PURPOSE: to find out the preference in regard to the way of delivery among primigravidae, as well as the reasons for their choice, in order to improve the quality of the doctor-patient relationship. METHODS: a qualitative-type study was conducted through analysis of the collective subject, including primigravidae attended from September to November 2003 at the emergency rooms of the hospital of the "Faculdade de Medicina de Jundiaí". A questionnaire, specially developed to accomplish the proposed objectives was applied. An informed and free consent, signed by the pregnant woman and one of the researchers in charge was obtained. This questionnaire was based on doubts of patients attended at this hospital some months before the trial. For the purpose of sample standardization, the patients' selection followed some inclusion criteria: age above 16, primigravidae that were receiving prenatal assistance and a post-informed and free consent. Mental disorders and clinical and/or obstetric pathologies that could interfere in the patient's choice were considered exclusion criteria. RESULTS: the studied population had as prevailing profile women in the third quarter of gestation, above 21 years of age, white, married and with completed school. Most of the women (90%) preferred vaginal delivery for the following main reasons: ease to be done (94%) and the fear of suffering and pain during the postpartum period caused by cesarean section. There was a relationship between older and married women and the preference for vaginal delivery, with no significant difference between races. CONCLUSION: these results show an enormous contrast between women's preference and the high cesarean section rates in Brazil. We conclude that there may be a lack of information and dialogue between the health professionals and patients about the possible difficulties, doubts and anxieties that involve the women's choice for a specific way of delivery. From an ethical point of view, we conclude that obstetricians should question every cesarean section indication and take into account the women's right to choose, without ignoring clinical criteria, when making the medical decision about the way of delivery.
Way of delivery; Primigravid; Normal pregnancy; Normal delivery; Cesarean section
