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  • Title: Swedish caregivers' attitudes towards caesarean section on maternal request.
    Author: Karlström A, Engström-Olofsson R, Nystedt A, Thomas J, Hildingsson I.
    Journal: Women Birth; 2009 Jun; 22(2):57-63. PubMed ID: 19195958.
    Abstract:
    BACKGROUND: Caesarean section (CS) is not an option that women in Sweden can chose themselves, although the rise in CS rate has been attributed to women. This study describes obstetricians' and midwives' attitudes towards CS on maternal request. METHODS: A qualitative descriptive study, with content analysis of 5 focus group discussions where 16 midwives and 9 obstetricians participated. RESULTS: The overarching theme was identified as "Caesarean section on maternal request-a balance between resistance and respect". On the one hand, CS was viewed as a risky project; on the other hand, request for a CS was understood and respected when women had had a previous traumatic birth experience. Still, a CS was not really seen as a solution for childbirth related fear. Five categories were related to the theme. Overall, our findings indicate that caregivers blamed the women for the increase, they considered the management of CS on maternal request difficult, and they suggested preventive methods to reduce CS and means to strengthen their professional roles. KEY CONCLUSIONS AND IMPLICATION FOR PRACTICE: Both midwives and obstetricians considered the management of CS on maternal request difficult, and the result showed that they balanced between resistance and respect. The result also showed that the participants stressed the importance of professionals advocating natural birth with evidence-based knowledge and methods to prevent maternal requests. Ongoing discussions among health professionals on attitudes and practice would strengthen their professional roles and lead to a decrease in CS rates in Sweden.
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