Expectation and experiences of childbirth in primiparae with caesarean section

BJOG. 2008 Feb;115(3):324-31. doi: 10.1111/j.1471-0528.2007.01564.x.


Objective: The aim of this study was to examine the expectations and experiences in women undergoing a caesarean section on maternal request and compare these with women undergoing caesarean section with breech presentation as the indication and women who intended to have vaginal delivery acting as a control group. A second aim was to study whether assisted delivery and emergency caesarean section in the control group affected the birth experience.

Design: A prospective group-comparison cohort study.

Setting: Danderyd Hospital, Stockholm, Sweden.

Sample: First-time mothers (n= 496) were recruited to the study in week 37-39 of gestation and follow up was carried out 3 months after delivery. Comparisons were made between 'caesarean section on maternal request', 'caesarean section due to breech presentation' and 'controls planning a vaginal delivery'.

Methods: The instrument used was the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ).

Main outcome measures: Expectations prior to delivery and experiences at 3 months after birth.

Results: Mothers requesting a caesarean section had more negative expectations of a vaginal delivery (P < 0.001) and 43.4% in this group showed a clinically significant fear of delivery. Mothers in the two groups expecting a vaginal delivery, but having an emergency caesarean section or an assisted vaginal delivery had more negative experiences of childbirth (P < 0.001).

Conclusions: Women requesting caesarean section did not always suffer from clinically significant fear of childbirth. The finding that women subjected to complicated deliveries had a negative birth experience emphasises the importance of postnatal support.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Breech Presentation
  • Cesarean Section / psychology*
  • Cohort Studies
  • Elective Surgical Procedures
  • Emergency Treatment
  • Fear*
  • Female
  • Humans
  • Parity
  • Patient Satisfaction*
  • Pregnancy
  • Pregnant Women / psychology*
  • Prospective Studies