Cesarean Section on Maternal Request in Tehran 2010-2011: Incidence and Predisposing Factors

Background and Autonomy in making decision is one of the most fundamental principles of medical ethics. Respect for patient autonomy is a moral duty, therefore, many doctors agree to perform unnecessary cesarean. This study was designed to determine the incidence of maternal demands for cesarean sections and influential factors on making decision among pregnant women in Tehran, 2010-2011. This cross-sectional study was carried out in women attending some hospitals in Tehran for delivery. There were 850 pregnant women who delivered their babies through cesarean section. Data was analyzed using univariate logistic regression in SPSS. The prevalence of cesarean delivery on maternal request was 11.2%. The cause of cesarean among 82.3% was fear of vaginal childbirth. Pregnant women aged < 21 years old were 3.2 times more interested in having a cesarean section (OR=3.200, CI 95%=1.15-8.89), and those who had higher education were 18.5 times more likely to deliver their babies through cesarean (OR=18.5, CI95%=2.45-139.35). Performing cesarean on maternal request was found two times more in working women compared to housewives (OR=2.39, CI95%=1/45-3.93). Moreover, the employment status of husband (OR=6.037, CI95%=2.33-15.99), delivery in private hospital (OR=7.13, CI95%=4.08-12.44), and the idea of medical team (OR=45.89, CI95%=25.39-82.93) increased the probability of cesarean delivery. The findings indicated several factors that influenced cesarean birth on maternal request. Social norms were found as the most influential factor, therefore, providing the society with more training and education is necessary in enhancing the public idea about unnecessary cesarean section.