Expectant parents' preferences for mode of delivery and trade-offs of outcomes for breech presentation

Marjolein Kok*, Lonneke Gravendeel, Brent C. Opmeer, Joris A.M. van der Post, Ben W.J. Mol

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Objective: To assess patients' preferences and trade-offs for mode of delivery in case of breech presentation at term. Methods: Eighty women (40 with a foetus in breech presentation and 40 with a foetus in cephalic presentation) with a gestational age from 36 weeks onwards were offered scenarios of vaginal and caesarean breech delivery in which 1-month and 2-year neonatal and maternal complication rates were varied; expectant fathers (when present) were interviewed separately. Thresholds for complication rates where patients switch preferences were visualised graphically in trade-off curves. Differences in preference thresholds were tested using the Wilcoxon signed ranks test. Results: Caesarean delivery was the preferred mode of delivery for breech presentation in 65% of the patients interviewed. The trade-off questions showed that the 2-year neonatal outcome after breech delivery was the most important outcome for the mothers, whereas the fathers were more influenced by the maternal outcome. Conclusion: When realistic assumptions for complications are made, most women prefer a caesarean delivery over vaginal delivery for at term breech presentation. In the balance of pros and cons, 2-year neonatal outcome is the most important factor in the decision between caesarean and vaginal delivery. Practice implications: The results of this study can be used by the clinician to help patients weigh risk, benefit, and potential harm with regard to breech delivery.

Original languageEnglish
Pages (from-to)305-310
Number of pages6
JournalPatient Education and Counseling
Volume72
Issue number2
DOIs
Publication statusPublished - 1 Aug 2008

Keywords

  • Breech delivery
  • Breech presentation
  • Preference

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