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Women's Perceptions of Contributory Factors for Not Achieving a Vaginal Birth After Cesarean (VBAC)

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BACKGROUND: With cesarean rates around the world escalating, concern is growing around why women wanting a vaginal birth after cesarean (VBAC) are not achieving their goal.

AIM: To gain an understanding of women's perceptions of factors they felt contributed to not achieving a VBAC.

SETTING AND PARTICIPANTS: Fifteen women were interviewed following a nonelective repeat cesarean section (NERCS). They had attended a Western Australian midwifery-led service, next birth after cesarean (NBAC), and labored but were not successful in achieving a VBAC because of reasons around delayed progress. Interview transcripts were analyzed using Colaizzi's method of thematic analysis.

FINDINGS: Five themes emerged: “Tentative commitment with lingering doubts,” “My body failed me,” “Compromised by a longer than tolerable labor,” “Unable to effectively self-advocate in a climate of power struggling and poor support,” and “The inflexibility of hospital processes.” The final theme included two subthemes: “Restrictive policies” on labor and use of the cardiotocography, “The CTG.”

CONCLUSIONS: When labor did not progress as envisaged and hospital processes adversely affected how women were supported, women's doubts around being able to achieve a VBAC were reinforced with a NERCS. Maternity services need to ensure clinical practice reflects best evidence while assuring staff are supportive of women's choice.
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Keywords: CHILDBIRTH; PERCEPTION; QUALITATIVE EVALUATION; VBAC

Document Type: Research Article

Publication date: 2013-06-01

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  • The International Journal of Childbirth is a peer-reviewed, quarterly journal publishing original research, reviews, and case studies concerned with the practice of midwifery, women's health, prenatal care, and the birth process. The journal encourages the exploration of the complex and contextual issues surrounding childbirth provision and outcomes and invites manuscripts from a wide range of clinical, theoretical, political, methodological, psychological, public health, policy, and multicultural and interdisciplinary perspectives.
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