Preferences for mode of delivery after previous caesarean section: what do women want, what do they get and how do they value outcomes?
BACKGROUND
Women with one previous caesarean section must decide which mode of delivery they would prefer in their next pregnancy. This involves a choice between attempted vaginal birth and elective caesarean section.


OBJECTIVE
To explore women's mode of delivery preferences and the values placed on the outcomes of decision making. Greater insight into these issues could benefit both clinical care and future research.


METHODS
Observational study using longitudinal data collected within a randomized controlled trial.


METHODS
Seven hundred and forty-two women with one previous caesarean section recruited at four antenatal clinics in South West England and Scotland.


METHODS
Mode of delivery preference recorded at 19 and 37 weeks' gestation and visual analogue scale ratings of health and delivery outcomes.


RESULTS
Comparison of mid and late pregnancy preferences and actual mode of delivery shows that 57% of women hold the same mode of delivery preferences at both times and 65% of women actually have the birth they prefer. The visual analogue scale ratings show variation in the way women value the outcomes of the decision.


CONCLUSIONS
Understanding the way women's mode of delivery preferences change, how these relate to actual mode of delivery and how women value the outcomes of their decision will be beneficial to health professionals who wish to support women both during pregnancy and after birth. In addition, the visual analogue scale ratings provide evidence that may improve the development of population-level and economic models of decision making.
Emmett
Clare L
CL
Academic Unit of Primary Health Care, University of Bristol, Bristol, UK. Clare.emmett@bristol.ac.uk
Montgomery
Alan A
AA
Murphy
Deirdre J
DJ
D000328:Adult; D003657:Decision Making; D004739:England; D005260:Female; D006801:Humans; D057240:Patient Preference; D011247:Pregnancy; D012606:Scotland; D011795:Surveys and Questionnaires; D016064:Vaginal Birth after Cesarean