Making decisions about birth after caesarean

Messages to health professionals

We asked the women who took part in our study to reflect on their experiences and tell us what messages they would like to give to health professionals. Several were very satisfied with the care they had received before, during, and after birth and did not have anything specific they wanted to say. However, others made a range of suggestions about how they thought care for women who have had a previous caesarean could be improved.

Communication
Listen carefully to what a woman is asking advice about - choosing how to give birth is a big decision

  • Allow enough time for discussion 
  • Treat women as individuals and tailor information to their personal circumstances
  • Don't make a woman feel guilty about opting for a caesarean

Providing Information 

  • Discuss options for birth early on when talking to a woman who has had a previous caesarean
  • Provide information in a format that a woman can take away to read and revisit in her own time 
  • Don't gloss over complications if a woman wants to discuss the risks of labour and birth
  • If a woman hasn't experienced labour provide more information about different kinds of pain relief and how it might affect the birth process
  • Bear in mind that a woman who wants a VBAC (vaginal birth after caesarean) might need to refresh her knowledge about labour and birthing positions
  • Midwives might be better placed than consultants to offer information to women during pregnancy

Supporting women's decision-making

  • Ask a woman how she wants to be involved in decisions about method of delivery - some women want advice, others just want information 
  • Make sure the information you offer is accurate and up-to-date
  • Respect and support a woman's decisions, even if you don't agree with them
  • Explore to what extent a woman wants to be involved in decisions about her care during birth itself

Discussing vaginal birth after caesarean

  • There are many complex reasons why women might have a preference for planned caesarean, and it is seldom simply a matter of convenience
  • You may need to reassure a woman that there is no hidden agenda to persuade her to attempt VBAC 
  • If a woman wants to attempt vaginal birth, be encouraging  - don't use negative terminology such as 'trial of scar'
  • A woman who wants a VBAC might find it helpful to hear the experiences of others who have done it 

Last reviewed April 2015.

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