{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T09:06:39Z","timestamp":1793351199563,"version":"4.5.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T00:00:00Z","timestamp":1648598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019871","name":"Beijing Obstetrics and Gynecology Hospital, Capital Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have found that the rates of cesarean preference were much lower than the actual rates of cesarean births in China. We aimed to observe this inconsistency between preferred and actual modes of delivery and the factors associated with the inconsistency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective cohort study at the maternity hospital with the largest number of deliveries in Beijing. We collected data through a questionnaire applied in the outpatient department, and medical records from the hospital's information system. Unconditional logistic regression was used to identify factors influencing the inconsistency between preferred and actual delivery mode.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The rates of actual cesarean section and of cesarean preference were 41 and 17%, respectively (\u03c7<jats:sup>2<\/jats:sup> = 82.9, <jats:italic>P<\/jats:italic> &amp;lt; 0.0001). The overall inconsistency rate was 31%, with 119 women preferred vaginal delivery but experienced cesarean section, accounting for 67% women undergoing cesarean section. Risk factors for this inconsistency between preferred vaginal delivery and actual cesarean section included: maternal obesity, receiving assisted reproduction, having an abnormal amniotic fluid volume, and fetal distress. Pre-labor rupture of membranes was a unique factor associated with such inconsistency between cesarean section preference and vaginal delivery at delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The inconsistent rate between preferred delivery at late pregnancy and actual delivery is high in China. Further research is needed to understand how to lower cesarean rates in China, taking maternal preferences for vaginal deliveries into account.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.782784","type":"journal-article","created":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T11:07:59Z","timestamp":1648638479000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["The Inconsistency Between Women's Preference and Actual Mode of Delivery in China: Findings From a Prospective Cohort Study"],"prefix":"10.3389","volume":"10","author":[{"given":"Jing","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"P\u00e9rez-Escamilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/S0140-6736(18)31928-7","article-title":"Global epidemiology of use of and disparities in caesarean sections","volume":"392","author":"Boerma","year":"2018","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"5671","DOI":"10.1136\/bmjgh-2021-005671","article-title":"Trends and projections of caesarean section rates: global and regional estimates","volume":"6","author":"Betran","year":"2021","journal-title":"BMJ Glob Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.2147\/IJWH.S41410","article-title":"Cesarean section in the People's Republic of China: current perspectives","volume":"6","author":"Feng","year":"2014","journal-title":"Intern J Womens Health"},{"key":"B4","unstructured":"2019"},{"key":"B5","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1001\/jama.2016.18663","article-title":"Geographic variations and temporal trends in cesarean delivery rates in China, 2008\u20132014","volume":"317","author":"Li","year":"2017","journal-title":"JAMA"},{"key":"B6","doi-asserted-by":"publisher","first-page":"k817","DOI":"10.1136\/bmj.k817","article-title":"Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016: observational study of nearly seven million health facility births","volume":"360","author":"Liang","year":"2018","journal-title":"BMJ"},{"key":"B7","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1111\/1471-0528.13526","article-title":"WHO working group on caesarean section. WHO statement on caesarean section rates","volume":"123","author":"Betran","year":"2016","journal-title":"BJOG"},{"key":"B8","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/s12978-015-0043-6","article-title":"What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies","volume":"12","author":"Betran","year":"2015","journal-title":"Reprod Health"},{"key":"B9","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1111\/1471-0528.13592","article-title":"Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data","volume":"123","author":"Ye","year":"2016","journal-title":"BJOG"},{"key":"B10","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s00404-012-2609-7","article-title":"Cesarean section rate differences by migration indicators","volume":"287","author":"Gagnon","year":"2013","journal-title":"Arch Gynecol Obstet"},{"key":"B11","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.tjog.2014.12.014","article-title":"The changing indications and rates of cesarean section in one academic center over a 16-year period (1997\u20132012)","volume":"55","author":"Lurie","year":"2016","journal-title":"Taiwan J Obstet Gynecol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/AOG.0b013e31821e5f65","article-title":"Indications contributing to the increasing cesarean delivery rate","volume":"118","author":"Barber","year":"2011","journal-title":"Obstet Gynecol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.srhc.2018.04.009","article-title":"Women's preference for caesarean section and the actual mode of delivery - Comparing five sites in Norway","volume":"16","author":"Lindstad L\u00f8v\u00e5smoen","year":"2018","journal-title":"Sex Reprod Healthc"},{"key":"B14","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1186\/s12884-014-0410-2","article-title":"A descriptive analysis of the indications for caesarean section in mainland China","volume":"14","author":"Liu","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"B15","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1186\/s12884-017-1597-9","article-title":"Large reductions in cesarean delivery rates in China: a qualitative study on delivery decision-making in the era of the two-child policy","volume":"17","author":"Wang","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e0186304","DOI":"10.1371\/journal.pone.0186304","article-title":"Reducing the rate of cesarean delivery on maternal request through institutional and policy interventions in Wenzhou, China","volume":"12","author":"Yu","year":"2017","journal-title":"PLoS ONE"},{"key":"B17","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1186\/s12884-020-03398-6","article-title":"Trends in cesarean delivery rates in primipara and the associated factors","volume":"20","author":"Sun","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"B18","doi-asserted-by":"publisher","first-page":"30","DOI":"10.2471\/BLT.11.090399","article-title":"Factors influencing rising caesarean section rates in China between 1988 and 2008","volume":"90","author":"Feng","year":"2012","journal-title":"Bull World Health Organ"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e029757","DOI":"10.1136\/bmjopen-2019-029757","article-title":"Effect of prepregnancy maternal BMI on adverse pregnancy and neonatal outcomes: results from a retrospective cohort study of a multiethnic population in Qatar","volume":"9","author":"Shaukat","year":"2019","journal-title":"BMJ Open"},{"key":"B20","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.ajog.2013.11.021","article-title":"Strength of preference for vaginal birth as a predictor of delivery mode among women who attempt a vaginal delivery","volume":"210","author":"Wu","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1080\/0167482x.2016.1181055","article-title":"Pregnant women's preference for cesarean section and subsequent mode of birth - a six-country cohort study","volume":"37","author":"Ryding","year":"2016","journal-title":"J Psychosom Obstet Gynaecol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e008994","DOI":"10.1136\/bmjopen-2015-008994","article-title":"Factors contributing to the rapid rise of caesarean section: a prospective study of primiparous Chinese women in Shanghai","volume":"5","author":"Ji","year":"2015","journal-title":"BMJ Open"},{"key":"B23","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s12884-016-0897-9","article-title":"Influencing factors associated with the mode of birth among childbearing women in Hunan Province: a cross-sectional study in China","volume":"16","author":"Shi","year":"2016","journal-title":"BMC Pregnancy Childbirth"},{"key":"B24","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1111\/jog.12153","article-title":"Change of childbirth preference after delivery among nulliparous Chinese women and their partners","volume":"40","author":"Li","year":"2014","journal-title":"J Obstet Gynaecol Res"},{"key":"B25","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1177\/0300060517696217","article-title":"Predictors of preference for caesarean delivery among pregnant women in Beijing","volume":"45","author":"Zhang","year":"2017","journal-title":"J Int Med Res"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2540","DOI":"10.2337\/dc14-0243","article-title":"Changes in BMI before and during economic development and subsequent risk of cardiovascular disease and total mortality: a 35-year follow-up study in China","volume":"37","author":"He","year":"2014","journal-title":"Diabetes Care"},{"key":"B27","doi-asserted-by":"publisher","first-page":"3622","DOI":"10.3109\/14767058.2016.1140137","article-title":"Non-medical factors affecting antenatal preferences for delivery route and actual delivery mode of women in southwestern Iran","volume":"29","author":"Rajabi","year":"2016","journal-title":"J Matern Fetal Neonatal Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1055\/s-0035-1549937","article-title":"Caesarean Sections in Beijing, China - Results from a Descriptive Study","volume":"78","author":"Hu","year":"2015","journal-title":"Das Gesundheitswesen"},{"key":"B29","doi-asserted-by":"publisher","first-page":"37168","DOI":"10.1038\/srep37168","article-title":"Association of pre-pregnancy body mass index, gestational weight gain with cesarean section in term deliveries of China","volume":"6","author":"Xiong","year":"2016","journal-title":"Sci Rep"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.2147\/PPA.S171533","article-title":"Women's cesarean section preferences and influencing factors in relation to China's two-child policy: a cross-sectional study","volume":"12","author":"Liang","year":"2018","journal-title":"Patient Prefer Adherence"},{"key":"B31","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1111\/j.1523-536X.2007.00157.x","article-title":"Taiwan's high rate of cesarean births: impacts of national health insurance and fetal gender preference","volume":"34","author":"Liu","year":"2007","journal-title":"Birth"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e1002672","DOI":"10.1371\/journal.pmed.1002672","article-title":"Prevalence of and reasons for women's, family members', and health professionals' preferences for cesarean section in China: a mixed-methods systematic review","volume":"15","author":"Long","year":"2018","journal-title":"PLoS Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1001\/jama.2017.3635","article-title":"Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis","volume":"317","author":"Goldstein","year":"2017","journal-title":"JAMA"},{"key":"B34","doi-asserted-by":"publisher","first-page":"j1","DOI":"10.1136\/bmj.j1","article-title":"Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child","volume":"356","author":"Catalano","year":"2017","journal-title":"BMJ"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/S0140-6736(18)31930-5","article-title":"Short-term and long-term effects of caesarean section on the health of women and children","volume":"392","author":"Boerma","year":"2018","journal-title":"Lancet"},{"key":"B36","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1097\/AOG.0000000000000740","article-title":"Association of isolated polyhydramnios at or beyond 34 weeks of gestation and pregnancy outcome","volume":"125","author":"Aviram","year":"2015","journal-title":"Obstet Gynecol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1803","DOI":"10.1016\/j.ajog.2004.12.062","article-title":"Reevaluation of the relationship between amniotic fluid volume and perinatal outcome","volume":"192","author":"Ott","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1159\/000048013","article-title":"Relationship between meconium staining and amniotic fluid volume in term pregnancies","volume":"17","author":"Blackwell","year":"2002","journal-title":"Fetal Diagn Ther"},{"key":"B39","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.ajog.2011.06.013","article-title":"Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation","volume":"205","author":"Melamed","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1016\/s0140-6736(14)60501-8","volume":"383","year":"2014"},{"key":"B41","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1111\/birt.12231","article-title":"Survey of Obstetric Care and Cesarean Delivery Rates in Shanghai, China Birth","volume":"43","author":"Hellerstein","year":"2016"},{"key":"B42","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1111\/j.1447-0756.2006.00443.x","article-title":"Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: duration of labor and mode of delivery","volume":"32","author":"Park","year":"2006","journal-title":"J Obstet Gynaecol Res"},{"key":"B43","doi-asserted-by":"publisher","first-page":"e575","DOI":"10.5546\/aap.2018.eng.e575","article-title":"Preterm premature rupture of membranes","volume":"116","author":"Meller","year":"2018","journal-title":"Arch Argent Pediatr"},{"key":"B44","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1080\/01443615.2016.1274291","article-title":"Factors affecting the rates of caesarean sections in cases with premature rupture of membranes (PROM) at term","volume":"37","author":"Namli Kalem","year":"2017","journal-title":"J Obstet Gynaecol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.782784\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T11:08:08Z","timestamp":1648638488000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.782784\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,30]]},"references-count":44,"alternative-id":["10.3389\/fpubh.2022.782784"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.782784","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,30]]},"article-number":"782784"}}