ArticleBMC pregnancy and childbirth2018
Factors influencing decision-making for caesarean section in Sweden - a qualitative study.
Article in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in Iran: a mixed-methods systematic review.Reproductive health · 2021Pooled it
- Health workers' perspectives on the quality of maternal and newborn health care around the time of childbirth: Results of the Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) project in 12 countries of the World Health Organization European Region.Journal of global health · 2024Trial
- Clinical, psychosocial and cognitive outcomes following VBAC: a protocol for a sub-national cohort study in Saudi Arabia (2019-2024).BMJ open · 2026Article
- Healthcare providers' perspectives on implementing evidence-based practice guidelines to reduce cesarean section rates: a qualitative study.BMC health services research · 2026Article
- Ready for change? The effect of profession and organization on patient safety culture and organizational readiness for change - a cross-sectional study.BMC health services research · 2026Article
- Article
- Mapping the gendered dynamics of cesarean section: A scoping review.PLOS global public health · 2026Article
- The Rising Global Cesarean Section Rates and Their Impact on Maternal and Child Health: A Scoping Review.Journal of clinical medicine · 2025Review
- The struggle over caesarean section on maternal request: an ethical principles approach to Swedish media portrayal.Reproductive health · 2025Article
- Attitudes, Perceptions and Determinants of Non-Medically Indicated Caesarean Section Preference Among Pregnant Women in Thailand: A Three-Phase Mixed-Methods Study.International journal of women's health · 2025Article
- How structured cultural changes can reduce cesarean section rate in a Danish tertiary hospital.PloS one · 2025Article
- Caesarean section on maternal request: a qualitative study of conflicts related to shared decision-making and person-centred care in Sweden.Reproductive health · 2024Article
- Exploring the shared decision making process of caesarean sections at a teaching hospital in Ghana: a mixed methods study.BMC pregnancy and childbirth · 2023Article
- Behavioural factors associated with fear of litigation as a driver for the increased use of caesarean sections: a scoping review.BMJ open · 2023Article
- Conflicting attitudes between clinicians and women regarding maternal requested caesarean section: a qualitative evidence synthesis.BMC pregnancy and childbirth · 2023Article
- Has the cesarean epidemic in Czechia been reversed despite fertility postponement?BMC pregnancy and childbirth · 2022Article
- Clinicians' views of factors influencing decision-making for CS for first-time mothers-A qualitative descriptive study.PloS one · 2022Article
- What would reduce caesarean section rates?-Views from pregnant women and clinicians in Ireland.PloS one · 2022Article
- Is Primary Cesarean Section a Cause of Increasing Cesarean Section Rates in Greece?Materia socio-medica · 2020Article
- Factors obstetricians, family physicians and midwives consider when counselling women about a trial of labour after caesarean and planned repeat caesarean: a qualitative descriptive study.BMC pregnancy and childbirth · 2020Article
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Authors and funding
7 authors.
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Abstract
backgroundRising rates of caesarean section (CS) are a concern in many countries, yet Sweden has managed to maintain low CS rates. Exploring the multifactorial and complex reasons behind the rising trend in CS has become an important goal for health professionals. The aim of the study was to explore Swedish obstetricians' and midwives' perceptions of the factors influencing decision-making for CS in nulliparous women in Sweden.
methodsA qualitative design was chosen to gain in-depth understanding of the factors influencing the decision-making process for CS. Purposive sampling was used to select the participants. Four audio-recorded focus group interviews (FGIs), using an interview guide with open ended questions, were conducted with eleven midwives and five obstetricians from two selected Swedish maternity hospitals after obtaining written consent from each participant. Data were managed using NVivo
resultsThe thematic analysis resulted in three main themes; 'Belief in normal birth - a cultural perspective'; 'Clarity and consistency - a system perspective' and 'Obstetrician makes the final decision, but...', and each theme contained a number of subthemes. However, 'Belief in normal birth' emerged as the core central theme, overarching the other two themes.
conclusionFindings suggest that believing that normal birth offers women and babies the best possible outcome contributes to having and maintaining a low CS rate. Both midwives and obstetricians agreed that having a shared belief (in normal birth), a common goal (of achieving normal birth) and providing mainly midwife-led care within a 'team approach' helped them achieve their goal and keep their CS rate low.
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