Pregnant women´s views on the timing of prophylactic antibiotics during
caesarean delivery: a qualitative semi-structured interview study
Objective: To gain insight into pregnant women’s preference if given a
choice between getting antibiotic prophylaxis before or after cord
clamping during caesarean delivery. Design: A qualitative
semi-structured interview-study Setting: The interviews were conducted
at a Danish Hospital, with about 4000 births a year. Sample: Fourteen
pregnant women, either considering or having a planned caesarean
section, or scheduled for induction due to post-term gestational age.
Methods: Fourteen individual semi-structured interviews were conducted,
and a systematic text condensation approach was used to analyse the
transcribed interviews. Main Outcome Measures: Patient perspectives.
Results: Ten of the fourteen women favoured antibiotic administration
after cord clamping. Despite any adverse effects to the infant’s
microbiota and increased risk of long-term health outcomes were only
hypothetical and the risk reduction in postpartum infections being well
documented, they did not want to expose their offspring to antibiotics.
Those who preferred antibiotic prophylaxis before cord clamping were
concerned, if they would be able to care for the infant in case of a
maternal infection. Three of the women preferring antibiotics after cord
clamping said they would potentially change preference, if the maternal
risk was higher. Most women preferred to be informed of the use of
prophylactic antibiotic and that the timing has consequences for
trans-placental exposure to the infant. Conclusions: With most of the
interviewed women preferring antibiotic administration after cord
clamping, we suggest patients should be involved in the decision
regarding timing of prophylactic antibiotics before caesarean section.