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Vaginal birth after a previous CS –what is the best option and how decide?

Conference contribution
Authors Ingela Lundgren
Cecily Begley
Christina Nilsson
Published in NJF Congress, May 12-14, 2016, Göteborg, Sverige.
Pages 41
ISBN 978-91-637-4269-9
Publication year 2016
Published at Institute of Health and Care Sciences
Pages 41
Language en
Links njfcongress.se/wp-content/uploads/2...
Subject categories Obstetrics and gynaecology, Health Sciences

Abstract

Background: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after caesarean section (VBAC) rates vary widely in different healthcare settings and countries. Obtaining knowledge about the differences across Europe, and women´s and clinicians’ views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Aim: The aim is to discuss the best birthing option for women with a previous CS and the decision-making process between VBAC or CS, based on a summary of research and findings from OptiBIRTH, an ongoing study. Methods: OptiBIRTH is a cluster randomised trial, funded by the European Commission, aiming to increase VBAC rates across Europe through enhanced woman-centred maternity care. An intervention is being tested in Italy, Germany and Ireland based on two systematic reviews and interviews with 71 women and 115 clinicians (midwives and obstetricians) in these countries as well as in countries with high VBAC rates (Finland, Sweden and the Netherlands). Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country. Results: The European perspective related to best option and decision-making, derived from systematic reviews of interventions for clinicians and interventions for women, will be presented and led by Cecily Begley. Women´s views and clinicans´views of best option and how to decide will be presented and led by Christina Nilsson (women) and Ingela Lundgren (clinicians). Findings showed that both women and clinicians wished to have more knowledge about the benefits and drawbacks of VBAC and repeat CS. Conclusion: The evidence-based intervention now includes education of women and information-giving to clinicians, and then bringing both groups together to discuss future birthing plans.

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