• I Wiklund, G Edman, E-L Ryding, and E Andolf.
• Division of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden. ingela.wiklund@bb.ptj.se
• BJOG. 2008 Feb 1;115(3):324-31.

ObjectiveThe aim of this study was to examine the expectations and experiences in women undergoing a caesarean section on maternal request and compare these with women undergoing caesarean section with breech presentation as the indication and women who intended to have vaginal delivery acting as a control group. A second aim was to study whether assisted delivery and emergency caesarean section in the control group affected the birth experience.DesignA prospective group-comparison cohort study.SettingDanderyd Hospital, Stockholm, Sweden.SampleFirst-time mothers (n= 496) were recruited to the study in week 37-39 of gestation and follow up was carried out 3 months after delivery. Comparisons were made between 'caesarean section on maternal request', 'caesarean section due to breech presentation' and 'controls planning a vaginal delivery'.MethodsThe instrument used was the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ).Main Outcome MeasuresExpectations prior to delivery and experiences at 3 months after birth.ResultsMothers requesting a caesarean section had more negative expectations of a vaginal delivery (P < 0.001) and 43.4% in this group showed a clinically significant fear of delivery. Mothers in the two groups expecting a vaginal delivery, but having an emergency caesarean section or an assisted vaginal delivery had more negative experiences of childbirth (P < 0.001).ConclusionsWomen requesting caesarean section did not always suffer from clinically significant fear of childbirth. The finding that women subjected to complicated deliveries had a negative birth experience emphasises the importance of postnatal support.

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