Views of women towards cesarean

We read with interest the article of Lulu A. Al-Nuaim.1 The author, however, did not refer to our study regarding women’s perceptions and experiences of childbirth in the United Arab Emirates (UAE)2 despite the claim of reviewing recent international studies. Our study was a cross-sectional survey of a consecutive sample of 715 multi-ethnic mothers who delivered during 3 months in Al-Ain Hospital, Al-Ain, UAE in 2001. Subjects were interviewed on the third postnatal day regarding their experience and satisfaction with childbirth using a structured questionnaire. Women delivered by cesarean (n=104, 14.5%) were significantly less satisfied with the information provided by their caregivers and their involvement in decision-making before the operation than the vaginal group (p=0.001). Adverse maternal experiences and negative feelings such as fear, anger, sorrow and regret, guilt, jealousy, sense of failure and disappointment were furthermore significantly more observed with cesarean delivery (p=0.00001). Irrespective of mode of delivery, most participants strongly agreed that cesarean delivery is worse than vaginal delivery whatever the reason and should be performed only for medical reasons. Given the similar socio-cultural, geo-demographic and reproductive characteristics of the 2 study populations, we conclude that women’s impression regarding cesarean birth as a painless and safer alternative to vaginal birth does not, fortunately, seem to prevail in the Gulf region unlike other developing countries.3 Childbirth experience and prevalence and correlates of post-cesarean psychosocial morbidity in UAE were not different from those observed elsewhere.4 Our findings were also similar to the preliminary data reported by Lulu A. Al-Nuaim in Saudi Arabian women. As we have pledged for more local and regional studies in the fields of reproductive health and maternal psychology to complement our results, the final report of the current Saudi Arabian study regarding women’s views towards cesarean birth is awaited with interest.