Factors that Influence Women's Decision on the Mode of Birth After a Previous Caesarean Section: A Meta-ethnography.
Emma L Hamilton, Karen McLaughlin, Lyndall Mollart
PMID 37489229WHAT IT FOUND
Women's choice of birth mode after a caesarean is driven by previous trauma, partner influence, and conflicting advice from clinicians.
Nurses and midwives were often seen as more supportive of vaginal birth than obstetricians. Shared decision-making and early debriefing are key.
Key findings
01Health professionals significantly influence birth decisions, with nurses and midwives often viewed as more supportive of vaginal birth after caesarean (VBAC) than obstetricians.
02Women frequently experienced 'scare tactics' and unbalanced information favouring repeat caesarean sections, leading to fear and a lack of informed choice.
03The previous birth experience, whether traumatic or positive, and the influence of partners are major determinants in the decision-making process for the next birth.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only English-language studies were included, which may miss relevant cultural perspectives. The review did not include Web of Science or Scopus databases. Factors influencing women who choose ERCS were not well understood due to a lack of studies focusing specifically on this group. The role of partners was under-researched in the included studies.
Declared interests
The study was financially supported by Hunter New England Health District honours scholarship. No other conflicts of interest were declared.
The easy way to misread this
Do not interpret the higher reported support for VBAC from nurses and midwives as evidence that their clinical advice is superior or safer than that of obstetricians. The review reports women's perceptions and experiences of communication, not the clinical accuracy or safety of the advice given by different professional groups.