Caroline – Interview 08
Caroline’s first baby was born by emergency caesarean. In her next pregnancy she took part in a trial comparing different types of information and decision aids about birth choices for women after a previous caesarean. She chose to attempt a natural birth.
Caroline’s first baby was born by emergency caesarean. She found it an unpleasant experience, far removed from the home birth she had planned, and she felt the care she received was not good. Although she would have liked to think about a home birth for her second baby, her husband was too worried about complications and so they decided to have a hospital birth. During a visit for a scan, Caroline was asked if she would take part in a trial investigating different types of information and computerised decision aids about whether to have another caesarean and comparing these with normal information. Caroline was allocated to the group receiving computerised information. She felt she had already decided she wanted to try for a natural delivery, so taking part in the trial did not really change her decision-making. She really took part to help with research, because she has worked in healthcare and knows it can be difficult to find volunteers, rather than to benefit herself. However, having the detailed information provided about the level of risk in trying a natural delivery after a previous caesarean did reassure her that the risks were relatively low.
Caroline suggests professionals need to be sensitive to the fact that women in pregnancy and after birth are in a vulnerable and emotional state and that they may find it difficult to concentrate or absorb lots of complex information. After her second baby was born she agreed to take part in an audit of the information given to women before going home. She felt that because she could not remember answers to the questions in exactly the correct format the researcher wanted, she was made to feel she had failed as a mother, and that it was implied the midwife looking after her had failed to inform her properly, which she did not think was the case.
She feels clinical trials are essential, but more research is also needed into women’s experience of maternity care, which is not captured by clinical trials research. She is concerned that because much of the money for trials comes from the pharmaceutical industry and is therefore focused on drugs, research into other aspects of care may get neglected. Caroline is not sure if she would take part in any more health research, and advises people to think carefully about what the benefit is for themselves, whether the research is addressing an important question, and whether they can cope with it at a time when they are already feeling vulnerable.
You can see more about experiences of taking part in this trial on our sectionMaking decisions about birth after caesarean.