Women's involvement with the decision preceding their caesarean section and their degree of satisfaction

Objective To assess the extent to which women contribute to the decision for caesarean section and their satisfaction with the decision and procedure. Design Observational study of women undergoing caesarean section who were interviewed using a standard proforma. Setting University College Hospital, London. Participants One hundred and two consecutive women undergoing caesarean section. Results The women's perceived reason for the caesarean section agreed with the doctors' reason in 91 cases (89.2%). Only 2/29 women having elective sections stated they had no contribution, compared with 22/73 women having emergency sections (P = 0.018, two-tailed Fisher's exact test). Twenty out of 29 women (69%) having elective procedures and 37/73 women (51%) having emergency sections recorded medium or more contribution. All women except one were 50% or more satisfied with the decision. Women's satisfaction with the operation was high in the immediate post-operative period and remained so over the following six weeks. Forty-three women (49%) said they would prefer an elective section in the next pregnancy given the choice. Conclusions Women undergoing caesarean section were well informed and took a considerable part in the decision-making process, This suggests that women's wishes may be playing a role in increasing caesarean section rates. High levels of satisfaction with both the decision and the procedure itself indicate that caesarean section is an acceptable method of delivery, particularly when an elective procedure.