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Attitudes of Midwives in Sweden Toward a Woman's Refusal of an Emergency Cesarean Section or a Cesarean Section on Request.

Danerek, Margaretha LU ; Marsal, Karel LU ; Cuttini, Marina; Lingman, Göran LU ; Nilstun, Tore LU and Dykes, Anna-Karin LU (2011) In Birth 38(1). p.71-79
Abstract
Background: A woman's refusal or request for a cesarean section can be a problem for midwives and obstetricians working in maternity units. The objective of this study was to describe the attitudes of midwives in Sweden toward the obstetrician's decision making in relation to a woman's refusal of an emergency cesarean section and to a woman's request for a cesarean section without a medical indication. Methods: The study has a cross-sectional multicenter design and used an anonymous, structured, and standardized questionnaire for data collection. The study group comprised midwives who had experience working at a delivery ward at 13 maternity units with neonatal intensive care units in Sweden (n = 259). Results: In the case of a woman's... (More)
Background: A woman's refusal or request for a cesarean section can be a problem for midwives and obstetricians working in maternity units. The objective of this study was to describe the attitudes of midwives in Sweden toward the obstetrician's decision making in relation to a woman's refusal of an emergency cesarean section and to a woman's request for a cesarean section without a medical indication. Methods: The study has a cross-sectional multicenter design and used an anonymous, structured, and standardized questionnaire for data collection. The study group comprised midwives who had experience working at a delivery ward at 13 maternity units with neonatal intensive care units in Sweden (n = 259). Results: In the case of a woman's refusal to undergo an emergency cesarean section for fetal reasons, most midwives (89%) thought that the obstetrician should try to persuade the woman to agree. Concerning a woman's request for a cesarean section without any medical indications, most midwives thought that the obstetrician should agree if the woman had previous maternal or fetal complications. The reason was to support the woman's decision out of respect for her autonomy; the midwives at six university hospitals were less willing to accept the woman's autonomy in this situation. If the only reason was "her own choice," 77 percent of the midwives responded that the obstetrician should not comply. Conclusions: The main focus of midwives seems to be the baby's health, and therefore they do not always agree with respect to a woman's refusal or request for a cesarean section. The midwives prefer to continue to explain the situation and persuade the woman to agree with the recommendation of the obstetrician. (BIRTH 38:1 March 2011). (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Birth
volume
38
issue
1
pages
71 - 79
publisher
Medical Consumer Communications
external identifiers
  • wos:000287485900011
  • pmid:21332777
  • scopus:79951786390
ISSN
0730-7659
DOI
10.1111/j.1523-536X.2010.00440.x
language
English
LU publication?
yes
id
09be349b-e27d-4e23-82f6-f792ba7a64e2 (old id 1831656)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21332777?dopt=Abstract
date added to LUP
2011-03-01 17:11:06
date last changed
2017-06-18 04:40:22
@article{09be349b-e27d-4e23-82f6-f792ba7a64e2,
  abstract     = {Background: A woman's refusal or request for a cesarean section can be a problem for midwives and obstetricians working in maternity units. The objective of this study was to describe the attitudes of midwives in Sweden toward the obstetrician's decision making in relation to a woman's refusal of an emergency cesarean section and to a woman's request for a cesarean section without a medical indication. Methods: The study has a cross-sectional multicenter design and used an anonymous, structured, and standardized questionnaire for data collection. The study group comprised midwives who had experience working at a delivery ward at 13 maternity units with neonatal intensive care units in Sweden (n = 259). Results: In the case of a woman's refusal to undergo an emergency cesarean section for fetal reasons, most midwives (89%) thought that the obstetrician should try to persuade the woman to agree. Concerning a woman's request for a cesarean section without any medical indications, most midwives thought that the obstetrician should agree if the woman had previous maternal or fetal complications. The reason was to support the woman's decision out of respect for her autonomy; the midwives at six university hospitals were less willing to accept the woman's autonomy in this situation. If the only reason was "her own choice," 77 percent of the midwives responded that the obstetrician should not comply. Conclusions: The main focus of midwives seems to be the baby's health, and therefore they do not always agree with respect to a woman's refusal or request for a cesarean section. The midwives prefer to continue to explain the situation and persuade the woman to agree with the recommendation of the obstetrician. (BIRTH 38:1 March 2011).},
  author       = {Danerek, Margaretha and Marsal, Karel and Cuttini, Marina and Lingman, Göran and Nilstun, Tore and Dykes, Anna-Karin},
  issn         = {0730-7659},
  language     = {eng},
  number       = {1},
  pages        = {71--79},
  publisher    = {Medical Consumer Communications},
  series       = {Birth},
  title        = {Attitudes of Midwives in Sweden Toward a Woman's Refusal of an Emergency Cesarean Section or a Cesarean Section on Request.},
  url          = {http://dx.doi.org/10.1111/j.1523-536X.2010.00440.x},
  volume       = {38},
  year         = {2011},
}