To C or not to C: do body image concerns affect birthing preferences?

Cesarean section is currently the most frequently performed major surgery undergone by females internationally. This has raised many concerns due to the associated risks of increased maternal and neonatal mortality and morbidity, and financial costs involved. While some cesarean section births are undertaken for lifesaving reasons others may not be. Although body scarring has been linked to negative body image perceptions, no research has been undertaken exploring women’s body image concerns related to cesarean scarring. Aims: The aim of this study was to determine whether body image concerns might influence a woman’s preference for elective cesarean birth in an uncomplicated pregnancy. We tested whether exposure to images of vaginal or cesarean section birth, and physical scars (some related to cesarean section and others more general) affect birth preferences. Also, we investigated whether the accuracy, adequacy, and source of women’s knowledge reportedly relied upon for birthing choices was predictive of their birth preferences. Lastly we explored the relationship between body image concerns and birthing preferences. Method: Female participants over 18 years were recruited via email distribution lists and social media. Demographic details and birthing history details were collected. Current emotional state was assessed using the Positive and Negative Affect Scale (PANAS). A questionnaire regarding the factors that influenced birthing decisions, and a Body Image and Attractiveness Scale were completed. Participants were then asked to rate their emotional response to images of birthing modalities and scarring. A preferred birthing modality scale was completed before and after viewing the images. Results: It is hypothesised that body image concerns related to cesarean scarring might negatively affect attitudes towards elective cesarean delivery.