• Annika Karlström, Astrid Nystedt, and Ingegerd Hildingsson.
• Mid Sweden Research and Development Centre, Västernorrland County Council, Sundsvall SE-851 86, Sweden. annika.karlstrom@miun.se
• Sex Reprod Healthc. 2011 Aug 1;2(3):93-9.

ObjectiveThe aim of this study was to compare experiences and feelings during pregnancy and childbirth in women who preferred caesarean section during pregnancy and were delivered by a planned caesarean section, and women who preferred to give birth vaginally and actually had a spontaneous vaginal birth.DesignLongitudinal cohort study where 693 women participated, 420 of whom were multiparas.MethodsData were collected from questionnaires distributed to women during pregnancy and two months postpartum in a Mid Sweden county.ResultsWomen who preferred and actually were delivered by caesarean section experienced a fear of childbirth to a higher degree as compared to women with a vaginal birth. Despite a fulfilled request, women who had a caesarean section were not pleased with the decision making process. In addition, women who had a caesarean section on request were less satisfied with antenatal care and had a more negative birth experience, which made them doubt whether they would have more children.ConclusionsThis study shows that a fulfilled request on mode of birth does not guarantee a positive birth experience. Antenatal information of all aspects of a caesarean section is vital for women who consider caesarean section where no medical indication is present. More research is needed about the decision making process regarding caesarean section on maternal request. Childbirth related fear is a common reason to request a caesarean birth. More knowledge about how women reason about caesarean section is required, and treatment related to fear of birth needs to be developed.Copyright © 2011 Elsevier B.V. All rights reserved.

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