Strength of preference for vaginal birth as a predictor of delivery mode among women who attempt a vaginal delivery

Erica Wu, Anjali J. Kaimal, Kathryn Houston, Lynn M. Yee, Sanae Nakagawa, Miriam Kuppermann

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Objective We sought to assess the relationship between strength of preference for vaginal birth and likelihood of vaginal delivery among women attempting this delivery mode. Study Design We conducted a longitudinal study of mode of delivery preferences among women who were <36 weeks' pregnant. Participants completed a sociodemographic and clinical questionnaire and were asked if they preferred vaginal or cesarean delivery. Participants who preferred vaginal delivery completed a standard gamble exercise to assess the strength of this preference on a 0-to-1 scale (higher scores indicate stronger preference for vaginal delivery); those preferring cesarean delivery were assigned a value of 0. Data on clinical characteristics and delivery mode were obtained via telephone interview or chart review. Logistic regression was used to identify predictors of delivery mode among women who attempted a vaginal delivery. Results Of 210 participants, 156 attempted a vaginal delivery. Their mean and median vaginal delivery preference scores were 0.70 (SD 0.31) and 0.75 (interquartile range, 0.50-0.99), respectively. In multivariate analyses, women with a prior cesarean delivery (adjusted odds ratio [aOR], 0.08; 95% confidence interval [CI], 0.02-0.39) or who delivered an infant ≥4000 g (aOR, 0.04; 95% CI, 0.01-0.28) had significantly lower odds of having a vaginal delivery. After controlling for potential confounders, participants with a stronger preference for vaginal delivery were at significantly higher odds of having a vaginal delivery (aOR, 1.54; 95% CI, 1.01-2.34 for every 0.2 increase on the 0-to-1 scale). Conclusion Among women who attempt a vaginal delivery, the strength of preference for vaginal birth is predictive of the delivery mode ultimately undergone.

Original languageEnglish (US)
Pages (from-to)440.e1-440.e6
JournalAmerican journal of obstetrics and gynecology
Volume210
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • delivery mode
  • patient preferences

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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