Search Results (7)

Background: In Greece, the cesarean section (CS) rate reached 62.15% in 2023. This study aims to document Greek obstetricians’ preferences and choices regarding the delivery mode of their own children. Methods: A questionnaire was emailed to Greek obstetricians, capturing demographics, preferred and actual delivery modes, regrets about delivery choices, and opinions on factors contributing to the high CS rate. Results: Of the 337 respondents, 78.8% preferred normal labor, but only 55.8% reported a vaginal delivery for their first child. Only 31% would opt for vaginal birth after CS. Male and married obstetricians were more likely to prefer vaginal birth, while those with more children or children born earlier were more likely to have delivered vaginally their first child. Partner preference influenced both the obstetrician’s choice and the actual delivery mode. According to Greek obstetricians, the primary reasons for the high CS rate are hostile medico-legal conditions (56.3%), advanced maternal age and in vitro fertilization (42.6%), and lack of training in instrumental deliveries (37.2%). Maternal request was cited by 25% of respondents. Conclusions: Although four in five Greek obstetricians favor normal labor for their own children, the CS rate among them mirrors that of the general population. Convenience scheduling does not appear to drive Greece’s high CS rate. Obstetricians suggest that legislative reforms, improved training, and public health strategies to reduce maternal CS requests are essential for lowering the CS rate. Full article

Birth is a physiological act that is part of the morpho-functional economy of the maternal body. Each stage in the act of birth has a predetermined pathway that is neurohormonally induced and morpho-functionally established through specific and characteristic adaptations. Like maternity, childbirth also has an important impact on the maternal body as a biological structure and psycho-emotional behavior. Cesarean section performed at the request of the mother with no medical underlying conditions besides the prolonged hospitalization risk can also cause breathing problems in children, delayed breastfeeding, and possible complications in a future pregnancy. Vaginal birth remains the path of choice for a physiological evolution pregnancy. Although erroneously considered safe and easy today, cesarean section delivery must remain an emergency procedure or a procedure recommended for pregnancies where birth is a risk to the mother and to the child, as cesarean section itself is a risk factor for negative outcomes for both mother and baby. This review summarizes the impact that both cesarean section and natural birth have on mother and newborn in their attempt to adapt to postpartum events and extrauterine life. Full article

Pregnant women who receive the COVID-19 vaccine develop anti-SARS-CoV-2 antibodies, which can be transferred to the fetus. However, the effectiveness of placental transfer has not been evaluated in twin pregnancy, especially in cases vaccinated with heterologous CoronaVac (Sinovac)—ChAdOx1 (Oxford-AstraZeneca) regimen, which was commonly used in many countries. Case: A 34-year-old Thai woman with a twin pregnancy attended our antenatal care clinic at 21 + 2 weeks of gestation and requested COVID-19 vaccination. Her medical history and physical examination were unremarkable. She had not received COVID-19 vaccination before. Ultrasound screening for fetal anomaly revealed a dichorion diamnion twin pregnancy. Both twins showed no structural anomaly. She received the CoronaVac vaccine at 21 + 2 weeks of gestation without serious side effects and the ChAdOx1 vaccine at 24 + 2 weeks of gestation. Cesarean delivery was performed at 36 + 5 weeks of gestation, giving birth to the two healthy babies. The levels of anti-spike protein IgG levels (BAU/mL) in maternal blood just before delivery and umbilical cord blood of the two newborns were 313.349, 678.219, and 874.853, respectively. The levels of % inhibition (wild-type and delta) in the two newborns were also higher than those in the mother. In conclusion, heterologous CoronaVac-ChAdOx1-S vaccination in a twin pregnancy could effectively provide protective immunity to both twin newborns. The antibody levels in both were approximately two times higher than those in the mothers. This case report may serve as a reference in counseling couples with a twin pregnancy, while the studies on placental transfer of vaccine-derived antibodies in twin pregnancy are currently not available, especially in countries experiencing a vaccine shortage or unavailability of mRNA vaccines. Full article

Introduction: The ratio of cesarean deliveries (CDs) has been increasing worldwide, with a growing problem of cesarean delivery on maternal request (CDMR) and an alarmingly increasing rate of CD in the private sector. There are numerous factors influencing women’s preferences for the mode of delivery and their opinion about shared decision making (SDM). Material and method: The study was designed as an online survey, filled in by 1040 women. The questionnaire included questions about women’s preferences for the mode of delivery, their opinions about CDMR and the process of decision making regarding the mode of delivery. Results: There were no statistically significant differences found between women with a BMI ≤ 25 kg/m² and >25 kg/m², nor with a BMI ≤ 30 kg/m² and >30 kg/m², on the subject of the preferred method of delivery, and the opinion regarding SDM and CDMR without medical indications. More than 85% of women in all groups, who preferred CD as the mode of delivery, wanted to have CDMR. Conclusion: We have not found obesity and overweight to be a factor influencing women’s preferred mode of delivery, their opinion about SDM and their preference for CDMR without medical indications. However, the sample size of women with morbid obesity with a BMI ≥ 35 kg/m² was too small for the results to be considered significant in this group, and it will therefore be subject to further studies. Full article

Background and Objectives: Shared-decision making has become an important trend in the problem of women’s preference for the way of delivery. There are different factors influencing women, including obstetric history, culture, religion, family and social influences. Materials and Methods: The study was designed as an online survey with the aim of acquiring information about women’s knowledge, opinions and preferences about the mode of delivery and the decision-making process. Data were collected from 1175 women in 2010 and 1033 in 2020. Results: A significant increase in the proportion of women who prefer vaginal delivery (VD) was found to be present with an increasing level of education, with the lowest rate in the group with primary education (66.0% in 2010 and 33.3% in 2020) and highest with medical education—86.3% in 2010 and 69.3% in 2020 (p < 0.05). This trend existed both in 2010 and 2020; however, the proportion of women who preferred VD has decreased over the last decade in all groups, and even two-fold in the primary education group. No significant correlation was found between a history of previous delivery and the preference of the way of delivery, decision-making or paid cesarean delivery on maternal request (CDMR). A history of VD significantly reduced the preference for having a cesarean delivery, with only 6.9% of women in 2010 with a history of VD, and 8.9% in 2020 having preferred a cesarean delivery. In 2010, 34.9% of women with a history of cesarean section (CS) only, compared to 6.9% of women with a history VD only, had preference for CS with, respectively, 36.4% vs. 5.8% in 2020. Conclusions: As the proportion of women who prefer cesarean delivery has significantly increased over the last decade, we should emphasize the importance of educating women about the advantages and disadvantages of vaginal and cesarean delivery. The patient’s preference should always be discussed with the obstetrician and the medical indications explained. Full article

Background and Objectives: The maternal preference of mode of delivery is an important problem in respect of patient’s autonomy and shared decision-making. The objective of the study was to obtain information about women’s preferences of the mode of delivery and knowledge about the cesarean section and its’ consequences. Materials and Methods: The study was based on a survey filled in by 1175 women in 2010 and 1033 women in 2020. Respondents were asked about their preference of mode of delivery, possible factors influencing their decision and their knowledge about risks and benefits of cesarean section. Results: There was a significant increase in the rate of women who declared cesarean section as their preferred mode of delivery, from 43.97% in 2010 to 56.03% in 2020 (p < 0.05). In 2010 26.51% of women thought that choice of mode of delivery should be their autonomic decision, 46.36% preferred decision-sharing with their obstetrician, 25.64% thought that cesarean section should be performed for medical indications only (respectively 34.86%, 44.45% and 19.38% in 2020). Conclusions: There has been a significant increase in the rate of Polish women who prefer cesarean delivery over the last decade, as well as in the rate of women who consider the mode of delivery as their autonomic decision. Full article

Background and Objective. The aim of this study was to establish whether Lithuanian women would request an elective cesarean section in a low-risk pregnancy and to compare how the women’s opinion changed during the 5-year period.
Material and Methods. A study was conducted at the Hospital of Lithuanian University of Health Sciences from November 1 to December 31, 2006, and from January 1 to February 28, 2011. A total of 204 and 239 women were enrolled in 2006 and 2011, respectively. Self-administered anonymous questionnaires collected information on women’s knowledge about the advantages of the different modes of delivery and their preferred type of birth in a low-risk pregnancy.
Results. Overall, 82.4% of the participants in 2006 and 74.5% in 2011 thought that women should be able to choose the mode of delivery in a low-risk pregnancy. If they had had such an opportunity, 15.2% of women in 2006 and 14.9% in 2011 would have chosen cesarean section without any medical indication. The most frequently mentioned advantage of vaginal delivery was that it is natural, while safety for the newborn and the possibility of avoiding delivery pain were the mentioned advantages of cesarean section.
Conclusions. Approximately 15% of Lithuanian women would request an elective cesarean section, and this percentage did not change during the 5-year period. While the national cesarean section rate is increasing with every year, it seems that “maternal request” cannot be blamed for this phenomenon. Despite all the available information about the different modes of delivery, women still lack professional and reliable knowledge about it. Full article