Women’s cesarean section preferences and influencing factors in relation to China’s two-child policy: a cross-sectional study

Figures & data

Table 1 Demographic characteristics of pregnant women by mode of delivery preference

Characteristics	VB (N=939) n (%)	CS (N=103) n (%)	No clear preference (N=127) n (%)	P-value
Age (years)				>0.001
Under 40	922 (98.2)	92 (89.3)	124 (97.6)
40 and above	17 (1.8)	11 (10.7)	3 (2.4)
Ethnicity				0.007
Han	768 (81.8)	71 (68.9)	103 (81.1)
Minority	171 (18.2)	32 (31.1)	24 (18.9)
Marital status				0.209
Unmarried	25 (2.7)	3 (2.9)	7 (5.5)
Married	914 (97.3)	100 (97.1)	120 (94.5)
Education				0.467
High school and below	179 (19.1)	25 (24.3)	32 (25.2)
Junior college	304 (32.4)	34 (33.0)	42 (33.1)
Bachelors	368 (39.2)	33 (32.0)	41 (32.3)
Masters and above	88 (9.4)	11 (10.7)	12 (9.4)
Annual household income				0.444
<50,000 RMB	221 (23.5)	33 (32.0)	32 (25.2)
50,000–100,000 RMB	469 (49.9)	46 (44.7)	61 (48.0)
>100,000 RMB	249 (26.5)	24 (23.3)	34 (26.8)
Occupation				0.793
Public servant	208 (22.2)	25 (24.3)	33 (26.0)
Enterprise staff	274 (29.2)	21 (20.4)	29 (22.8)
Private business owner	161 (17.1)	20 (19.4)	22 (17.3)
Farmer and laborer	31 (3.3)	3 (2.9)	5 (3.9)
Unemployed	192 (20.4)	26 (25.2)	27 (21.3)
Other	73 (7.8)	8 (7.8)	11 (8.7)
Living environment				0.628
Urban	530 (56.4)	63 (61.2)	74 (58.3)
Rural	409 (43.6)	40 (38.8)	53 (41.7)

Abbreviations: VB, vaginal birth; CS, cesarean section.

Table 2 Prenatal and family characteristics of pregnant women by mode of delivery preference

Characteristics	VB (N=939) n (%)	CS (N=103) n (%)	No clear preference (N=127) n (%)	P-value
Parity				0.171
Nulliparous	741 (78.9)	80 (77.7)	109 (85.8)
Multiparous	198 (21.1)	23 (22.3)	18 (14.2)
Gravidity				0.263
1st pregnancy	657 (70.0)	67 (65.0)	91 (71.7)
2nd pregnancy	205 (21.8)	21 (20.4)	27 (21.3)
3rd and above	77 (8.2)	15 (14.6)	9 (7.1)
Gestational age				0.662
28–36 weeks	586 (62.4)	66 (64.1)	87 (68.5)
37–38 weeks	208 (22.2)	21 (20.4)	26 (20.5)
≥ 39 weeks	145 (15.4)	16 (15.5)	14 (11.0)
History of abortion				0.253
No	788 (83.9)	80 (77.7)	104 (81.9)
Yes	151 (16.1)	23 (22.3)	23 (18.1)
Self-evaluated difficulty in getting pregnant				<0.001
Easy	540 (57.5)	48 (46.6)	60 (47.2)
Normal	297 (31.6)	28 (27.2)	44 (34.6)
Difficult	102 (10.9)	27 (26.2)	23 (18.1)
Doctor’s suggestion				0.003
VB	106 (11.3)	7 (6.8)	8 (6.3)
CS	9 (1.0)	5 (4.9)	4 (3.1)
No clear suggestion	824 (87.8)	91 (88.3)	115 (90.6)
Husband’s preference toward CS				<0.001
No	909 (96.8)	70 (68.0)	119 (93.7)
Yes	30 (3.2)	33 (32.0)	8 (6.3)
Only-child family				0.682
No	599 (63.8)	69 (67.0)	78 (61.4)
Yes	340 (36.2)	34 (33.0)	49 (38.6)
Ideal children number				<0.001
0 or 1	253 (26.9)	49 (47.6)	44 (34.6)
2 or more	686 (73.1)	54 (52.4)	83 (65.4)
Choosing lucky day for delivery				<0.001
No	910 (96.9)	67 (65.0)	114 (89.8)
Yes	29 (3.1)	36 (35.0)	13 (10.2)

Abbreviations: VB, vaginal birth; CS, cesarean section.

Table 3 Multinomial logistic regression for the preference of delivery mode (reference group of outcome variable=VB)

	CS	No clear preference
	Adjusted RRR (95% CI)	Adjusted RRR (95% CI)
Age (years)
Under 40	Ref	Ref
40 and above	4.21 (1.43–12.40)**	1.78 (0.49–6.49)
Ethnicity
Han	Ref	Ref
Minority	2.00 (1.17–3.41)*	0.98 (0.60–1.59)
Parity
Nulliparous	Ref	Ref
Multiparous	1.34 (0.71–2.52)	0.63 (0.36–1.10)
Self-evaluated difficulty in getting pregnant
Easy	Ref	Ref
Normal	0.98 (0.56–1.70)	1.33 (0.87–2.03)
Difficult	2.23 (1.20–4.13)*	1.97 (1.16–3.77)*
Doctor’s suggestion
VB	Ref	Ref
CS	5.23 (0.99–27.45)	5.44 (1.31–22.69)*
No clear suggestion	1.82 (0.73 –4.50)	1.89 (0.89–4.02)
Husband’s preference toward CS
No	Ref	Ref
Yes	7.62 (4.00–14.54)***	1.65 (0.72–3.77)
Ideal children number
0 or 1	Ref	Ref
2 or more	0.37 (0.22–0.61)***	0.73 (0.48–1.09)
Choosing lucky day for delivery
No	Ref	Ref
Yes	12.36 (6.62–23.08)***	3.22 (1.60–6.50)**

Notes:

*** P<0.001,

** P<0.01,

* P<0.05.

Abbreviations: VB, vaginal birth; CS, cesarean section; Ref, reference group of predictors; RRR, relative risk ratio.

Table 4 Ranking of main reasons for delivery mode preference among 103 women preferring CS

Ranking	Reasons	N	%
1	CS is safer than VB	53	51.5
2	CS is less pain than VB	42	40.8
3	CS is better for baby’s health than VB	25	24.3
4	CS is better for women’s health than VB	23	22.3
5	CS is better for couple’s life than VB	9	8.7
6	CS is of lower cost than VB	6	5.8
7	Other reasons	6	5.8

Note: Women were asked to choose at most three important reasons for their preference of delivery mode.

Abbreviations: VB, vaginal birth; CS, cesarean section.