Cesarean Delivery on Maternal Request: Prevalence and Underlying Factors in Sharkia Governorate, Egypt

Background: Cesarean delivery percentage in Egypt has reached 72% of total deliveries in 2021. It’s believed that cesarean delivery on maternal request (CDMR) has been associated with an increase in the frequency of CS. However, there is a lack of studies reporting the frequency of CDMR in Egypt. So, our objectives were to assess prevalence of cesarean sections and CDMR in Sharkia governorate, to determine maternal motives and to explore preferences, attitudes and practice of obstetricians about CDMR. Methods: A cross-sectional study was conducted on 182 pregnant women who were selected using a simple random sampling technique from 4 health units and 2 health centers in Sharika governorate and obstetricians from 2 general hospitals. The characteristics of the women and their motives for undergoing a CS for the current pregnancy also, preferences of health professionals for mode of delivery, their practices and attitude towards CDMR were collected through semi-structured questionnaires. Results: CSs rate was found to be 77.5% while the prevalence of previous CDMR was found to be 22% among CS population. The most common motives for demanding a CS in the absence of medical indications were fear of pain (37.4%), fear of episiotomy (31.9%). Most of the obstetricians included in the study preferred Vaginal delivery 84.3%. More than half of obstetricians (56.9%) had negative attitude towards CDMR. Conclusion: Maternal requests for cesarean sections are driven by fear of pain and lack of knowledge. Counseling pregnant women about normal vaginal delivery benefits and risks can influence decision-making and decrease rates.