University women's and men's mindsets surrounding postcesarean birth: Findings and implications for practice and policy
2017
Background
Nearly twice as many women report preferring vaginal birth after cesarean (VBAC) than actually undergo it. It is unknown whether the preference pattern would hold in childbearing-aged individuals who had not yet been directly influenced by care experiences. We therefore examined postcesarean birth preferences in nulliparous university women and men to provide additional evidence to help advance related policy and practice.
Methods
An online study of 558 university women and 164 men who read a hypothetical postcesarean birth scenario was conducted. Students selected the option they would prefer for themselves or a partner in a similar situation; these data were analyzed descriptively and for gender differences. Students’ written rationales were analyzed qualitatively.
Results
Of women, 38.2% reported preference for VBAC compared with 47.6% of men (P < .05). Thematic analysis revealed that women and men based their preferences on safety, quality of experience, and other concerns similar to those reported among pregnant women making the decision. Assumptions and misinformation were also noted.
Conclusion
Given the current primary cesarean rate of ~20%, the current childbearing generation will be facing cesarean and postcesarean birth decisions in appreciable numbers. The relatively high VBAC preference rate reported by our participants, particularly men, is useful in advocating for expanded access and practice. From a constructivist perspective, evidence of young adults’ mindsets and misconceptions surrounding postcesarean birth is valuable for developing effective educational interventions.
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