ArticleBMJ global health2024
Rising caesarean section rates and factors affecting women's decision-making about mode of birth in Indonesia: a longitudinal qualitative study.
Article in BMJ global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The efficacy and safety of enhanced recovery after surgery (ERAS) protocols in cesarean delivery: a meta-analysis of randomized controlled trials.Archives of gynecology and obstetrics · 2026Pooled it
- Women and clinicians' views, preferences and experiences of caesarean section and vaginal birth in India: a qualitative substudy of the 'Misoprostol or Oxytocin for Labour Induction' (MOLI) trial.BMJ global health · 2025Trial
- Profit over woman-centred care? A commentary on drivers of high rates of caesarean birth in Indonesia.BMJ global health · 2026Article
- Delineating the risk factors, sources of acquisition and clinical outcomes in neonates colonised with multidrug-resistant bacteria: the NeoCol study.Nature communications · 2026Article
- "Everywhere you see, C-sections are happening": examining trends and reasons for a rise in cesarean-section deliveries among women in urban informal settlements, Mumbai Metropolitan Region, using a mixed methods approach.BMC pregnancy and childbirth · 2026Article
- Facilitators and barriers affecting healthy lifestyle behaviors among suburban Javanese women living in Indonesia: a qualitative study.BMC public health · 2026Article
- Financial and regulatory interventions to reduce unnecessary caesarean sections: An updated scoping review.PLOS global public health · 2026Article
- Factors behind high caesarean section in Bangladesh: insight from a systematic literature review and meta-synthesis.BMJ public health · 2026Article
- Optimizing Availability and Appropriate Use of Assisted Vaginal Birth: Protocol for Generic Formative Research of an Implementation Preparation.JMIR research protocols · 2025Article
- Pomeroy Sterilization in a Teen with Recurrent Pregnancy and Multiple Cesarean Deliveries: A Case Report.International medical case reports journal · 2025Article
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Abstract
introductionCaesarean section (CS) rates in Indonesia are increasing rapidly. Understanding women's preferences about mode of birth is important to help contextualise these rising rates and can help develop interventions to optimise CS. This study aimed to explore Indonesian women's preferences and decision-making about mode of birth, and how their preferences may change throughout pregnancy and birth.
methodsWe conducted a longitudinal qualitative study using in-depth interviews with 28 women accessing private and public health facilities in Jakarta, the region with the highest CS rates. Interviews were conducted two times: during the woman's third trimester of pregnancy and in the postpartum period, between October 2022 and March 2023. We used a reflexive thematic approach for analysis.
resultsWe generated three themes: (1) preferences about the mode of birth, (2) decision-making about the mode of birth and (3) regrets about the actual mode of birth. Most women preferred vaginal birth. However, they were influenced by advertisements promoting enhanced recovery after CS (ERACS) as an 'advanced technique' of CS, promising a comfortable, painless and faster recovery birth. This messaging influenced women to perceive CS as equivalent or even superior to vaginal birth. Where women's preferences for mode of birth shifted around the time of birth, this was primarily due to the obstetricians' discretion. Women felt they did not receive adequate information from obstetricians on the benefits and risks of CS and vaginal birth and felt disappointed when their actual mode of birth was not aligned with their preferences.
conclusionOur study shows that despite rising CS rates, Indonesian women prefer vaginal birth. This highlights the need for better communication strategies and evidence-based information from healthcare providers. Given the rising popularity of ERACS, more work is urgently needed to standardise and regulate its use.
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