Antenatal discussion of the risks and benefits of VBAC and ERCS: Letter in response to BJOG themed issue 'Management of pregnancy after caesarean section'

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

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.