Mothers undergoing cesarean delivery may experience later skin-to-skin contact, greater difficulty breastfeeding, and decreased satisfaction than mothers delivering vaginally. Mimicking a vaginal delivery, the family-centered cesarean section (FCS) allows a mother to watch the birth through a lowered or clear surgical drape and receive her baby immediately after delivery. We sought to document previously-unknown FCS utilization patterns through a nationwide survey.METHODS:
Our survey targeted providers who deliver in US hospitals. Using a publicly-available sampling frame of 1,031 hospitals and a regionally-stratified two-stage random sampling design, we post-mailed invitations containing the web address of our anonymous 19-item online questionnaire to 2,324 providers at 250 hospitals. Patterns in awareness and use of FCS across provider, patient-population, and healthcare-setting characteristics were examined.RESULTS:
Survey respondents (n=130) were geographically distributed and suggested broadly-dispersed awareness/use of FCS, with 87% (105/121) reporting awareness, 58% (65/121) reporting facility use, and 55% (64/116) reporting personal observation/performance. Overall, 81% (94/116) of providers recommended future use, 65% (34/52) in those who had not experienced FCS and 94% (60/64) in those who previously performed/observed FCS. In facilities having performed FCS, 60% (38/63) of providers reported that ≤20% of all cesarean sections were FCSs. In facilities without prior FCS use, 27% (15/56) of providers reported facility consideration of future use. Awareness and use of FCS also differed regionally and showed strong associations with provider demographics and credentials, patient socioeconomic characteristics, and facility size.CONCLUSION:
Despite reporting moderate use of FCS, providers nationally suggest high levels of awareness and strong desire for future use.