"Because It Eases My Childbirth Plan": a Qualitative Study on Factors Contributing to Preferences for Caesarean Section in Thailand

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2023 Apr 24

PMID 37095449

Authors

Sasitara Nuampa

Ameporn Ratinthorn

Pisake Lumbiganon

Somporn Rungreangkulkij

Nilubon Rujiraprasert

Natthapat Buaboon

Nampet Jampathong

Alexandre Dumont

Claudia Hanson

Myriam de Loenzien

Meghan A Bohren

Ana Pilar Betran

Affiliations

Soon will be listed here.

Abstract

Background: Although caesarean section (CS) rates have increased rapidly in Thailand, the upward trend is not supported by significant maternal or perinatal health benefits. The appropriate use of CS through QUALIty DECision-making by women and providers (QUALI-DEC project) aims to design and implement a strategy to optimize the use of CS through non-clinical interventions. This study aimed to explore the factors influencing women's and health professionals' preferences for CS delivery in Thailand.

Methods: We conducted a formative qualitative study by using semi-structured in-depth interviews with pregnant and postpartum women, and healthcare staff. Purposive sampling was used to recruit participants from eight hospitals across four regions of Thailand. Content analysis was used to develop the main themes.

Results: There were 78 participants, including 27 pregnant and 25 postpartum women, 8 administrators, 13 obstetricians, and 5 interns. We identified three main themes and seven sub-themes of women and healthcare providers' perceptions on CS: (1) avoiding the negative experiences from vaginal birth (the pain of labor and childbirth, uncertainty during the labor period); (2) CS is a safer mode of birth (guarantees the baby's safety, a protective shield for doctors); and (3) CS facilitates time management (baby's destiny at an auspicious time, family's management, manage my work/time).

Conclusions: Women mentioned negative experiences and beliefs about vaginal delivery, labor pain, and uncertain delivery outcomes as important factors influencing CS preferences. On the other hand, CS is safer for babies and facilitates multiple tasks in women's lives. From health professionals' perspectives, CS is the easier and safer method for patients and them. Interventions to reduce unnecessary CS, including QUALI-DEC, should be designed and implemented, taking into consideration the perceptions of both women and healthcare providers.

Citing Articles

Comparison of perinatal outcome and mode of birth of twin and singleton pregnancies in migrant and refugee populations on the Thai Myanmar border: A population cohort.

Prins T, Min A, Gilder M, Tun N, Schepens J, McGregor K PLoS One. 2024; 19(4):e0301222.

PMID: 38635671 PMC: 11025774. DOI: 10.1371/journal.pone.0301222.

Correction: "Because it eases my childbirth plan": a qualitative study on factors contributing to preferences for caesarean section in Thailand.

Nuampa S, Ratinthorn A, Lumbiganon P, Rungreangkulkij S, Rujiraprasert N, Buaboon N BMC Pregnancy Childbirth. 2024; 24(1):202.

PMID: 38486165 PMC: 10938736. DOI: 10.1186/s12884-024-06379-1.

Evaluation of cesarean delivery rates and factors associated with cesarean delivery among women enrolled in a pregnancy cohort study at two tertiary hospitals in Thailand.

Patamasingh Na Ayudhaya O, Kittikraisak W, Phadungkiatwatana P, Hunt D, Tomyabatra K, Chotpitayasunondh T BMC Pregnancy Childbirth. 2024; 24(1):149.

PMID: 38383397 PMC: 10880209. DOI: 10.1186/s12884-024-06314-4.

How does hospital organisation influence the use of caesarean sections in low- and middle-income countries? A cross-sectional survey in Argentina, Burkina Faso, Thailand and Vietnam for the QUALI-DEC project.

Etcheverry C, Betran A, de Loenzien M, Robson M, Kabore C, Lumbiganon P BMC Pregnancy Childbirth. 2024; 24(1):67.

PMID: 38233792 PMC: 10792793. DOI: 10.1186/s12884-024-06257-w.

Implementing the QUALI-DEC project in Argentina, Burkina Faso, Thailand and Viet Nam: a process delineation and theory-driven process evaluation protocol.

Cleeve A, Annerstedt K, Betran A, Alvesson H, Kabore Wendyam C, Carroli G Glob Health Action. 2023; 16(1):2290636.

PMID: 38133667 PMC: 10763892. DOI: 10.1080/16549716.2023.2290636.

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