The accuracy of predicting parity as a prerequisite for cesarean delivery on maternal request

OBJECTIVE: The National Institutes of Health and American College of Obstetricians and Gynecologists consensus guidelines state that cesarean delivery on maternal request is not recommended for women desiring several children. We sought to estimate the accuracy with which women were able to predict their final parity. METHODS: Women (N=1,719) completed an Internet survey regarding childbearing. Parous women finished with childbearing recalled the maximum number of children they planned to give birth to while pregnant with their first child. This estimate was compared with their final parity. RESULTS: Of the women who completed the survey, 458 women planned a maximum of two or fewer children and had completed childbearing. Correlation between planned maximum number of children and actual parity was poor (r=0.04, 95% confidence interval 0.00-0.13). In fact, 39% (95% confidence interval 34-43%) underestimated their final parity. CONCLUSION: At the time of first pregnancy, many women underestimate their final parity. This raises questions about making an estimate of parity a consideration for offering cesarean delivery on maternal request. LEVEL OF EVIDENCE: III.

Citation (view)