The Importance of Mode of Birth After Previous Cesarean: Success, Satisfaction, and Postnatal Health
Version of Record online: 9 FEB 2012
© 2012 by the American College of Nurse-Midwives
Journal of Midwifery & Womens Health
Volume 57, Issue 2, pages 126–132, March/April 2012
How to Cite
Shorten, A. and Shorten, B. (2012), The Importance of Mode of Birth After Previous Cesarean: Success, Satisfaction, and Postnatal Health. Journal of Midwifery & Womens Health, 57: 126–132. doi: 10.1111/j.1542-2011.2011.00106.x
- Issue online: 20 MAR 2012
- Version of Record online: 9 FEB 2012
- cesarean birth;
- mode of birth;
- postnatal health;
Introduction: The recent National Institutes of Health consensus conference on vaginal birth after cesarean (VBAC) recommended a focus on strategies that increase women's opportunities to make informed choices about VBAC. This study aimed to expand knowledge of women's experiences of planned VBAC by focusing on postnatal experiences of women who participated in an Australian birth-after-cesarean study.
Methods: At 6 to 8 weeks after birth, 165 women who experienced childbirth after a previous cesarean rated satisfaction with their birth experiences using a 10-point visual analogue scale, reported on postnatal health problems, and indicated whether they would make the same birth choice again.
Results: Significant differences were found in satisfaction scores by mode of birth. Mean scores out of a possible score of 10 ranged from 8.86 for spontaneous vaginal birth, 7.86 for elective repeat cesarean delivery, 6.71 for emergency cesarean delivery, to 6.15 for instrumental vaginal birth (F= 5.33; P= .002). Mean satisfaction scores for spontaneous vaginal birth and elective repeat cesarean delivery were statistically higher than for instrumental vaginal birth and emergency cesarean birth. Women who experienced instrumental vaginal birth and emergency cesarean birth also reported a higher number of postnatal health-related problems and were least likely to agree that they would make the same birth choice again.
Discussion: Mode of birth was the most important determinant of postnatal satisfaction, postnatal health, and whether women felt they would make the same birth choice again. Clinicians, researchers, and policymakers should identify effective labor management practices that enhance women's opportunities to achieve spontaneous vaginal birth during planned VBAC.