# Maternal perspective on requesting elective caesarean birth

## TL;DR

The study explores why first-time mothers request elective caesarean births without medical reasons, finding factors like fear and negative birth stories.

## Contribution

The study identifies multifactorial reasons for elective caesarean requests, emphasizing psychological and social influences.

## Key findings

- Four main themes were identified: psychological fear, negative birth experiences, behavioral control, and maternal firmness.
- Traumatic birth stories from relatives and friends significantly influenced fear of vaginal delivery.
- Most participants cited multiple reasons for requesting a caesarean section.

## Abstract

This study was conducted to explore the underlying factors for requesting elective caesarean section without an obstetric indication in primigravida.

A qualitative case study was conducted in Obstetrics & Gynaecology department at Central Park Hospital from September 2023 to February 2024. The study participants were primigravidas who presented after 37 weeks of gestation and requested for caesarean section without any medical indication. Semi-structured interviews were taken from fifteen participants for an in-depth analysis of the causes of elective caesarean section. Thematic analysis was done using NVivo 14.

The analysis of the reasons given by women to seek caesarean section led to the identification of four main themes: psychological fear, negative birth experiences, behavioral control, and maternal firmness. Traumatic birth experiences of near relatives and friends emerged as a main reason that resulted in fear of childbirth. Psychological fear related to labour pains and vaginal examination were yet another reason. Behaviour control expressed as distress after witnessing another woman’s labour, ashamed of exposure and lithotomy positioning were described by few of participants. Most respondents reported more than one reason for requesting caesarean section.

We found that CDMR in primigravidas is multifactorial and had personal, behavioural and social contexts. Listening to horrific birth stories from surroundings was most pronounced factor that created a negative impression of vaginal delivery on first-time mothers and generated self-perceived harm which led to multi-faceted fear regarding birth process.