Women’s decision-making process on their mode of birth among pregnant women with previous cesarean section in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia 2023: a qualitative study

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Date

2023

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Addis Ababa University

Abstract

Background: Women who have had previous cesarean delivery face a decision to birth option in a next pregnancy. Vaginal birth after caesarean is an alternative choice for most women with a prior cesarean section (CS) whereas its uptake is low. Reflects the limitations imposed on decision making. This decision making process varies for individuals and may result from considering several factors. In Ethiopia, no qualitative research is conducted, particularly on women’s decision making of their birth mode following previous CS. Objective: To explore decision-making processes on mode of birth among pregnant women with previous cesarean section in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2023. Methods: An explorative qualitative study was conducted from February 20 to march 20, 2023 among women seeking antenatal care. A total of 20 Participants were selected purposively and interviewed using semi-structured guide until data saturation reached. Thematic analysis was used. ATLAS ti 9 qualitative software was used to support the analysis and management of the data. Result: Three themes were identified: Women’s involvement in decision making, factors affecting Women’s decision making and women’s decision-making process. Women put forward their plan of mode of birth for next pregnancy immediately following caesarean delivery. Out of women who have a decision most decide to attempt Vaginal delivery after cesarean (VBAC). Conversely, some women plan repeated CS (RCS) because of labor pain experience and concern towards vaginal birth. However women’s decision is only in their mind and not discussed with their antenatal care providers. The process of decision making involves judging the experience, wanting VBAC or RCS, seeking information and wanting a supportive health provider. Conclusion: However women made the decision about their mode of birth themselves, their decisions were not based on thorough understanding of the advantages and disadvantages of vaginal versus cesarean delivery, rather on their previous experiences and their attitude in combination with other factors. Supporting women by providing clear, appropriate and adequate medical education timely will help women to make informed decisions that are consistent with their values and preferences.

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Keywords

Decision making, caesarean section, vaginal birth after cesarean, repeated cesarean section, women, Ethiopia

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