Class III Obese Women's Preferences and Concerns for Cesarean Skin Incision: A Multicenter Survey

Marcela C. Smid, Rodney K. Edwards, Joseph R. Biggio, Karen Dorman, Rachel C. Leduke, Laurie L. Lesher, Tracy A. Manuck, George R. Saade, Ashley E. Salazar, David M. Stamilio, Alison M. Stuebe, Alan T.N. Tita, Caroline M. Torres, Michael W. Varner, Ronald J. Wapner

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective This study aims to assess class III obese women's preferences and concerns regarding cesarean delivery (CD) skin incisions. Study Design Through the National Perinatal Research Consortium (NPRC), women with body mass index ≥ 40 kg/m2 at the time of enrollment completed an anonymous survey in English or Spanish. We evaluated seven domains of preferences and concerns about the cesarean skin incision. Results We surveyed 546 women at five NPRC sites. Median age (interquartile range) was 29 (25, 35) years; 364 (66%) were parous and 161 (30%) had a prior CD. Women self-identified race/ethnicity as White (31%), non-Hispanic Black (31%), Hispanic (31%), other (6%), and not reported (1%). A total of 542 women (99%) rated both delivering the baby in the best possible condition and decreasing incision opening/infection risk as important. Women were less likely to rate other domains as important (all p < 0.001), including: having least pain possible, n = 521 (95%); decreasing the risk of complications in the next pregnancy, n = 490 (90%); decreasing interference with breastfeeding, n = 474 (87%); decreasing operative time, n = 388 (71%); and having the least visible incision, n = 369 (68%). Conclusion Women with class III obesity prioritize immediate maternal and fetal safety regarding CD skin incision over other concerns including cosmetic outcome.

Original languageEnglish (US)
Pages (from-to)289-294
Number of pages6
JournalAmerican Journal of Perinatology
Issue number3
StatePublished - Feb 1 2017


  • cesarean delivery
  • obesity
  • patient preference
  • survey

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology


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