Der selbst-initiierte Kaiserschnitt. Angst und Autonomie im Kontext von Medikalisierung und Nutzerorientierung.

Over the last few years, there has been an increase in the number of women preferring to deliver by caesarean section. This study focuses on three main issues: reasons for this preference, context of decision-making, and needs concerning antenatal and obstetrical care in primiparous women requesting a caesarean section in the absence of a medical indication. An explorative approach was used, applying qualitative methods. Eighteen women were interviewed (semi-structured). Data analysis was carried out following the method of grounded theory. All of the women interviewed express strong concerns regarding their physical and foremost their psychological integrity in connection with vaginal delivery. The decision for a caesarean delivery is made before or at an early stage of pregnancy largely separate from the dialogue with health-care professionals. Women´s health-care needs comprise acceptance, freedom of decision, information and safeness. In conclusion, appropriate antenatal care should involve the assessment of women´s mental status and offer care structures that enable women to develop a trusting relationship to health-care professionals.