An Evaluation of Patient Satisfaction with Elective Caesarean Section where Tocophobia was the Primary Indication

Abstract

Background: Tocophobia, a severe of pregnancy or childbirth, affects approximately 5.3% of women in Ireland [1]. Often, it manifests as an intense fear of harm to the mother or the baby during labour. Caesarean section (CS), particularly when unplanned, is often associated with lower birth satisfaction [2], but it is unclear whether this applies to women choosing elective CS due to tocophobia. This research sought to assess maternal satisfaction following elective CS where tocophobia was the primary indication.

Methods: This cross-sectional study included primiparous women who underwent elective CS at Cork University Maternity Hospital (2021-2023) for tocophobia. Eligible participants were identified from theatre logbooks. After applying inclusion and exclusion criteria, those who consented received the questionnaire by email. The Birth Satisfaction Scale-Revised (BSS-R), a validated questionnaire assessing birth satisfaction across stress, maternal attributes, and quality of care, was used. Quantitative data were analysed descriptively. Qualitative free-text comments were analysed thematically.

Results: Of 3,478 nulliparous CS during the study period, 48 were performed for tocophobia. Fifteen women completed the survey. The median BSS-R score was 31 out of 40 (range: 26-39), suggesting high satisfaction overall. Thematic analysis highlighted themes of communication, emotional response, and quality of support.

Conclusion: Women undergoing elective CS for tocophobia reported high birth satisfaction, supporting evidence that preference aligned birth is associated with improved satisfaction. These findings support an individualised approach to birthing options. Larger studies are needed to validate these results and inform patient care.