Cultural perspectives on vaginal birth after previous caesarean section in countries with high and low rates - A hermeneutic study.
Caesarean section
Culture
Hermeneutic
Vaginal birth after previous caesarean section
Journal
Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
29
03
2019
revised:
27
07
2019
accepted:
28
07
2019
pubmed:
26
8
2019
medline:
8
9
2020
entrez:
26
8
2019
Statut:
ppublish
Résumé
Caesarean section (CS) rates are increasing worldwide, an increase that is multifactorial and not well understood. There is considerable variation in the rates of vaginal birth after previous Caesarean section (VBAC). Cultural differences could be one explanation of the varying rates. To interpret cultural perspectives on VBAC. A hermeneutic approach for analysing findings from four published qualitative studies that were part of the OptiBIRTH study, focusing on clinicians and women's views of important factors for improving the rate of VBAC. 115 clinicians and 73 women participated in individual interviews and focus group interviews in countries with low rates (Germany, Italy and Ireland) and countries with high rates (Sweden, Finland and the Netherlands), in the original studies. Three themes demonstrated how the culture differs between the high and low VBAC rate countries; from being an obvious first alternative to an issue dependent on many factors; from something included in the ordinary care to something special; and from obstetrician making the final decision to a choice by the woman. The fourth theme, preparing for a new birth by early follow-up and leaving the last birth behind, reflects coherence between the cultures. The findings deepen our understanding of why the VBAC rates vary across countries and healthcare settings, and can be used for improving the care for women. In order to improve VBAC rates both maternity care settings and individual professionals need to reflect on their VBAC culture, and make make changes to develop a 'pro-VBAC culture'.
Sections du résumé
BACKGROUND
BACKGROUND
Caesarean section (CS) rates are increasing worldwide, an increase that is multifactorial and not well understood. There is considerable variation in the rates of vaginal birth after previous Caesarean section (VBAC). Cultural differences could be one explanation of the varying rates.
OBJECTIVE
OBJECTIVE
To interpret cultural perspectives on VBAC.
METHODS
METHODS
A hermeneutic approach for analysing findings from four published qualitative studies that were part of the OptiBIRTH study, focusing on clinicians and women's views of important factors for improving the rate of VBAC. 115 clinicians and 73 women participated in individual interviews and focus group interviews in countries with low rates (Germany, Italy and Ireland) and countries with high rates (Sweden, Finland and the Netherlands), in the original studies.
RESULTS
RESULTS
Three themes demonstrated how the culture differs between the high and low VBAC rate countries; from being an obvious first alternative to an issue dependent on many factors; from something included in the ordinary care to something special; and from obstetrician making the final decision to a choice by the woman. The fourth theme, preparing for a new birth by early follow-up and leaving the last birth behind, reflects coherence between the cultures.
DISCUSSION
CONCLUSIONS
The findings deepen our understanding of why the VBAC rates vary across countries and healthcare settings, and can be used for improving the care for women.
CONCLUSION
CONCLUSIONS
In order to improve VBAC rates both maternity care settings and individual professionals need to reflect on their VBAC culture, and make make changes to develop a 'pro-VBAC culture'.
Identifiants
pubmed: 31445846
pii: S1871-5192(19)30222-7
doi: 10.1016/j.wombi.2019.07.300
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e339-e347Informations de copyright
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.