Few women want a second elective cesarean.(Obstetrics)

PRAGUE -- Very few women in their first pregnancy appear to request an elective cesarean section but when they do, few would do it again, according to a study of nearly 400 German and U.S. women presented at the 20th European Congress of Perinatal Medicine.

In a prospective study of maternal preferences for birth, questionnaires were completed by 55 of 64 American and 342 of 366 German women.

All of the women were primigravid with singleton pregnancies and in good health when they completed questionnaires in the third trimester and 8-12 weeks after their pregnancy, Dr. Beate Schucking reported.

In 2005, the 29% rate of cesarean section in Germany closely mirrored that of the United States, said Dr. Schucking of the University of Osnabruck (Germany).

In the third trimester, nearly all U.S. (95%) and German (96%) women said that they preferred vaginal delivery. The women reported that they believed a vaginal birth would offer more security, an easier recovery, and less pain and injury than would a cesarean section.

Three of the 55 women in the United States were indecisive about which method they preferred. The 13 German women who preferred a C-section said they wanted the surgical procedure because of anxiety, and they wanted to avoid pain and injuries, to have security for their baby, and to deliver a breech-positioned fetus safely.

Unlike the women who decided that they wanted a vaginal delivery early in their pregnancy, the women who preferred a C-section were indecisive about which method they preferred until the end of their pregnancy.