Caesarean section vs vaginal birth: a narrative review of decision making and postnatal outcomes

Background/Aims: Few studies have mapped decision-making factors behind mode of birth to postpartum outcomes. This review's aim was to compare factors that drive women's decision making on mode of birth and postnatal outcomes. Methods: This narrative literature review of Google Scholar, PubMed, Medline and Wiley Online Library explored studies published from 2000 onwards that compared caesarean section and vaginal birth in relation to decision-making factors and postnatal quality of life. Extracted data were analysed thematically. Results: A total of 10 articles were included. Most women favoured vaginal birth, associating it with satisfaction, fear of surgery and cultural norms. Caesarean sections were favoured because of a fear of pain, previous caesarean section experience and the perception that it was easier. There were poorer physical and mental postpartum quality of life outcomes for caesarean sections and assisted vaginal birth, even after 10 years. Conclusions: Healthcare professionals require more exposure to supporting women to decide on mode of birth. Routine checks for new mothers require a holistic, person-centred approach as opposed to generalised care. Implications for practice: Healthcare workers can and should make every contact with intending and present mothers count. Open conversations about childbirth need to be had, even outside of women's health spaces, with appropriate referrals and signposting to best available evidence for informed decisions to be made regarding mode of childbirth and expected outcomes.