399
ISSN
  • 0306-5456 (ISSN-L)
  • 1470-0328
DOI
10.1111/j.1471-0528.2010.02793.x
PMC
PMC3312015
OpenAlex
W2120980029
Cited by
306
References
1
Citations by year
2026: 11 · 2025: 18 · 2024: 11 · 2023: 13 · 2022: 19 · 2021: 42 · 2020: 16 · 2019: 25 · 2018: 27 · 2017: 23 · 2016: 17 · 2015: 23 · 2014: 27 · 2013: 17 · 2012: 13
FWCI
1.55
Type
journal article
Language
en
Open access
Licence
doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 1729 d)
Locations
  • BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
Fogarty International Center (D43TW007784, R24TW007988)
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 › Surgery › Anesthesia and Pain Management
Keywords
cesarean section, maternal preferences, caesarean delivery rates, previous cesarean section, middle-income countries, high-income countries
MeSH terms
Cesarean Section, Cross-Sectional Studies, Female, Humans, Pregnancy, Regression Analysis, Pregnant People, Pregnant Women, Patient Preference

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