The context of women's childbirth decisions regarding vaginal birth after cesarean section

Persistent Link:
http://hdl.handle.net/10150/288799
Title:
The context of women's childbirth decisions regarding vaginal birth after cesarean section
Author:
Disney, Jody Annette
Issue Date:
1998
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The purpose of this study was to investigate the influences, both internal and external, identified by women in their choice of vaginal birth after a previous cesarean section (VBAC) or repeat cesarean section (RCS). The rate of cesarean section (C/S) is currently approximately one in four to five births in the United States. Thus the stakes in obstetrical decision making both financially and philosophically, have become enormous (Keeler & Brodie, 1993). The method for this descriptive study combined 6 focus group interviews (n=19) with development and pilot-testing of the Cesarean Decision Making Questionnaire (C/S DMQ) to measure influences on method of delivery choice (N=31). Women who chose VBAC or RCS comprised the focus group sample. An additional 12 women were recruited to complete the questionnaires by mail. Factors identified in the literature and supported by clinical experience as influencing the decision making process constituted dimensions and items of the C/S DMQ developed for this study and served as the initial framework for content analysis of the focus groups. It was evident from the qualitative data that childbirth model and influence of health care providers (primarily physicians), along with perceptions of risk to baby, followed by risk to self, most influenced women's decisions regarding their method of delivery. Desire for control of decisions and childbirth practices was very important for the women who chose VBAC as compared to women who chose RCS. The C/S DMQ pilot results contained several dimensions or aspects with respectable internal consistencies. These included Childbirth Models, Desire for Control, Health Care Providers, and Social Support. Other dimensions with less internal consistency were Perceptions of Risk and Vulnerability, Uncertainty, and Demographics. The concepts of Risk and Uncertainty require further conceptualization for adequate instrumentation. Low internal consistency of Demographics may reflect the variety of demographic variables measured. The difference between women who chose VBAC and RCS was reflected in the dimension of Childbirth Models as a mediating variable for risk, supporting the social model for women who choose VBAC.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Health Sciences, Obstetrics and Gynecology.; Health Sciences, Nursing.; Health Sciences, Public Health.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Nursing
Degree Grantor:
University of Arizona
Advisor:
May, Kathleen M.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_US
dc.titleThe context of women's childbirth decisions regarding vaginal birth after cesarean sectionen_US
dc.creatorDisney, Jody Annetteen_US
dc.contributor.authorDisney, Jody Annetteen_US
dc.date.issued1998en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe purpose of this study was to investigate the influences, both internal and external, identified by women in their choice of vaginal birth after a previous cesarean section (VBAC) or repeat cesarean section (RCS). The rate of cesarean section (C/S) is currently approximately one in four to five births in the United States. Thus the stakes in obstetrical decision making both financially and philosophically, have become enormous (Keeler & Brodie, 1993). The method for this descriptive study combined 6 focus group interviews (n=19) with development and pilot-testing of the Cesarean Decision Making Questionnaire (C/S DMQ) to measure influences on method of delivery choice (N=31). Women who chose VBAC or RCS comprised the focus group sample. An additional 12 women were recruited to complete the questionnaires by mail. Factors identified in the literature and supported by clinical experience as influencing the decision making process constituted dimensions and items of the C/S DMQ developed for this study and served as the initial framework for content analysis of the focus groups. It was evident from the qualitative data that childbirth model and influence of health care providers (primarily physicians), along with perceptions of risk to baby, followed by risk to self, most influenced women's decisions regarding their method of delivery. Desire for control of decisions and childbirth practices was very important for the women who chose VBAC as compared to women who chose RCS. The C/S DMQ pilot results contained several dimensions or aspects with respectable internal consistencies. These included Childbirth Models, Desire for Control, Health Care Providers, and Social Support. Other dimensions with less internal consistency were Perceptions of Risk and Vulnerability, Uncertainty, and Demographics. The concepts of Risk and Uncertainty require further conceptualization for adequate instrumentation. Low internal consistency of Demographics may reflect the variety of demographic variables measured. The difference between women who chose VBAC and RCS was reflected in the dimension of Childbirth Models as a mediating variable for risk, supporting the social model for women who choose VBAC.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectHealth Sciences, Obstetrics and Gynecology.en_US
dc.subjectHealth Sciences, Nursing.en_US
dc.subjectHealth Sciences, Public Health.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplineNursingen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorMay, Kathleen M.en_US
dc.identifier.proquest9829362en_US
dc.identifier.bibrecord.b38554070en_US
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