Decision making about mode of delivery among pregnant women who have previously had a caesarean section: a qualitative study
Article first published online: 4 DEC 2006
RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 114, Issue 1, pages 86–93, January 2007
How to Cite
Moffat, M., Bell, J., Porter, M., Lawton, S., Hundley, V., Danielian, P. and Bhattacharya, S. (2007), Decision making about mode of delivery among pregnant women who have previously had a caesarean section: a qualitative study. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 86–93. doi: 10.1111/j.1471-0528.2006.01154.x
- Issue published online: 4 DEC 2006
- Article first published online: 4 DEC 2006
- Accepted 27 September 2006. Published OnlineEarly 24 November 2006.
- Caesarean section;
- decision making;
- mode of delivery;
Objective To explore prospectively women’s decision making regarding mode of delivery after a previous caesarean section.
Main outcome measures The evolution of decision making, women’s participation in decision making, and factors affecting decision making.
Design and methods A qualitative study using diaries, observations and semi-structured interviews. Data were analysed thematically from both a longitudinal and a cross-sectional perspective.
Setting An antenatal unit in a large teaching hospital in Scotland and participants’ homes.
Sample Twenty-six women who had previously had a caesarean section for a nonrecurrent cause.
Results Women were influenced by their own previous experiences and expectations, and the final decision on mode of delivery often developed during the course of the pregnancy. Most acknowledged that any decision was provisional and might change if circumstances necessitated. Despite a universal desire to be involved in the process, many women did not participate actively and were uncomfortable with having responsibility for decision making. Feelings about the amount and quality of the information received regarding delivery options varied greatly, with many women wishing for information to be tailored to their individual clinical circumstances and needs. In contrast to the impression created in the media, there was no evidence of clear preferences or strong demands for elective caesarean section.
Conclusion Women who have had a previous caesarean section do not usually have firm ideas about mode of delivery. They look for targeted information and guidance from medical personnel based on their individual circumstances, and some are unhappy with the responsibility of deciding how to deliver in the current pregnancy.