Women's Perceptions of Barriers and Facilitators to Vaginal Birth After Cesarean in the United States: An Integrative Review.
Bridget Basile Ibrahim, Holly Powell Kennedy, Robin Whittemore
PMID 32352635WHAT IT FOUND
Women planning birth after cesarean said clear knowledge, trust in their bodies, social support, and VBAC-supportive providers helped.
Fear, negative provider language, distance, and insurance limited access.
Key findings
01Women reported that not knowing they were medically eligible for labor after cesarean, or not knowing it was an option, made planning a later birth harder.
02In two included studies, women said the closest hospital that allowed VBAC was more than 2 hours away.
03Women described VBAC-supportive providers, hospital policies, labor and delivery unit culture, and nurses' support as facilitators.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
It reviewed women's perceptions, not outcomes, so it does not show that any barrier or facilitator changes VBAC rates. Some included sources were not peer-reviewed research, including a patient education article, an investigative reporting book, and a law journal article. Several sources were published before the 2010 NIH Consensus and ACOG practice bulletin, so they may not reflect current practice. One study assumed that most internet discussion board posts came from the United States. Included samples were small and varied, from 13 women to 310 internet posts, so the themes are not generalizable.
The easy way to misread this
Do not read this as evidence that education, peer support, or VBAC-supportive policies increase successful birth after cesarean. The review reports women's perceived barriers and facilitators, not tested interventions or outcomes.