UBC Graduate Research

How Are Women Making the Decision to Have an Elective Cesarean Section When There is No Medical Indication? : A Scoping Review Randhawa, Prabhjot


Background: Globally, elective cesarean sections without medical indication have recently seen a rise and British Columbia holds one of the highest rates of cesarean delivery in Canada. The decision-making process behind a woman’s choice to have an elective surgical delivery when there is no medical indication is important to gain knowledge about, as this procedure is not without maternal and neonatal risks, is costly, and adds further strain to nursing workload. Methods: A scoping review was conducted and 12 published articles were examined using the 2005 Arksey and O’Malley methodological framework and the Matrix Method Garrard (2011). Findings: Various approaches were noted globally, in terms of who was the provider of counseling (the primary care provider, team members, or pregnant women themselves) and how counseling was provided (during regular prenatal appointments, dedicated counseling sessions, or independent research by the woman). Themes were identified amongst the type of information women receive during counseling, including discussion of the risks and benefits of both cesarean and vaginal delivery, the woman’s fears/concerns, and future reproductive family planning. Conclusion: The comprehensive review of the literature suggested that a team-based and multisessional counseling approach when discussing mode of delivery may decrease the number of women opting for a cesarean section without medical indication. This is a type of counseling that Canadian nurses may be able to provide for pregnant women as they are respected members of the health care team and it is within their scope to educate and support women during the perinatal period. Finally, knowledge gaps were identified which require further research, including gaining knowledge on Canadian approaches to decision-making for women regarding mode of delivery and determining adequacy of counseling

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