Maternal Perceptions of Cesarean Delivery Care: A Qualitative Study to inform ERAS Guideline Development
Bibliographic record
Abstract
Abstract INTRODUCTION: Cesarean delivery (CD) is the most common inpatient surgical procedure; however, there are no internationally-accepted, standardized clinical guidelines. The Enhanced Recovery After Surgery (ERAS®) program aims to improve outcomes through the development of international guidelines (IG). The purpose of this study is to obtain and consolidate women’s experiences with CD to inform the development of an ERAS international guideline (IG). METHODS: Qualitative methods were used to assess the patient experience with current evidence-based CD protocols across operative phases. Twelve women who experienced CD were interviewed using an open-ended, semi-structured interview guide at six-weeks post-partum. Two researchers coded the emerging themes separately and compared findings. RESULTS: Women described feeling informed, but felt they did not have a choice. Pre-surgery, women wanted more information about the risks of CD. Pre-operatively, women expressed confusion with the procedures, but felt informed about local anaesthesia and thermoregulation. Post-CD, women felt informed about pain and nausea control; however, urinary catheter removal was delayed when compared to the ERAS recommendations. Information about post-partum infant care was not well communicated, as many women were uninformed about delayed cord-clamping and infant thermoregulation. DISCUSSION: This qualitative study provides opportunities to improve communication, the patient-provider relationship, and the overall satisfaction throughout the CD process. The findings support the implementation of patient decision aids and training with the shared decision model. The improved procedures recommended in the ERAS IG for CD have the potential to deliver significant improvements to patient satisfaction, mother-infant bonding and mental wellness.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.004 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".