Birth after emergency caesarean section: Women’s perspectives on the factors influencing their decision making

Abstract

The study explored the decisions women made in relation to mode of birth following a previous emergency lower segment caesarean section (emLSCS), particularly focusing on what different factors influenced women to choose a particular mode of birth and what they described as the rationale underpinning that decision. Participants were recruited from a population of students and staff within the School of Human and Health Sciences at a university in the north of England. Sixteen individuals were selected using convenience sampling, who then completed open-ended questionnaires. The questions were non-leading and asked the women to identify and expand upon factors that influenced their decision on mode of birth. Data were analysed using a basic thematic framework analysis. Many of the identified themes mirrored those well recognised in existing research: the woman’s previous birth, her perception of risks, the influence of professionals and the influence of peers were all apparent. One factor not explored in existing literature, namely a sense of duty to existing children, appeared to be strongly influential in this data set. Interestingly, it was observed that each woman’s philosophical framework and her relationship with the element of control substantially underpinned her consideration of key factors, leading her to an individual decision. This article provides an interesting insight into the complexity of individual decision making in maternity care. The findings highlight the fact that professional guidelines may fail to meet the personal and individual needs of their subjects. This is a thought-provoking topic for policy and guideline authors, as well as for the professionals who counsel patients through decision-making processes in maternity care and wider fields of healthcare.