Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2011 Mar;118(4):391-9.
doi: 10.1111/j.1471-0528.2010.02793.x. Epub 2010 Dec 7.

Women's preference for caesarean section: a systematic review and meta-analysis of observational studies

A Mazzoni  1 , F Althabe, N H Liu, A M Bonotti, L Gibbons, A J Sánchez, J M Belizán
Affiliations
Meta-Analysis

Women's preference for caesarean section: a systematic review and meta-analysis of observational studies

A Mazzoni et al. BJOG. 2011 Mar.

Abstract

Background: The striking increase in caesarean section rates in middle- and high-income countries has been partly attributed to maternal request. We conducted a systematic review and meta-analysis of women's preferences for caesarean section.

Objectives: To review the published literature on women's preferences for caesarean section.

Search strategy: A systematic search of MEDLINE, EMBASE, LILACS and PsychINFO was performed. References of all included articles were examined.

Selection criteria: We included studies that quantitatively evaluated women's preferences for caesarean section in any country. We excluded articles assessing health providers' preferences and qualitative studies.

Data collection and analysis: Two reviewers independently screened abstracts of all identified citations, selected potentially eligible studies, and assessed their full-text versions. We conducted a meta-analysis of proportions, and a meta-regression analysis to determine variables significantly associated with caesarean section preference.

Main results: Thirty-eight studies were included (n = 19,403). The overall pooled preference for caesarean section was 15.6% (95% CI 12.5-18.9). Higher preference for caesarean section was reported in women with a previous caesarean section versus women without a previous caesarean section (29.4%; 95% CI 24.4-34.8 versus 10.1%; 95% CI 7.5-13.1), and those living in a middle-income country versus a high-income country (22.1%; 95% CI 17.6-26.9 versus 11.8%; 95% CI 8.9-15.1).

Authors' conclusions: Only a minority of women in a wide variety of countries expressed a preference for caesarean delivery. Further research is needed to better estimate the contribution of women's demand to the rising caesarean section rates.

PubMed Disclaimer

Conflict of interest statement

Disclosure of interests

All authors declare that there are not conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection process
Figure 2
Figure 2
See this image and copyright information in PMC

References

    1. Arias E, MacDorman M, Strobino D, Guyer B. Annual summary of vital statistics 2002. Pediatrics. 2003;112:1215–30. - PubMed
    1. Belizan JM, Althabe F, Barros FC, Alexander S. Rates and implications of caesarean sections in Latin America: ecological study. BMJ. 1999;319:1397–400. - PMC - PubMed
    1. Belizan JM, Althabe F, Cafferata ML. Health consequences of the increasing caesarean section rates. Epidemiology. 2007;18:485–6. - PubMed
    1. Althabe F, Sosa C, Belizán JM, Gibbons L, Jacquerioz F, Bergel E. Cesarean section rates and maternal and neonatal mortality in low-, medium-, and high-income countries: an ecological study. Birth. 2006;33(4):270–7. - PubMed
    1. Betrán AP, Merialdi M, Lauer JA, Bing-Shun W, Thomas J, Van Look P, Wagner M. Rates of caesarean section: analysis of global, regional and national estimates. Paediatr Perinat Epidemiol. 2007;21(2):98–113. - PubMed

Publication types