What factors affect women's preferences for the mode of birth? A cross-sectional quantitative study based on the generalized resistance resources framework of salutogenesis.

BACKGROUND: With evolving reproductive policies and socioeconomic development in China, women's birth preferences and influencing factors have changed. Guided by the theory of salutogenesis, this study aimed to identify characteristics associated with different delivery preferences and to explore influencing factors, providing evidence to support the development of midwifery clinics. METHODS: In this cross-sectional study, 462 mothers were recruited from the postnatal ward of a tertiary maternal and child health hospital between January and April 2025. The participants completed structured questionnaires on the basis of the generalized resistance resources framework of salutogenesis. RESULTS: Binary logistic regression analysis revealed that key factors within the generalized resistance resources framework significantly influenced women's preferences for the mode of delivery. Physiological: Women with two (OR = 4.936, 95% CI: 1.788-13.629) or three or more prior pregnancies (OR = 7.316, 95% CI: 2.326-23.008) or a history of cesarean birth (OR = 6.923, 95% CI: 2.029-23.623) were more likely to prefer cesarean birth; those with a history of vaginal birth preferred vaginal birth (OR = 0.084, 95% CI: 0.030-0.237). Emotional: Emotional instability reduced the preference for cesarean section (OR = 0.737, 95% CI: 0.575-0.945). Interpersonal-relational: Spousal support for vaginal birth (OR = 0.059, 95% CI: 0.012-0.292) or a lack of explicit advice (OR = 0.207, 95% CI: 0.054-0.792) reduced cesarean preference. CONCLUSIONS: At the current stage, childbirth preferences among pregnant women are shifting. Personalized prenatal education combined with partner involvement serves as a key strategy for maternal health interventions, while focusing on individual psychological characteristics and social support structures can effectively enhance pregnant women's confidence in vaginal birth.