Introduction:

Cesarean delivery on maternal request, which occurs without maternal or fetal medical indication, has increased in recent years. Reasons for patients to request it have been described, such as emotional experiences, social norms, and the interrelationship with the healthcare team.

Methodology:

The objective was to determine possible determinants for cesarean request. An observational study was conducted with cases (patients who requested cesarean delivery without medical indication) and controls (spontaneous vaginal delivery), non-matched, in a 2:1 ratio. A pre-designed survey was used to determine possible determinants, including fear of childbirth through a W-DEQ adapted questionnaire, social support, concern for fetal-neonatal safety, and the influence of the treating physician.

Results:

A total of 171 patients were included. Among patients with cesarean delivery on maternal request, 52.5% reported choosing cesarean due to high concern for fetal-neonatal safety, 32.8% due to some influence from the treating physician, 31.7% due to its predictability (better home organization or the anxiety of uncertainty about the timing of delivery), and 42.6% due to personal concern about the consequences of vaginal delivery. The W-DEQ variable, categorized into tertiles, showed a statistically significant association for requesting cesarean delivery. Previous traumatic history showed an association of 4.17.

Conclusions:

The factors that influenced the decision to request a cesarean delivery were previous traumatic history, the influence of the treating physician, and the existence of tocophobia. What connects all these factors is that they are all modifiable.

        · abstract in Spanish | Portuguese     · text in Spanish     · Spanish ( pdf )