Believing in birth--choosing VBAC: the childbirth expectations of a self-selected cohort of Australian women.
OBJECTIVE
This study explored the childbirth expectations and knowledge of women who had experienced a caesarean and would prefer a vaginal birth in a subsequent pregnancy.


BACKGROUND
Vaginal birth after caesarean is considered best practice. However, in most western world countries, despite the inherent risks of caesarean for both mother and baby, the number of women labouring after a previous caesarean is declining.


METHODS
Newspaper advertisements were used to recruit Western Australian women who had experienced a caesarean. Thematic analysis was used to analyse the interview data collected from women who attempted a vaginal birth (n=24), or stated they would choose this option, in a subsequent pregnancy (n=11).


RESULTS
For this cohort of women, their caesarean experience reinforced their previously held expectations about birthing naturally. The women held strong views about the importance of working with their bodies to achieve a vaginal birth, which was considered an integral part of being a woman and mother. Positive support from family and friends and a reluctance to undergo another caesarean was also influential. Women articulated the risks of caesarean and considered vaginal birth enhanced the health and well-being of the mother and baby, promoted maternal infant connection and the eased the transition to motherhood.


CONCLUSIONS
This study documents how the importance of birth, as a significant life event, remained the focus of these women's childbirth expectations influencing future decisions on birth mode and mediating against the 'pressure' of medical discourse promoting caesarean.


CONCLUSIONS
Knowledge and appreciation of the multiple dimensions that contribute to women's decisions after a caesarean provides valuable information on which service providers and researchers can draw as they investigate interventions that enhance the uptake and success of women birthing vaginally after a caesarean.
Fenwick
Jennifer
J
School of Nursing and Midwifery, Curtin University & King Edward Memorial Hospital, Curtin University of Technology, Perth, WA, Australia. j.fenwick@curtin.edu.au
Gamble
Jenny
J
Hauck
Yvonne
Y
D000328:Adult; D001294:Attitude to Health; D017604:Cesarean Section, Repeat / Q000009:adverse effects / Q000193:education / Q000523:psychology; D002755:Choice Behavior; D004522:Educational Status; D005190:Family / Q000523:psychology; D005260:Female; D033062:Friends / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007229:Infant Welfare; D007231:Infant, Newborn; D017533:Marital Status; D008429:Maternal Welfare; D008875:Middle Aged; D015404:Nursing Methodology Research; D011247:Pregnancy; D036301:Qualitative Research; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D019564:Unnecessary Procedures / Q000009:adverse effects / Q000523:psychology; D016064:Vaginal Birth after Cesarean / Q000009:adverse effects / Q000193:education / Q000523:psychology*; D014904:Western Australia; D014930:Women / Q000193:education / Q000523:psychology*