Elective cesarean section and decision making: a critical review of the literature

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Title Elective cesarean section and decision making: a critical review of the literature
Author McCourt, Chris; Weaver, Jane; Statham, Helen; Beake, Sarah; Gamble, Jennifer Ann; Creedy, Debra
Journal Name Birth: Issues in Perinatal Care
Editor Diony Young
Year Published 2007
Place of publication United States
Publisher Wiley-Blackwell Publishing Inc
Abstract Background: The cesarean section rate continues to rise in many countries with routine access to medical services, yet this increase is not associated with improvement in perinatal mortality or morbidity. A large number of commentaries in the medical literature and media suggest that consumer demand contributes significantly to the continued rise of births by cesarean section internationally. The objective of this article was to critically review the research literature concerning women’s preference or request for elective cesarean section published since that critiqued by Gamble and Creedy in 2000. Methods: A search of key databases using a range of search terms produced over 200 articles, of which 80 were potentially relevant. Of these, 38 were research-based articles and 40 were opinion-based articles. A total of 17 articles fitted the criteria for review. A range of methodologies was used, with varying quality, making meta-analysis of findings inappropriate, and simple summaries of results difficult to produce. Results: The range and quality of studies had increased since 2001, reflecting continuing concern. Women’s preference for cesarean section varied from 0.3 to 14 percent; however, only 3 studies looked directly at this preference in the absence of clinical indications. Women’s preference for a cesarean section related to psychological factors, perceptions of safety, or in some countries, was influenced by cultural or social factors. Conclusions: Research between 2000 and 2005 shows evidence of very small numbers of women requesting a cesarean section. A range of personal and societal reasons, including fear of birth and perceived inequality and inadequacy of care, underpinned these requests.
Peer Reviewed Yes
Published Yes
Alternative URI http://dx.doi.org/10.1111/j.1523-536X.2006.00147.x
Volume 34
Issue Number 1
Page from 65
Page to 79
ISSN 0730-7659
Date Accessioned 2007-06-25
Date Available 2013-07-30T23:56:06Z
Language en_US
Research Centre Centre for Health Practice Innovation; Griffith Health Institute
Faculty Griffith Health Faculty
Subject PRE2009-Health and Community Services
URI http://hdl.handle.net/10072/19194
Publication Type Journal Articles (Refereed Article)
Publication Type Code c1

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