Protocol - Mode of Delivery - Interview

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A woman who gave birth is asked several questions about how the baby was delivered.

Specific Instructions:

The maternal interview should be administered if the obstetric medical record (Mode of Delivery ¿ Medical Record Abstraction protocol) with information about the delivery is unavailable. The maternal interview may yield inaccurate information due to potential recall bias. Information from the maternal interview may supplement the information in the medical record.


1. Before you had your new baby, did you ever have a baby by cesarean delivery or c-section (when a doctor cuts through the mother’s belly to bring out the baby)?

[ ] 1 No

[ ] 2 Yes

2. How was your new baby delivered?

[ ] Vaginally (if yes, then skip to question 5)

[ ] Cesarean delivery (c-section)

3. Which statement best describes whose idea it was for you to have a cesarean delivery (c-section)?

Check ONE answer

[ ] My health care provider recommended a cesarean delivery before I went into labor

[ ] My health care provider recommended a cesarean delivery while I was in labor

[ ] I asked for the cesarean delivery

4. What was the reason that your new baby was born by cesarean delivery (c-section)? Check ALL that apply

[ ] I had a previous cesarean delivery (c-section)

[ ] My baby was in the wrong position (such as breech)

[ ] I was past my due date

[ ] My health care provider worried that my baby was too big

[ ] I had a medical condition that made labor dangerous for me (such as heart condition, physical disability)

[ ] I had a complication in my pregnancy (such as preeclampsia, placental problems, infection, preterm labor)

[ ] My health care provider tried to induce my labor, but it didn’t work

[ ] Labor was taking too long

[ ] The fetal monitor showed that my baby was having problems before or during labor (fetal distress)

[ ] I wanted to schedule my delivery

[ ] I didn’t want to have my baby vaginally

[ ] Other Please tell us ____________________________

5. Did your doctor, nurse, or other health care worker try to induce your labor (start your contractions using medicine)?

[ ] 1 No → Skip Item 6

[ ] 2 Yes

[ ] I don’t know → Skip Item 6

6. Why did your doctor, nurse, or other health care worker try to induce your labor (start your contractions using medicine)? Check ALL that apply

[ ] My water broke and there was a fear of infection

[ ] I was past my due date

[ ] My health care provider worried about the size of the baby

[ ] My baby was not doing well and needed to be born

[ ] I had a complication in my pregnancy (such as low amniotic fluid or preeclampsia)

[ ] Labor stopped or was not progressing

[ ] I wanted to schedule my delivery

[ ] I wanted to give birth with a specific health care provider

[ ] Other Please tell us: __________________________________

Protocol Name from Source:

Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 7 Standard Questions


Publicly available

Personnel and Training Required

No specific training is needed if data are collected through a self-administered questionnaire. If interviewers administer the questionnaire, the interviewer must be trained to conduct personal interviews with individuals from the general population and found competent to administer these particular questions (i.e., tested by an expert) at the end of the training. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

These questions can be administered in a computerized or noncomputerized format (i.e., paper-and pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer or handheld computer to administer or to allow the respondent to self-administer a computer-assisted questionnaire.

Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered or interviewer-administered questionnaire

Life Stage:

Adolescent, Adult, Pregnancy


Mother after a live birth

Selection Rationale

The questions were used in the Pregnancy Risk Assessment Monitoring System (PRAMS), a major study with thousands of participants.


English, Spanish

Common Data Elements (CDE) Pregnancy Birth Mode Assessment Text 5633923 CDE Browser
Derived Variables


Process and Review

The Expert Review Panel has not reviewed this measure yet.


Centers for Disease Control and Prevention, Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 7 Standard Questions K1, K3, K6, K7, K9, K10.

Certification for the Spanish translation can be found here.

General References

Bovbjerg, M. L. & Siega-Riz, A. M. (2009). Exercise during pregnancy and cesarean delivery: North Carolina PRAMS, 2004-2005. Birth, 36(3), 200-207.

Protocol ID:


Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
Measure Name:

Mode of Delivery

Release Date:

January 31, 2017


Information about the initiating event of a woman’s delivery, the mode of delivery, and if it was an assisted delivery.


The mode of delivery may influence the health of the mother. Cesarean deliveries are becoming more common in the United States, often performed without a medical reason, and put the mother at increased risk of infection, hemorrhaging, blood clots, or experiencing a reaction to the anesthesia. Mode of delivery may also impact the health of the neonate. Cesarean section in the absence of labor has been associated with an increased occurrence of difficulties in respiratory transition to newborn life; for example, an increased risk of transient tachypnea of the newborn. Instrumental vaginal deliveries (forceps and vacuum) have been associated with increased risk of birth injuries such as facial nerve damage (forceps) and subgaleal hematomas (vacuum).


Pregnancy, vaginal delivery, cesarean delivery, Pregnancy Risk Assessment Monitoring System, PRAMS, Centers for Disease Control and Prevention, CDC, Maternal Fetal Medicine Units Network, MFMU, A Randomized Trial of Induction Versus Expectant Management, ARRIVE