Why do some pregnant women prefer cesarean? The influence of parity, delivery experiences, and fear

OBJECTIVE: We sought to identify predictors of preferences for cesarean among pregnant women, and estimate how different predictors influence preferences. STUDY DESIGN: This was a cross-sectional study based on the Norwegian Mother and Child Cohort Study (n = 58,881). RESULTS: Of the study population, 6% preferred cesarean over vaginal delivery. While 2.4% of nulliparous had a strong preference for cesarean, the proportion among multiparous was 5.1%. The probability that a woman, absent potential predictors, would have a cesarean preference was similar (<2%) for both nulliparous or multiparous. In the presence of concurrent predictors such as previous cesarean, negative delivery experience, and fear of birth, the predicted probability of a cesarean request ranged from 20-75%. CONCLUSION: The proportion of women with a strong preference for cesarean was higher among multiparous than nulliparous women, but the difference was attributable to factors such as previous cesarean or fear of delivery and not to parity per se.