Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Influencing factors associated with the mode of birth among childbearing women in Hunan Province: a cross-sectional study in China

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

Login to get access

Abstract

Background

An unnecessary Caesarean section (CS) can cause increased maternal and perinatal morbidity and other adverse short- and long-term outcomes. However, countries worldwide have witnessed an increasing trend toward the use of CS. Our objectives were to explore the influencing factors associated with the mode of birth among childbearing women in Hunan Province and to provide evidence and suggestions for the improvement and further understanding of vaginal birth (VB) in China.

Methods

A total of 977 childbearing women (375 pregnant women and 602 mothers of infants) were enrolled in this study using a two-stage cluster sampling method, and a self-administered questionnaire was used to collect data relating to the mode of birth. A t-test and χ 2-test were used to analyse the differences between groups, and logistic regression analysis was used to explore the factors that influenced the mode of birth.

Results

The VB ratio was 46.2 %, while the CS ratio was 53.8 % in Hunan Province. Among women whose preference was VB, only 69.4 % gave birth by VB. Among women whose preference was CS, 98.1 % gave birth by CS. The top four reasons for preferring CS were a lack of confidence in VB (37.3 %), an abnormality in the prenatal examination (36.6 %), the notion that the baby would suffer fewer risks (34.8 %) and the fear of pain from VB (32.7 %). Age, prenatal examination, and doctors’ suggestion were significantly associated with women’s mode of birth preference, while place of household registration, husband’s preference, prenatal examination and doctors’ suggestion had a significant influence on women who changed their choice from VB to CS.

Conclusions

The percentage of CS in Hunan was extremely high. Medical factors, such as abnormalities in prenatal examinations, and non-medical factors, such as a lack of confidence in VB, the fear of pain during VB, the desire to select the time of birth and healthy birth systems, should be seriously considered. Targeted health promotion interventions should be implemented to improve the performance of VB.
Appendix
Available only for authorised users
Literature
1.
Lee YM, D’Alton ME. Cesarean delivery on maternal request: maternal and neonatal complications. Curr Opin Obstet Gynecol. 2008;20(6):597–601.PubMed
2.
Hankins GD, Clark SM, Munn MB. Cesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise. Semin Perinatol. 2006;30(5):276–87.CrossRefPubMed
3.
4.
Gurol-Urganci I, Bou-Antoun S, Lim CP, Cromwell DA, Mahmood TA, Templeton A, van der Meulen JH. Impact of Caesarean section on subsequent fertility: a systematic review and meta-analysis. Hum Reprod. 2013;28(7):1943–52.CrossRefPubMed
5.
Fawcus S, Moodley J. Postpartum haemorrhage associated with caesarean section and caesarean hysterectomy. Best Pract Res Clin Obstet Gynaecol. 2013;27(2):233–49.CrossRefPubMed
6.
Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, Shah A, Campodonico L, Bataglia V, Faundes A. Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006;367(9525):1819–29.CrossRefPubMed
7.
Hyde MJ, Modi N. The long-term effects of birth by caesarean section: the case for a randomised controlled trial. Early Hum Dev. 2012;88(12):943–9.CrossRefPubMed
8.
Bager P, Simonsen J, Nielsen NM, Frisch M. Cesarean section and offspring’s risk of inflammatory bowel disease: a national cohort study. Inflamm Bowel Dis. 2012;18(5):857–62.CrossRefPubMed
9.
Khan A, Zaman S. Costs of vaginal delivery and Caesarean section at a tertiary level public hospital in Islamabad, Pakistan. BMC Pregnancy Childbirth. 2010;10:2.CrossRefPubMedPubMedCentral
10.
WHO. Appropriate technology for birth. Lancet. 1985;2(8452):436–7.
11.
Martin JA, Hamilton BE, Ventura SJ, Osterman MJ, Kirmeyer S, Mathews TJ, Wilson EC. Births: final data for 2009. Natl Vital Stat Rep. 2011;60(1):1–70.PubMed
12.
13.
Long Q, Zhang Y, Raven J, Wu Z, Bogg L, Tang S, Hemminki E. Giving birth at a health-care facility in rural China: is it affordable for the poor? Bull World Health Organ. 2011;89(2):144–52.CrossRefPubMed
14.
Tang S, Li X, Wu Z. Rising cesarean delivery rate in primiparous women in urban China: evidence from three nationwide household health surveys. Am J Obstet Gynecol. 2006;195(6):1527–32.CrossRefPubMed
15.
Lumbiganon P, Laopaiboon M, Gulmezoglu AM, Souza JP, Taneepanichskul S, Ruyan P, Attygalle DE, Shrestha N, Mori R, Nguyen DH. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet. 2010;375(9713):490–9.CrossRefPubMed
16.
Robson SJ, Tan WS, Adeyemi A, Dear KB. Estimating the rate of cesarean section by maternal request: anonymous survey of obstetricians in Australia. Birth. 2009;36(3):208–12.CrossRefPubMed
17.
MacDorman MF, Menacker F, Declercq E. Cesarean birth in the United States: epidemiology, trends, and outcomes. Clin Perinatol. 2008;35(2):293–307.CrossRefPubMed
18.
McCourt C, Weaver J, Statham H, Beake S, Gamble J, Creedy DK. Elective cesarean section and decision making: a critical review of the literature. Birth. 2007;34(1):65–79.CrossRefPubMed
19.
Dursun P, Yanik FB, Zeyneloglu HB, Baser E, Kuscu E, Ayhan A. Why women request cesarean section without medical indication? J Matern Fetal Neonatal Med. 2011;24(9):1133–7.CrossRefPubMed
20.
Huang K, Tao F, Faragher B, Raven J, Tolhurst R, Tang S, Broek NV. A mixed-method study of factors associated with differences in caesarean section rates at community level: The case of rural China. Midwifery. 2013;29(8):911–20.CrossRefPubMed
21.
D’Souza R. Caesarean section on maternal request for non-medical reasons: putting the UK National Institute of Health and Clinical Excellence guidelines in perspective. Best Pract Res Clin Obstet Gynaecol. 2013;27(2):165–77.CrossRefPubMed
22.
Gamble J, Creedy DK, McCourt C, Weaver J, Beake S. A critique of the literature on women’s request for cesarean section. Birth. 2007;34(4):331–40.CrossRefPubMed
23.
Huang Y. Clinical epidemiology (second version). Beijing: People’s medical publishing house; 2008. p. 85.
24.
Ye D, Li M, Xie D, Zhao L, Wu N, Fu C, Sun Z. Study on the factors related to Cesarean Section(CS) in Hu-nan Province by two-level models analysis. Chin J Health Stat. 2010;27(4):341–4.
25.
Meng Q, Xu L, Zhang Y, Qian J, Cai M, Xin Y, Gao J, Xu K, Boerma JT, Barber SL. Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study. Lancet. 2012;379(9818):805–14.CrossRefPubMed
26.
Hildingsson I. How much influence do women in Sweden have on caesarean section? A follow-up study of women’s preferences in early pregnancy. Midwifery. 2008;24(1):46–54.CrossRefPubMed
27.
Fenwick J, Staff L, Gamble J, Creedy DK, Bayes S. Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery. 2010;26(4):394–400.CrossRefPubMed
28.
Wiklund I, Edman G, Andolf E. Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers. Acta Obstet Gynecol Scand. 2007;86(4):451–6.CrossRefPubMed
29.
Lo JC. Patients’ attitudes vs. physicians’ determination: implications for cesarean sections. Soc Sci Med. 2003;57(1):91–6.CrossRefPubMed
30.
Tollanes MC. Increased rate of Caesarean sections--causes and consequences. Tidsskr Nor Laegeforen. 2009;129(13):1329–31.CrossRefPubMed
31.
Ji H. A study on associated factors related to high cesarean section rate and future intervention strategies from perspectives of both clients and providers in one district of Shangha. Shanghai: Fudan University; 2012.
32.
33.
Yip W, Hsiao WC. The Chinese health system at a crossroads. Health Aff (Millwood). 2008;27(2):460–8.CrossRef
34.
Eggleston K, Li L, Meng Q, Lindelow M, Wagstaff A. Health service delivery in China: a literature review. Health Econ. 2008;17(2):149–65.CrossRefPubMed
35.
Bogg L, Huang K, Long Q, Shen Y, Hemminki E. Dramatic increase of Cesarean deliveries in the midst of health reforms in rural China. Soc Sci Med. 2010;70(10):1544–9.CrossRefPubMed
36.
Hu W, Jin X, Du L, Luo R. The current status and equity of human resources allocation in obstetric healthcare of china. Chin J Women Child Health. 2013;4(1):1–3.
37.
Lin HC, Xirasagar S. Institutional factors in cesarean delivery rates: policy and research implications. Obstet Gynecol. 2004;103(1):128–36.CrossRefPubMed
38.
Ananth CV, Smulian JC, Vintzileos AM. The association of placenta previa with history of cesarean delivery and abortion: a metaanalysis. Am J Obstet Gynecol. 1997;177(5):1071–8.CrossRefPubMed
39.
Koifman A, Levy A, Zaulan Y, Harlev A, Mazor M, Wiznitzer A, Sheiner E. The clinical significance of bleeding during the second trimester of pregnancy. Arch Gynecol Obstet. 2008;278(1):47–51.CrossRefPubMed
40.
Song W, Jin Z. The effect of ante- primiparous artificial abortion to pregnancy and parturition. Sh J Prev Med. 2001;13(4):184–5.
41.
MOH. Chinese health year book 2012. Beijing: Chinese Peking Union Medical university press; 2012. p. 201.
42.
Xu J, Cheng L. Awareness and usage of emergency contraception among teenagers seeking abortion: a Shanghai survey. Eur J Obstet Gynecol Reprod Biol. 2008;141(2):143–6.CrossRefPubMed
43.
Shi Y, Wang D, Yuan Y, Jiang Y, Zeng Q, Chang C. The effect of prenatal education curriculum on mother’s prenatal examination utilization, delivery mode and recovery status: a cross-sectional survey in China. Environ Health Prev Med. 2015;20(6):397–403.CrossRefPubMedPubMedCentral
Metadata
Title
Influencing factors associated with the mode of birth among childbearing women in Hunan Province: a cross-sectional study in China
Publication date
01-12-2016
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0897-9

Other articles of this Issue 1/2016

BMC Pregnancy and Childbirth 1/2016 Go to the issue

Research article

Pathways to emotional closeness in neonatal units – a cross-national qualitative study

Research article

Bacterial vaginosis and adverse outcomes among full-term infants: a cohort study

Research article

Eating soup with nails of pig: thematic synthesis of the qualitative literature on cultural practices and beliefs influencing perinatal nutrition in low and middle income countries

Research article

Apunipima baby basket program: a retrospective cost study

Debate

Childbirth and consequent atopic disease: emerging evidence on epigenetic effects based on the hygiene and EPIIC hypotheses

Research article

A systematic review to examine the evidence regarding discussions by midwives, with women, around their options for where to give birth