Birth mode preference and associated factors among pregnant individuals in Eskişehir, Türkiye

Abstract Background Birth mode preferences are shaped by a complex interplay of personal, social, and clinical factors. These preferences may reflect previous experiences, perceived risks, or external influences such as medical advice. This study aimed to examine sociodemographic, obstetric, and psychosocial characteristics associated with preferred mode of delivery. Methods This analysis was conducted using an existing dataset collected between December 2024 and February 2025 at two hospitals in Eskişehir, Türkiye, among pregnant individuals who attended antenatal care and agreed to participate. Participants were recruited via convenience sampling and completed a questionnaire covering sociodemographic and obstetric characteristics and Fetal Health Anxiety Inventory. To compare vaginal and cesarean preferences, 1:1 propensity score matching was performed (nearest neighbor, without replacement) based on trimester, matching 379 cesarean-preferring participants to 379 vaginal-preferring participants. Results A total of 758 participants (mean age: 29.95±5.86) were included after matching. Participants preferring cesarean birth more often had higher education (p = 0.001), employment (p = 0.019), miscarriage history (p = 0.005), previous cesarean (p < 0.001), doctor recommendation for cesarean (p < 0.001), and higher fetal health anxiety scores (p = 0.039). Those preferring vaginal birth had more pregnancies (p < 0.001), higher prenatal class attendance (p = 0.037), and more often reported previous vaginal birth (p < 0.001). No significant differences were found in age, migration status, pregnancy planning, household income, curettage history, or pregnancy-related health problems. Conclusions Birth preferences among pregnant individuals appeared to be influenced by prior experiences, fetal health anxiety, prenatal education, and interactions with healthcare providers. These findings suggest the importance of supporting informed and person-centered choices within antenatal care. Key messages • Standardized medical guidance and addressing fetal health anxiety are essential for birth planning. • Awareness of underlying factors in birth decisions can contribute to more equitable maternity care.