Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries - Archive ouverte HAL Access content directly
Journal Articles PLOS Global Public Health Year : 2022

Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries

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Alexandre Dumont
Myriam de Loenzien
  • Function : Author
Hung Mac Quo Nhu
  • Function : Author
Marylène Dugas
  • Function : Author
Charles Kabore
  • Function : Author
Pisake Lumbiganon
  • Function : Author
Maria Regina Torloni
  • Function : Author
Celina Gialdini
  • Function : Author
Guillermo Carroli
  • Function : Author
Claudia Hanson
  • Function : Author
Ana Pilar Betrán
  • Function : Author

Abstract

Women's fear and uncertainty about vaginal delivery and lack of empowerment in decisionmaking generate decision conflict and is one of the main determinants of high caesarean section rates in low-and middle-income countries (LMICs). This study aims to develop a decision analysis tool (DAT) to help pregnant women make an informed choice about the planned mode of delivery and to evaluate its acceptability in Vietnam, Thailand, Argentina, and Burkina Faso. The DAT targets low-risk pregnant women with a healthy, singleton foetus, without any medical or obstetric disorder, no previous caesarean scarring, and eligibility for labour trials. We conducted a systematic review to determine the short-and long-term maternal and offspring risks and benefits of planned caesarean section compared to planned vaginal delivery. We carried out individual interviews and focus group discussions with key informants to capture informational needs for decision-making, and to assess the acceptability of the DAT in participating hospitals. The DAT meets 20 of the 22 Patient Decision Aid Standards for decision support. It includes low-to moderate-certainty evidencebased information on the risks and benefits of both modes of birth, and helps pregnant women clarify their personal values. It has been well accepted by women and health care providers. Adaptations have been made in each country to fit the context and to facilitate its implementation in current practice, including the development of an App. DAT is a simple method to improve communication and facilitate shared decision-making for planned modes PLOS GLOBAL PUBLIC HEALTH
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Dates and versions

ird-03889056 , version 1 (07-12-2022)

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Alexandre Dumont, Myriam de Loenzien, Hung Mac Quo Nhu, Marylène Dugas, Charles Kabore, et al.. Caesarean section or vaginal delivery for low-risk pregnancy? Helping women make an informed choice in low- and middle-income countries. PLOS Global Public Health, 2022, 2, ⟨10.1371/journal.pgph.0001264⟩. ⟨ird-03889056⟩
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