Table 2.
Social factors for increased CS.
| Category (Subcategory) | G1 N |
G2 N |
G3 N |
Category (Subcategory) | G1 N |
G2 N |
G3 N |
||
|---|---|---|---|---|---|---|---|---|---|
| Theme 1: Request for CS | Theme 1: Request for CS (continued) | ||||||||
| 1. Fear of vaginal childbirth | 5. Belief CS is safe and more comfortable | ||||||||
| 1.1. | Labor pain | 10 | 7 | 3 | 5.1. | CS can avoid any possible risk of vaginal delivery | 10 | 4 | |
| 1.2. | Unexpected risk for mother and baby | 7 | 1 | 7 | 5.2. | CS is painless than vaginal delivery | 4 | ||
| 1.3. | Episiotomy | 6 | 1 | 5.3. | CS surgery is quick and easy | 3 | 3 | ||
| 1.4. | Suffering for a long period of time | 5 | 2 | 5.4. | CS enables quick physical recovery | 3 | |||
| 1.5. | Negative experience of previous childbirth | 3 | 5.5. | Decision of CS makes mother feel secured | 2 | ||||
| 1.6. | Injection | 3 | 6. Belief child born by CS becomes beautiful and intelligent | ||||||
| 1.7. | Losing control and having a panicky attitude | 2 | 6.1. | Child born by CS is more intelligent than other | 2 | 1 | |||
| 1.8. | Negative attitude towards vacuum or forceps delivery | 1 | 3 | 6.2. | Child born by CS is more beautiful in shape | 1 | 1 | ||
| 2. Lack of self-efficacy for childbirth | 7. Traditional fortune-telling decide auspicious day and time | ||||||||
| 2.1. | Lack of self-confidence with giving birth | 3 | 2 | 7.1. | Belief that baby born in auspicious day and time brings fortune for baby and family | 10 | 7 | 14 | |
| 2.2. | Self-recognition of having a low tolerance with pain | 3 | 7.2. | Wish to avoid giving birth during the period between Western new year holiday and traditional new year holiday | 1 | ||||
| 3. Concern about older age | 8. Preference of receiving CS birth among wealthier family in urban areas. | ||||||||
| 3.1. | Concern about increased risk of complexity | 4 | 8.1. | Child is more regarded as ‘precious’ | 6 | ||||
| 3.2. | Older age is a valid reason for choosing CS | 2 | 8.2. | CS is more preferred among wealthier family | 2 | ||||
| 3.3. | Lack of self-confidence with her strength due to her older age | 2 | 8.3. | CS is more preferred among family living in urban areas. | 2 | ||||
| 8.4. | CS birth is becoming economically affordable | 1 | |||||||
| 4. Belief CS has social advantage | 9. CS varies in hospitals and regions | ||||||||
| 4.1. | CS has advantage of scheduling birth date | 6 | 3 | 9.1. | CS on request is conducted in private settings | 1 | 4 | ||
| 4.2. | CS gives less damage on sexuality | 1 | 1 | 9.2. | CS rate of urban tertiary hospitals is higher than other district hospitals among high risk mothers. | 1 | |||
| 4.3. | CS has advantage for receiving sterilization. | 1 | 9.3. | Misunderstanding that a provincial hospital is ready for CS among some family members. | 1 | ||||
| Theme 2: Mental strain of obstetricians | Theme 3: Decision-making process | ||||||||
| 10. Dilemma of obstetricians pressured by family | 11. A woman and family’s autonomy to decide CS | ||||||||
| 10.1. | Obstetricians sometimes decide CS earlier in order to ensure safety and protect themselves from being accused | 9 | 11.1. | Belief CS is a choice of a mother and her family | 5 | ||||
| 10.2. | Family pressure on obstetricians to suggest CS | 7 | 11.2. | Belief request CS is more acceptable in society | 8 | ||||
| 10.3. | Gray area to judge situations as normal or abnormal in labor childbirth | 4 | 12. CS should be decided by obstetricians | ||||||
| 10.4. | Lack of knowledge about CS among mothers and families | 4 | 12.1. | Disagreement between family and obstetricians for choosing CS. | 2 | ||||
| 10.5. | Informed consent to avoid a conflict between family and obstetricians | 3 | 12.2. | CS decision should be made following guideline by obstetricians | 1 | 2 | |||
| 10.6. | Fear of being claimed by family through social media | 2 | 13. Media has strong impact | ||||||
| 10.7. | Agreement of family is necessary in decision making of CS | 1 | 13.1. | Internet as an efficient tool to collect information | 6 | 3 | |||
| 13.2. | Fear of vaginal childbirth brought by video on the Internet and TV | 3 | 3 | ||||||
| 13.3. | Biased information on the Internet | 1 | |||||||
| 13.4. | Internet is accessible by everyone, however people get different conclusions | 3 | |||||||
| 13.5. | Great effort to capture maximum information through a variety of resources. | 3 | |||||||
| 14. Strongly influenced by family and friends. | |||||||||
| 14.1. | Feeling of confusion listening to opposite perceptions for mode of delivery | 4 | |||||||
| 14.2. | Decision making of CS influenced by relatives and friends | 1 | 7 | ||||||
| 14.3. | Fear of vaginal childbirth brought by other’s story | 1 | |||||||
G 1: pregnant women who wished CS (N = 10), G 2: pregnant women who did not wish CS (N = 19), G 3: healthcare professionals (N = 19), N: Number of participants mentioned about subcategory.