Navigating the choices of decision-making in cesarean sections: medical and personal perspectives from a qualitative study in Iraq

Pan Afr Med J. 2025 Mar 3:50:65. doi: 10.11604/pamj.2025.50.65.43936. eCollection 2025.

Abstract

Introduction: cesarean section (CS) rates have risen globally, prompting debates on their necessity and outcomes. This study explores factors affecting decision-making for planned CS in uncomplicated pregnancies, considering both medical and non-medical factors.

Methods: a descriptive qualitative study design was employed from the period June 2022 to December 2022, comprising one-on-one conversations with Karbala midwives and obstetricians. Data were analyzed thematically to uncover factors influencing CS decisions. Descriptive and inferential statistical analysis was followed.

Results: the study included 131 pregnant women, aged 20-35 (71.0%) with different educational levels. Prenatal care engagement was high, as 98.5% received care. Planned CS constituted 52.7%, and 47.3% were emergency CS. Decision factors included personal desire (22.9%), perception of efficiency and care (11.5%), and husband's desire (3.8%). Medical reasons (maternofetal factors) outweighed non-medical reasons (60.5% vs. 15.3%), with notable factors including cervical stiffness (21.4%) and fetal position/weight (17.6%). Conclusion: decision-making for CS involves a complex interaction of medical and non-medical causes. Healthcare professionals should understand the reasons behind planned CS to make well-informed decisions that align with each patient's unique situation.

Keywords: Decision-making; cesarean section; maternal autonomy; medical factors; non-medical factors.

MeSH terms

  • Adult
  • Cesarean Section* / statistics & numerical data
  • Choice Behavior
  • Decision Making*
  • Female
  • Humans
  • Iraq
  • Midwifery
  • Pregnancy
  • Prenatal Care* / methods
  • Prenatal Care* / statistics & numerical data
  • Qualitative Research
  • Young Adult