To determine how women decide to deliver their infants by cesarean instead of experiencing a trial of labor and expected vaginal delivery when appropriate. The specific goals were to answer the research questions: What is the decision-making process by which healthy, low risk women choose to give birth to their infants by cesarean in the absence of medical indications? What antecedents occur to influence a pregnant woman's decision to undergo a maternal request cesarean?
Exploratory study. Symbolic interactionism and feminism were utilized to provide a theoretical framework for the study. The grounded theory methodology by Strauss and Corbin was used to develop the core category, context, antecedents, intervening factors, and consequences.
Knox and Sevier Counties in East Tennessee.
Seven women underwent in-depth interviews. To qualify for the study, the women had to be healthy and low-risk, had an elective cesarean birth within the last 2 years, be 18 years or older, and reside in East Tennessee.
Grounded Theory Methodology by Strauss and Corbin.
From the data, a substantive theory was identified, “Having an elective c-section: Doing what's best.” Mothers voiced that they felt like having a cesarean was best for them and their infants. The antecedents of the women's decision were being scared and perceiving a cesarean as an easier way to give birth. Women made this choice after gathering information and seeking support from healthcare providers, friends, and family within the context of progressing through the pregnancy. Intervening facilitating factors included receiving support from others and the ability to schedule the cesarean. Hindering factors were nonsupportive people and inappropriate medical information. Once the decision was made and the cesarean was performed, the women voiced happiness with their decision.
Conclusion/Implications for Nursing Practice
The findings of this study may assist office nurses, public health nurses, midwives and advanced practice nurses, childbirth educators, and other women's health nurses to educate women that childbirth is a normal process and vaginal birth can be achieved in most women safely. These providers can educate women on the risks/benefits of both birthing options. Recommendations are given for further research.