Examining influences on women’s decision to try labour after previous caesarean section

Abstract

Objective: We examined variables that may influence women’s decision to try for a Vaginal Birth After Caesarean (VBAC) or an Elective Repeat Caesarean Delivery (ERCD). Background: After a primary caesarean delivery, many women must choose between a VBAC or an ERCD. Both options involve risk to the mother and neonate, and the decision is a complex one. Methods: Data were collected from 166 pregnant women and 117 intending-to-become pregnant women with one previous caesarean section. Through an online survey, women reported their birth plans (current, past and future), risk perception, influences on their decision, and their locus of control for labour and delivery. Results: Women planning to have a VBAC perceive a caesarean as the riskier option, while women choosing an ERCD perceive a VBAC as the riskier option. Women who plan to have a VBAC are less satisfied overall with their first birth. Women who are planning a VBAC have a higher internal locus of control for labour and delivery and a lower ‘powerful others’ locus of control than woman planning an ERCD. Our data suggest that women who plan to have a VBAC are more influenced by online sources and less influenced by healthcare providers, relative to women who plan an ERCD. Conclusion: Women’s risk perception, personality, and their perception of past experience likely influence women’s decision making for trying a VBAC.

Keywords:

• VBAC
• decision making
• caesarean birth
• TOLAC
• locus of control

Acknowledgements

The authors acknowledge Mark A. Stellmack, PhD, for his editorial help and Jeanne Boydston, BSN, RNC, C-EFM, and Peter Simonson, MD, for sharing their medical expertise.

Notes

1. The complete survey is available from the first author upon request.