Understanding women's knowledge and perceived benefits of vaginal birth and caesarean section: A multi-country survey from the QUALI-DEC project.

BACKGROUND

Pregnant women are increasingly exposed to various sources of information that shape their perceptions of modes of birth. While it is essential to support women's informed decision-making regarding childbirth, particularly where caesarean section (CS) rates are rising, women's perceptions on modes of birth remain poorly understood.

AIM: To assess women's perceptions of the benefits of vaginal birth and caesarean section.

METHODS

A cross-sectional survey was conducted among a representative sample of postpartum women in 32 participating hospitals in Argentina, Burkina Faso, Thailand, and Viet Nam. The survey included four open-ended questions asking women to list the perceived advantages and disadvantages of planned CS and vaginal birth (VB), which were analysed descriptively.

FINDINGS: Among the 3127 women included, the most frequently perceived benefits of VB were faster recovery and shorter hospital stay (85.7% of participants) and improved postpartum mobility (55.7%), while few women mentioned its clinical benefits. Women mainly perceived CS as a way of avoiding the disadvantages of VB, namely labour pain (49.2%), emergency CS (26%), or instrumental birth (22.4%). Few women mentioned the benefits of CS itself, such as greater convenience for time management.

CONCLUSION

Vaginal birth is valued by women for practical reasons related to social and domestic imperatives surrounding childbirth. At the same time, they perceive CS as a way to avoid the experience of vaginal birth, which may be considered negative. This study highlights the need to enhance access to effective labour pain management, strengthen psychosocial support, and provide comprehensive information to pregnant women.

CLINICAL TRIAL REGISTRY: The QUALI-DEC trial is registered on the Current Controlled Trials website (https://www.isrctn.com/) under the number ISRCTN67214403.