Background: Over the last three decades, cesarean section (CS) rates have been rising around the world despite\r\nno associated improvement in maternal and perinatal mortality and morbidity. The role of womenââ?¬â?¢s preferences for\r\nmode of delivery in contributing to the high CS rate remains controversial; however these preferences are difficult\r\nto assess, as they are influenced by culture, knowledge of risk and benefits, and personal and social factors. In this\r\nqualitative study, our objective was to understand womenââ?¬â?¢s preferences and motivational factors for mode of\r\ndelivery. This information will inform the development and design of an assessment aimed at understanding the\r\nrole of the womenââ?¬â?¢s preferences for mode of delivery.\r\nMethods: We conducted 4 focus group discussions (FGDs) and 12 in-depth interviews with pregnant women in\r\nBuenos Aires, Argentina in 4 large non-public and public hospitals. Our sample included 29 nulliparous pregnant\r\nwomen aged 18ââ?¬â??35 years old, with single pregnancies over 32 weeks of gestational age, without pregnancies\r\nresulting from assisted fertility, without known pre-existing medical illness or diseases diagnosed during pregnancy,\r\nwithout an indication of elective cesarean section, and who are not health professionals. FGDs and interviews\r\nfollowed a pre-designed guide based on the health belief model and social cognitive theory of health decisions\r\nand behaviors.\r\nResults: Most of the women preferred vaginal delivery (VD) due to cultural, personal, and social factors. VD was\r\nviewed as normal, healthy, and a natural rite of passage from womanhood to motherhood. Pain associated with\r\nvaginal delivery was viewed positively. In contrast, women viewed CS as a medical decision and often deferred\r\ndecisions to medical staff in the presence of medical indication.\r\nConclusions: These findings converge with quantitative and qualitative studies showing that women prefer\r\ntowards VD for various cultural, personal and social reasons. Actual CS rates appear to diverge from womenââ?¬â?¢s\r\npreferences and reasons are discussed.
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