Choice of Delivery in Tehran and Some Related Factors

This study assessed the influence of maternal request on elective cesarean rate and related factors in maternity hospitals in Tehran. This cross sectional descriptive analytic study was performed via a two-step random sampling technique, using data from 824 pregnant women who attended the maternity hospitals in Tehran in 2001. A questionnaire covering past and present obstetrical history and demographic characteristics was completed for each mother. SPSS software was used for data analysis. Descriptive analysis and inference tests, including chi-square and t-tests were used. Logistic regression test was also used to find the correlation between variables. P value less than 0.05 was considered for statistical significance. Totally 66.5% of mothers underwent cesarean and 33.5% had normal vaginal delivery. From cesarean cases 72% were elective and of these 22% were done upon maternal request. It was shown that 71% of mothers who selected cesarean had no scientific reason. Also, 65% of doctors suggested cesarean for their patients without any true medical indication. The majority of elective cesareans performed on maternal request were done in private hospitals (86% in private vs. 14% in public hospitals) (P<0.0001). High educational, employment status and first pregnancy significantly increase the demand for cesarean section. Increasing the level of awareness and attitude of mothers and providing painless normal vaginal delivery as well as vaginal delivery after previous cesarean, the frequency of unnecessary cesareans and related complications can be decreased.