Evaluating Patients’ Choice of General and Spinal Anesthesia for Elective Cesarean Sections and Related Factors

Abstract

Background: Cesarean delivery rates are rising globally, and anesthesia selection is a key determinant of maternal comfort, safety, and neonatal outcomes. In elective cesarean delivery, patient preference may influence the choice between general and spinal anesthesia and may reflect fear-driven misconceptions. Objective: To evaluate women’s preferences for general versus spinal anesthesia for elective cesarean delivery and assess socio-demographic associations with anesthesia choice. Methods: A cross-sectional observational study was conducted at Women’s Christian Hospital, Multan, Pakistan, from May to August 2025. Women admitted for elective cesarean delivery were recruited using non-probability purposive sampling. A structured questionnaire assessed anesthesia preference and belief-based factors. Data were analyzed using SPSS version 30.0 with descriptive statistics and chi-square testing. Results: Among 117 participants, 104 (88.9%) preferred spinal anesthesia and 13 (11.1%) preferred general anesthesia. In the general-anesthesia group, fear of back pain (100%) and fear of needles in the back (76.9%) were most common. Among women preferring spinal anesthesia, fear of postoperative pain (92.3%), nausea/vomiting (87.5%), and not waking up (85.6%) were frequently endorsed. No significant associations were observed between anesthesia preference and residence (p=0.922), education (p=0.339), or occupation (p=0.107). Conclusion: Spinal anesthesia was strongly preferred for elective cesarean delivery, and preference patterns were largely fear-driven, supporting the need for structured counseling to address misconceptions and optimize informed decision-making.