Factors associated with vaginal/cesarean birth attitudes among medical students
More details
Hide details
Department of Obstetrical and Gynecological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland
Publication date: 2023-10-24
Corresponding author
Anna Michalik   

Department of Obstetrical and Gynecological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland
Eur J Midwifery 2023;7(Supplement 1):A99
The use of cesarean section (CS) is increasing worldwide, with a current global rate of 21.1%. Researchers estimate the continuation of this tendency across all global regions1,2. Access to safe cesarean delivery represents a fundamental aspect of modern perinatal care. CS can effectively prevent maternal and perinatal mortality and morbidity. However, the distribution of CS across different populations does not meet all the recommendations, and medically justified, unmet needs coexist with overuse of the procedure2-4. The increasing number of CS cases constitutes one of the most frequently discussed topics in perinatal care worldwide, particularly as it applies to pregnant women from groups at low risk from vaginal birth (VB)-related complications. As with any surgery, CS is associated with short- and long-term complications that can extend many years beyond the delivery at hand, potentially affecting the health of the woman, her child, and future pregnancies. Addressing in detail the potential risks and benefits associated with CS procedures is vital and of particular importance for those situations in which CS is not indicated for the benefit of the neonate5,6. The objective of this study was to identify medical students’ opinions and attitudes concerning vaginal birth and cesarean birth. We posit that these attitudes reflect theoretical and practical education on perinatal care and can help identify areas for modification.

Material and Methods:
This cross-sectional study, which included 748 Polish medical students, aimed to identify medical students’ attitudes regarding birth methods. A descriptive questionnaire was distributed via the academic email addresses of surveyed medical students. Group comparisons were performed using Welch’s t-test for continuous data or a Chi-squared test for categorical data. We also used the Mann–Whitney U test and Kruskal–Wallis H test.

Midwifery students (96.2%) were the most unified group of students, with most agreeing that VB (vaginal birth) presents a safer option for women at low risk for VB-related complications vs. cesarean section. Of Medical Faculty students, 68% believed that fewer complications typically occur during vaginal birth than during CS. Students in their final vs. initial years of study furthermore considered VB more beneficial for women than CS.

An important factor identified at the individual clinician level is the presence of leadership and executive support. For medical students, we can interpret this as support from their trainers and supervisors.

The authors have no conflicts of interest to disclose.
This research received no external funding.
Betrán AP, Temmerman M, Kingdon C, et al. Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet. 2018;392(10155):1358-1368. doi:10.1016/S0140-6736(18)31927-5
Betran AP, Ye J, Moller AB, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021;6(6):e005671. doi:10.1136/bmjgh-2021-005671
Betran AP, Torloni MR, Zhang J, et al. What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. Reprod Health. 2015;12:57. doi:10.1186/s12978-015-0043-6
Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM; WHO Working Group on Caesarean Section. WHO Statement on Caesarean Section Rates. BJOG. 2016;123(5):667-670. doi:10.1111/1471-0528.13526
Pallasmaa N, Ekblad U, Aitokallio-Tallberg A, et al. Cesarean delivery in Finland: maternal complications and obstetric risk factors. Acta Obstet Gynecol Scand. 2010;89(7):896-902. doi:10.3109/00016349.2010.487893
Coates D, Thirukumar P, Henry A. Women's experiences and satisfaction with having a cesarean birth: An integrative review. Birth. 2020;47(2):169-182. doi:10.1111/birt.12478