Responses to vaginal birth after cesarean section.
OBJECTIVE
To compare women's reactions to their experiences of vaginal birth after cesarean (VBAC) with their reactions to their previous cesarean birth experiences, to identify the factors that influenced the women's decision to attempt VBAC, and to describe the causes the women ascribed to the outcome of their birth experiences.


METHODS
An exploratory descriptive study derived from the Roy Adaptation Model of Nursing.


METHODS
Hospital postpartum unit.


METHODS
Thirty-two women who had experienced a VBAC.


METHODS
The Perception of the Birth Scale and an investigator-developed questionnaire.


RESULTS
The women reported moderately positive perceptions of the VBAC experience. However, the mean score was lower than previously reported means for vaginally delivered women. A statistically significant association (X2 = 22.70, p < 0.0005) was found between type of delivery and adaptive and ineffective responses within the Roy Adaptation Model modes, with a greater proportion of adaptive responses to the VBAC than the previous cesarean. Information from obstetricians, nurses, family members, and print media influenced women's decisions to attempt the vaginal birth. Most causes ascribed to the successful VBAC came from external sources, were particular to a given pregnancy, and were beyond the woman's control.


CONCLUSIONS
The women reported both positive and negative aspects of childbearing, regardless of mode of delivery. The results indicate a need for a high quality of nursing and obstetric care for all women, with an emphasis on relief of pain and the provision of support and information.
Fawcett
J
J
University of Pennsylvania School of Nursing, Philadelphia.
Tulman
L
L
Spedden
J
J
D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D016294:Models, Nursing; D009035:Mothers / Q000523:psychology*; D009773:Obstetric Nursing / Q000379:methods; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D016064:Vaginal Birth after Cesarean / Q000523:psychology*