Owning the birth experience: what factors influence women’s vaginal birth after caesarean decision?

Abstract

Objective: Our quantitative analysis examined what factors influence pregnant women to choose a vaginal birth after a caesarean (VBAC).

Background: There is growing concern over the high rates of caesarean section; much of the high rate is driven by repeat caesareans. A trial of labour after a previous caesarean is an option for many women increasingly supported by medical literature.

Methods: Survey data from 173 pregnant women who had had only one birth by caesarean were analysed using a hierarchical binary logistic regression model.

Results: Desire for the experience of a vaginal birth strongly predicted choice of VBAC; however, this relationship was dampened among women with a high (versus low) powerful others (e.g. doctors and nurses) locus of control. Prior reason for a caesarean section and practical factors also play a role.

Conclusion: Women may be more likely to choose VBAC if they are encouraged to believe that they can help control the outcome, especially if their desire for a vaginal birth experience is high.

Keywords:

• VBAC
• vaginal birth after caesarean
• caesarean section
• ownership
• birth
• locus of control

Acknowledgements

We acknowledge Rosemarie Whyte for her work in survey development and data analysis, as well as providing valuable research assistance and feedback. We acknowledge Michele Barry for her work in developing the survey and providing feedback. We thank Dr Peter Simonson for his efforts in recruitment.