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Kadınların doğum şekline ilişkin tercihleri ve Türkiye'de sezaryen doğum yönteminin mevcut durumunun gözden geçirilmesi

Year 2022, Volume: 19 Issue: 3, 1412 - 1417, 30.09.2022
https://doi.org/10.38136/jgon.1160913

Abstract

Giriş:
Artan sezaryen (C/S) oranları giderek büyüyen bir halk sağlığı sorunu haline gelmiştir. Türkiye, son yıllarda dünyanın en yüksek sezaryen oranları olan ülkeleri arasında yer almaktadır. Kadınların neden vajinal doğum yerine sezaryen istemekte olduklarının bilinmesi, gereksiz sezaryenlerden kaçınmanın anahtarı olabilir. Bu çalışmada, Türkiye'nin en büyük doğum bakım hastanelerinden birinde anne adaylarının sezaryen taleplerinin olası nedenlerini değerlendirmeyi amaçladık.
Gereç ve Yöntem:
Gebelere doğum şekli tercihi ve tercih nedenlerine odaklanan bir anket uygulandı. Anket içerisinde doğum şekli tercihleri ve bu tercihlerini etkileyen nedenler sorgulandı.
Bulgular:
Doğum şekli ile ilgili anketi yanıtlayan 1200 kadının %45.7'si nullipardı ve bunların %85'i vajinal doğumu tercih etti. Daha önce vajinal doğum yapan kadınların %93.4'ü vajinal doğumu tercih etti.ğini bildirdi. Daha önce sezaryen olan kadınların %11.8'i vajinal doğum yapmayı tercih etti. C/S tercihini etkileyen ana faktör, daha önceki C/S öyküsü idi. Daha önce C/S öyküsü olan hastalar dışlandığında; önceki spontan abort öyküsü ve daha uzun evlilik süresinin C/S tercihiyle ilişkili faktörler olduğu bulundu. Vajinal doğumu tercih eden kadınların %55,8'i en doğal doğum şeklinin vajinal doğum olması nedeniyle bu tercihte bulunduğunu belirtmiştir.
Tartışma ve Sonuç:
Medikal bir endikasyon olmaksızın elektif sezaryen, obstetrik pratiğin en çok tartışılan konularından biridir. Mevcut C/S oranlarına mantıklı bir yaklaşım sağlamak için ilk C/S'nin nedeni çok iyi gözden geçirilmelidir. Doğum korkusu da özellikle nullipar kadınlar için dikkatle değerlendirilmesi gereken önemli bir noktadır.

References

  • Referans1 OECD (2022), Caesarean sections (indicator). DOI: 10.1787/adc3c39f-en (Accessed on 07 August 2022)
  • Referans2 WHO statement on cesarean section rates. Geneva: World Health Organization; 2015. Available from: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1
  • Referans3 Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health 2021;6:e005671.
  • Referans4 Burrows LJ, Meyn LA, Weber AM. Maternal morbidity associated with vaginal versus cesarean delivery. Obstet Gynecol 2004;103:907-12.
  • Referans5 Wax JR, Cartin A, Pinette MG, Blackstone J. Patient choice cesarean: an evidence-based review. Obstet Gynecol Surv 2004;59:601-16.
  • Referans6 Liu NH, Mazzoni A, Zamberlin N, Colomar M, Chang OH, Arnaud L, Althabe F, Belizán JM. Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study. Reprod Health 2013;14:10-2.
  • Referans7 Torloni MR, Betrán AP, Montilla P, Scolaro E, Seuc A, Mazzoni A, Althabe F, Merzagora F, Donzelli GP, Merialdi M. Do Italian women prefer cesarean section? Results from a survey on mode of delivery preferences. BMC Pregnancy Childbirth 2013;26:78.
  • Referans8 Mazzoni A, Althabe F, Liu NH, Bonotti AM, Gibbons L, Sánchez AJ, Belizán JM. Women's preference for caesarean section: a systematic review and meta-analysis of observational studies. BJOG 2011;118:391-9.
  • Referans9 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;86:451-6.
  • Referans10 Fenwick J, Staff L, Gamble J, Creedy DK, Bayes S. Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery 2010;26:394-400.
  • Referans11 Rouhe H, Salmela-Aro K, Halmesmäki E, Saisto T. Fear of childbirth according to parity, gestational age, and obstetric history. BJOG 2009;116:67-73.
  • Referans12 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;24:46-54.
  • Referans13 Karlström A, Nystedt A, Johansson M, Hildingsson I. Behind the myth--few women prefer caesarean section in the absence of medical or obstetrical factors. Midwifery 2011;27:620-7.
  • Referans14 Nakić Radoš S, Žigić Antić L, Jokić-Begić N. The Role of Personality Traits and Delivery Experience in Fear of Childbirth: A Prospective Study. J Clin Psychol Med Settings 2022 Jan 15. doi: 10.1007/s10880-022-09848-x. Epub ahead of print.
  • Referans15 Waldenström U, Hildingsson I, Ryding EL. Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG 2006;113:638-46.
  • Referans16 Richens Y, Hindley C, Lavender T. A national online survey of UK maternity unit service provision for women with fear of birth. British Journal of Midwifery 2015;23:574-9.
  • Referans17 Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997–2010. BJOG: an international journal of obstetrics and gynaecology 2014;121:965-70.
  • Referans18 O'Connell MA, Khashan AS, Leahy-Warren P, Stewart F, O'Neill SM. Interventions for fear of childbirth including tocophobia. Cochrane Database Syst Rev.2021;7:CD013321.
  • Referans19 Waldenström U, Rudman A, Hildingsson I. Intrapartum and postpartum care in Sweden: women's opinions and risk factors for not being satisfied. Acta Obstet Gynecol Scand 2006;85:551-60.
  • Referans20 Boz I, Akgun M, Duman F. A feasibility study of a psychoeducation intervention based on Human Caring Theory in nulliparous women with fear of childbirth. Journal of Psychosomatic Obstetrics and Gynaecology 2020;41:1-13.
  • Referans21 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;27:165-77.
  • Referans22 Reime B, Klein MC, Kelly A, Duxbury N, Saxell L, Liston R, Prompers FJ, Entjes RS, Wong V. Do maternity care provider groups have different attitudes towards birth? BJOG 2004;111:1388-93.
  • Referans23 Bergholt T, Østberg B, Legarth J, Weber T. Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey. Acta Obstet Gynecol Scand 2004;83:262-6.
  • Referans24 Habiba M, Kaminski M, Da Frè M, Marsal K, Bleker O, Librero J, Grandjean H, Gratia P, Guaschino S, Heyl W, Taylor D, Cuttini M. Caesarean section on request: a comparison of obstetricians' attitudes in eight European countries. BJOG 2006;113647-56.
  • Referans25 Derya, YA, Güler H. Kadın Doğum Hekimi ve Ebelerin Elektif Sezaryen Doğum Hakkındaki Görüş ve Deneyimleri. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 2014; 7:12-18.

Kadınların doğum şekline ilişkin tercihleri ve Türkiye'de sezaryen doğum yönteminin mevcut durumunun gözden geçirilmesi

Year 2022, Volume: 19 Issue: 3, 1412 - 1417, 30.09.2022
https://doi.org/10.38136/jgon.1160913

Abstract

Aim: Increasing cesarean section (C/S) rates have become a growing public health issue. Turkey ranked among the top countries in the world for the highest cesarean rates. Why women desire CS instead of vaginal birth may be the key to avoiding unnecessary C/Ss. In this study, we performed a questionnaire to evaluate the possible reasons for maternal CS requests in one of the largest maternity care hospitals in Turkey.
Materials and Methods: A questionnaire was applied among pregnant women, focused on the preference of the mode of delivery and the reasons for the preferences.
Results: Of the 1200 women who answered the questionnaire about the mode of delivery, 45.7% were nulliparous and of these, 85% preferred vaginal delivery. Of the women who had vaginal birth previously, 93.4% preferred vaginal delivery. Of the women who had a previous c-section, 11.8% preferred to try a vaginal delivery. The main factor that affected the preference for C/S was the previous history of C/S. When the patients with a previous history of C/S were excluded; a history of previous spontaneous abortion and longer marital relationships were found to be the factors associated with C/S preference. of women who preferred vaginal delivery 55.8% stated that vaginal delivery was preferred because the most natural way of childbirth was a vaginal birth.
Discussion and Conclusion: Elective cesarean section in the absence of clinical indications is one of the most discussed topics of obstetric practice. The reason for the first C/S should be very well-reviewed to provide a logical approach to the current rates of C/S. Childbirth fear is also an important point to be carefully evaluated for especially nulliparous women.

References

  • Referans1 OECD (2022), Caesarean sections (indicator). DOI: 10.1787/adc3c39f-en (Accessed on 07 August 2022)
  • Referans2 WHO statement on cesarean section rates. Geneva: World Health Organization; 2015. Available from: https://apps.who.int/iris/bitstream/handle/10665/161442/WHO_RHR_15.02_eng.pdf?sequence=1
  • Referans3 Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health 2021;6:e005671.
  • Referans4 Burrows LJ, Meyn LA, Weber AM. Maternal morbidity associated with vaginal versus cesarean delivery. Obstet Gynecol 2004;103:907-12.
  • Referans5 Wax JR, Cartin A, Pinette MG, Blackstone J. Patient choice cesarean: an evidence-based review. Obstet Gynecol Surv 2004;59:601-16.
  • Referans6 Liu NH, Mazzoni A, Zamberlin N, Colomar M, Chang OH, Arnaud L, Althabe F, Belizán JM. Preferences for mode of delivery in nulliparous Argentinean women: a qualitative study. Reprod Health 2013;14:10-2.
  • Referans7 Torloni MR, Betrán AP, Montilla P, Scolaro E, Seuc A, Mazzoni A, Althabe F, Merzagora F, Donzelli GP, Merialdi M. Do Italian women prefer cesarean section? Results from a survey on mode of delivery preferences. BMC Pregnancy Childbirth 2013;26:78.
  • Referans8 Mazzoni A, Althabe F, Liu NH, Bonotti AM, Gibbons L, Sánchez AJ, Belizán JM. Women's preference for caesarean section: a systematic review and meta-analysis of observational studies. BJOG 2011;118:391-9.
  • Referans9 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;86:451-6.
  • Referans10 Fenwick J, Staff L, Gamble J, Creedy DK, Bayes S. Why do women request caesarean section in a normal, healthy first pregnancy? Midwifery 2010;26:394-400.
  • Referans11 Rouhe H, Salmela-Aro K, Halmesmäki E, Saisto T. Fear of childbirth according to parity, gestational age, and obstetric history. BJOG 2009;116:67-73.
  • Referans12 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;24:46-54.
  • Referans13 Karlström A, Nystedt A, Johansson M, Hildingsson I. Behind the myth--few women prefer caesarean section in the absence of medical or obstetrical factors. Midwifery 2011;27:620-7.
  • Referans14 Nakić Radoš S, Žigić Antić L, Jokić-Begić N. The Role of Personality Traits and Delivery Experience in Fear of Childbirth: A Prospective Study. J Clin Psychol Med Settings 2022 Jan 15. doi: 10.1007/s10880-022-09848-x. Epub ahead of print.
  • Referans15 Waldenström U, Hildingsson I, Ryding EL. Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth. BJOG 2006;113:638-46.
  • Referans16 Richens Y, Hindley C, Lavender T. A national online survey of UK maternity unit service provision for women with fear of birth. British Journal of Midwifery 2015;23:574-9.
  • Referans17 Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Fear of childbirth in nulliparous and multiparous women: a population-based analysis of all singleton births in Finland in 1997–2010. BJOG: an international journal of obstetrics and gynaecology 2014;121:965-70.
  • Referans18 O'Connell MA, Khashan AS, Leahy-Warren P, Stewart F, O'Neill SM. Interventions for fear of childbirth including tocophobia. Cochrane Database Syst Rev.2021;7:CD013321.
  • Referans19 Waldenström U, Rudman A, Hildingsson I. Intrapartum and postpartum care in Sweden: women's opinions and risk factors for not being satisfied. Acta Obstet Gynecol Scand 2006;85:551-60.
  • Referans20 Boz I, Akgun M, Duman F. A feasibility study of a psychoeducation intervention based on Human Caring Theory in nulliparous women with fear of childbirth. Journal of Psychosomatic Obstetrics and Gynaecology 2020;41:1-13.
  • Referans21 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;27:165-77.
  • Referans22 Reime B, Klein MC, Kelly A, Duxbury N, Saxell L, Liston R, Prompers FJ, Entjes RS, Wong V. Do maternity care provider groups have different attitudes towards birth? BJOG 2004;111:1388-93.
  • Referans23 Bergholt T, Østberg B, Legarth J, Weber T. Danish obstetricians' personal preference and general attitude to elective cesarean section on maternal request: a nation-wide postal survey. Acta Obstet Gynecol Scand 2004;83:262-6.
  • Referans24 Habiba M, Kaminski M, Da Frè M, Marsal K, Bleker O, Librero J, Grandjean H, Gratia P, Guaschino S, Heyl W, Taylor D, Cuttini M. Caesarean section on request: a comparison of obstetricians' attitudes in eight European countries. BJOG 2006;113647-56.
  • Referans25 Derya, YA, Güler H. Kadın Doğum Hekimi ve Ebelerin Elektif Sezaryen Doğum Hakkındaki Görüş ve Deneyimleri. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 2014; 7:12-18.
There are 25 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Article
Authors

Tuğba Altun Ensari 0000-0002-7819-5325

Duygu Kavak 0000-0002-9977-6567

Bülent Yirci 0000-0002-1405-3774

Burak Elmas 0000-0001-7977-4364

Sertac Esin 0000-0001-9577-4946

Ethem Serdar Yalvaç 0000-0001-9941-4999

Özlem Moraloğlu Tekin 0000-0001-8167-3837

Publication Date September 30, 2022
Submission Date August 11, 2022
Acceptance Date August 13, 2022
Published in Issue Year 2022 Volume: 19 Issue: 3

Cite

Vancouver Altun Ensari T, Kavak D, Yirci B, Elmas B, Esin S, Yalvaç ES, Moraloğlu Tekin Ö. Kadınların doğum şekline ilişkin tercihleri ve Türkiye’de sezaryen doğum yönteminin mevcut durumunun gözden geçirilmesi. JGON. 2022;19(3):1412-7.