Counselling is needed. Very quick search Pubmed "C section counselling" these are most relevant -yes they are Scandinavian countries-but maybe this is as countries go they are better at offering this).Think about what a lot of these women have gone through and in some cases it works (look at percentages opting for VB). Csection as stated before has been linked with reduced number of children (for psychological reasons-not infertility) look into the cause this is a psychological problem and I do think for some women they may not best be looked after by csection on demand.
Indicates possible reasons:
Tidsskr Nor Laegeforen. 2008 Jun 12;128(12):1388-91.
[Is there an association between psychological stress and request for caesarian section?].
[Article in Norwegian]
Halvorsen L, Nerum H, Øian P, Sørlie T.
Source
Kvinneklinikken Universitetssykehuset Nord-Norge Postboks 100 9038 Tromsø. [email protected]
Abstract
BACKGROUND:
Caesarean section rates have increased in Norway, as in the rest of the western world since the beginning of the 1970s, and further explanations are needed to understand this development. The study aimed to examine whether demographic or psychological burdens differed among women who feared childbirth, according to whether or not they requested caesarean section.
MATERIAL AND METHODS:
In the period 2000-02, 164 pregnant women who feared childbirth were referred for counselling with two midwives (specialized in mental health) at the antenatal clinic at the University Hospital of North Norway. Data were retrieved from counselling sessions, referral letters, antenatal and intrapartum care records. The group that wished to have caesarean sections (n = 86) was compared with the one that did not (n = 78).
RESULTS:
80% of the women had previously experienced anxiety and/or depression, 32% had eating disturbances and 72% reported having been abused. In the group requesting caesarean section the women had more severe fear of childbirth, previous traumatic birth experiences, previous anxiety and depression, lack of confidence in the professional staff and fewer had been treated for their psychological problems. At the onset of labour, 86% who initially requested a caesarean delivery were prepared for a vaginal birth. The overall caesarean rate for both groups was 32%.
INTERPRETATION:
The women who feared childbirth generally had a larger burden of psychosocial and psychiatric problems than others, and those who requested a caesarean delivery had most. Charting and processing these burdens is presumably of significance for the birth outcome.
elective c section counselling
Birth. 2006 Sep;33(3):221-8.
Maternal request for cesarean section due to fear of birth: can it be changed through crisis-oriented counseling?
Nerum H, Halvorsen L, Sørlie T, Oian P.
Source
Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway.
Abstract
BACKGROUND:
A psychosocial team was established to meet the needs of an increasing number of pregnant women referred for fear of birth who wished a planned cesarean. This study describes the intervention, the women's psychosocial problems in relation to degree of fear of birth, changes in their wishes for mode of birth and birth outcome, women's satisfaction with the intervention, and their wishes for future births.
METHODS:
The study sample comprised 86 pregnant women with fear of birth and a request for planned cesarean, who were referred for counseling by a psychosocial team at the University Hospital of North Norway in the period 2000-2002. Data were gathered from referral letters, from antenatal and intrapartum care records, and from a follow-up survey conducted 2 to 4 years after the birth in question.
RESULTS:
Fear of birth was accompanied by extensive psychosocial problems in most women. Ninety percent had experienced anxiety or depression, 43 percent had eating disturbances, and 63 percent had been subjected to abuse. Twenty-four percent of those with psychiatric conditions had previously been in treatment. After the intervention, 86 percent changed their original request for cesarean section and were prepared to give birth vaginally. The follow-up survey confirmed long-term satisfaction with having changed their request for a cesarean delivery. Of these, 69 percent gave birth vaginally and 31 percent were delivered by cesarean for obstetrical indications.
CONCLUSIONS:
Impending birth activates previous traumatic experiences, abuse, and psychiatric disorders that may give rise to fear of vaginal birth. When women were referred to a specialist service for fear of birth and request for cesarean, they became conscious of, and to some degree worked through, the causes of their fear, and most preferred vaginal birth. They remained pleased with their choice later.
PMID:
16948722
[PubMed - indexed for MEDLINE]
BJOG. 2006 Jun;113(6):638-46.
Antenatal fear of childbirth and its association with subsequent caesarean section and experience of childbirth.
Waldenström U, Hildingsson I, Ryding EL.
Source
Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden. [email protected]
Abstract
OBJECTIVE:
To investigate the prevalence of fear of childbirth in a nationwide sample and its association with subsequent rates of caesarean section and overall experience of childbirth.
DESIGN:
A prospective study using between-group comparisons.
SETTING:
About 600 antenatal clinics in Sweden.
SAMPLE:
A total of 2,662 women recruited at their first visit to an antenatal clinic during three predetermined weeks spread over 1 year.
METHODS:
Postal questionnaires at 16 weeks of gestation (mean) and 2 months postpartum. Women with fear of childbirth, defined as 'very negative' feelings when thinking about the delivery in second trimester and/or having undergone counselling because of fear of childbirth later in pregnancy, were compared with those in the reference group without these characteristics.
MAIN OUTCOME MEASURES:
Elective and emergency caesarean section and overall childbirth experience.
RESULTS:
In total 97 women (3.6%) had very negative feelings and about half of them subsequently underwent counselling. In addition, 193 women (7.2%) who initially had more positive feelings underwent counselling later in pregnancy. In women who underwent counselling, fear of childbirth was associated with a three to six times higher rate of elective caesarean sections but not with higher rates of emergency caesarean section or negative childbirth experience. Very negative feelings without counselling were not associated with an increased caesarean section rate but were associated with a negative birth experience.
CONCLUSIONS:
At least 10% of pregnant women in Sweden suffer from fear of childbirth. Fear of childbirth in combination with counselling may increase the rate of elective caesarean sections, whereas fear without treatment may have a negative impact on the subsequent experience of childbirth.
Acta Obstet Gynecol Scand. 1993 May;72(4):280-5.
Investigation of 33 women who demanded a cesarean section for personal reasons.
Ryding EL.
Source
Department of Obstetrics and Gynecology, Central Hospital, Helsingborg, Sweden.
Abstract
The purpose of this study was to obtain a better understanding of women who demand a cesarean section when obstetricians do not think it is necessary. Thirty-three pregnant women were interviewed about their reasons for the demand. The 28 parous women referred to previous childbirth experiences and feared mainly for intractable labor pain and for the life and health of the child. The most prevalent fear of the five nulliparae was for vaginal rupture. According to their wishes and prerequisites the women received counselling or short-term psychotherapy by a psychotherapeutically trained obstetrician. At term 14 women chose vaginal delivery and 19 had elective cesareans, three on obstetric indications and 16 at their own choice.
PMID:
8389515
[PubMed - indexed for MEDLINE]