Choosing vaginal birth after caesarean section: Motivating factors.

Davis, D; S Homer, C; Clack, D; Turkmani, S; Foureur, M

Choosing vaginal birth after caesarean section: Motivating factors.

Davis, D S Homer, C Clack, D Turkmani, S

Foureur, M

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Midwifery, 2020, 88
Issue Date:: 2020-05-30

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Field	Value	Language
dc.contributor.author	Davis, D
dc.contributor.author	S Homer, C
dc.contributor.author	Clack, D
dc.contributor.author	Turkmani, S https://orcid.org/0000-0001-7819-5061
dc.contributor.author	Foureur, M https://orcid.org/0000-0002-0454-0165
dc.date.accessioned	2020-08-06T01:39:41Z
dc.date.available	2020-05-24
dc.date.available	2020-08-06T01:39:41Z
dc.date.issued	2020-05-30
dc.identifier.citation	Midwifery, 2020, 88
dc.identifier.issn	0266-6138
dc.identifier.issn	1532-3099
dc.identifier.uri	http://hdl.handle.net/10453/141984
dc.description.abstract	OBJECTIVES:to examine the factors that motivate women who have had a previous caesarean section to consider planning a vaginal birth. DESIGN:a qualitative descriptive study with thematic analysis, drawing on interviews with women participating in a two arm, un-blinded randomised controlled trial (RCT) of midwifery continuity of care for increasing the proportion of women planning VBAC. SETTING:A Maternity Unit attached to a district hospital in an outer metropolitan area of Sydney, Australia. PARTICIPANTS:a purposive sample of 18 women participating in an RCT who had experienced previous caesarean section and had no contraindications for vaginal birth. FINDINGS:These women were committed to natural birth and drew on their previous experience of caesarean section to highlight the downside of recovery post caesarean section. Decision making for these women was complex. During the decision-making process, women individualised the information provided to balance risk and chance within the context of their own circumstance. Supportive healthcare providers were important in motivating women towards vaginal birth and midwives were identified as being more supportive than obstetricians. CONCLUSIONS:Recovery post caesarean section is an important consideration that is under emphasised in the informed consent process. There is opportunity for midwives to contribute proactively in promoting vaginal birth for women who have experienced a previous caesarean section. IMPLICATIONS FOR PRACTICE:women should be assisted to make informed choices with balanced information that includes recovery from surgical birth. Models of care that include a significant role for midwives and strategies that proactively encourage vaginal birth for women after previous caesarean section are needed.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier BV
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT1023352
dc.relation	http://purl.org/au-research/grants/nhmrc/1023352
dc.relation.ispartof	Midwifery
dc.relation.isbasedon	10.1016/j.midw.2020.102766
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services
dc.subject.classification	Nursing
dc.title	Choosing vaginal birth after caesarean section: Motivating factors.
dc.type	Journal Article
utslib.citation.volume	88
utslib.location.activity	Scotland
utslib.for	1110 Nursing
utslib.for	1114 Paediatrics and Reproductive Medicine
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/DVC (Research)
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-08-06T01:39:32Z
pubs.publication-status	Published
pubs.volume	88

Abstract:

OBJECTIVES:to examine the factors that motivate women who have had a previous caesarean section to consider planning a vaginal birth. DESIGN:a qualitative descriptive study with thematic analysis, drawing on interviews with women participating in a two arm, un-blinded randomised controlled trial (RCT) of midwifery continuity of care for increasing the proportion of women planning VBAC. SETTING:A Maternity Unit attached to a district hospital in an outer metropolitan area of Sydney, Australia. PARTICIPANTS:a purposive sample of 18 women participating in an RCT who had experienced previous caesarean section and had no contraindications for vaginal birth. FINDINGS:These women were committed to natural birth and drew on their previous experience of caesarean section to highlight the downside of recovery post caesarean section. Decision making for these women was complex. During the decision-making process, women individualised the information provided to balance risk and chance within the context of their own circumstance. Supportive healthcare providers were important in motivating women towards vaginal birth and midwives were identified as being more supportive than obstetricians. CONCLUSIONS:Recovery post caesarean section is an important consideration that is under emphasised in the informed consent process. There is opportunity for midwives to contribute proactively in promoting vaginal birth for women who have experienced a previous caesarean section. IMPLICATIONS FOR PRACTICE:women should be assisted to make informed choices with balanced information that includes recovery from surgical birth. Models of care that include a significant role for midwives and strategies that proactively encourage vaginal birth for women after previous caesarean section are needed.

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http://hdl.handle.net/10453/141984