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. Funding: None.