Choice of a childbirth method after cesarean.
Concern about the rising cesarean-section rate and the high percentage of elective repeat cesareans led to an exploratory, retrospective examination of women's decision-making about a childbirth method after cesarean. Fifty women who had delivered by a repeat cesarean (RC) or vaginal birth after cesarean (VBAC) participated in a telephone interview. Three questions were addressed: (1) who made the decision for a birth method; (2) what factors were associated with the choice of method; and (3) was the choice of method associated with the actual method of delivery? The majority of women (90%) perceived that they were the primary decision-maker for a birth method, and choice of birth method was positively associated with actual method of delivery. The major reason for VBAC choice was to experience a vaginal birth, whereas the primary reason for RC choice was to avoid an unsuccessful labor. Other factors associated with choice of a birth method were: sources of information and support, beliefs, previous cesarean experience and locus of control. These findings have important implications for enhancing women's health-care decision-making, as well as for reducing the rate of repeat-cesarean deliveries.
Clackamas County Public Health Division, Oregon City, OR 97045.
M C
MC
Murphy
S M
SM
Harvey
D000328:Adult; D002585:Cesarean Section; D002755:Choice Behavior; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D011247:Pregnancy; D012086:Reoperation; D012189:Retrospective Studies; D012959:Socioeconomic Factors