Interventions for supporting pregnant women's decision-making about mode of birth after a caesarean

Women-centred interventions to increase vaginal birth after caesarean section (VBAC): A systematic review

“…Our findings are consistent with those of a recent systematic review on interventions to support women's decision-making about VBAC (Horey et al, 2013), which includes the same three studies from UK, Canada and Australia. It is notable that we did not find any additional studies focusing on childbirth, rather than pregnancy, and none from outside those three English-speaking developed countries.…”

“…These findings highlight the need for a wider research agenda, that includes research on other women-centred methods aimed at improving VBAC rates. Horey et al (2013) promote the need for more research focusing on interventions intended to help with shared decision making between pregnant women and their health professionals. We support this conclusion and would also recommend studies from different countries with different decision-making processes.…”

“…The authors of this metasynthesis recommend that clinicians should provide women with evidence-based information on both the risks and benefits of VBAC, to assist in their decision-making. A recent Cochrane Review examined randomised trials of interventions designed to support decision-making about VBAC, the acceptability of any such interventions to women and their partners and how feasible their implementation would be (Horey et al, 2013). Their findings, based on three studies involving 2270 women, were that the decision support interventions used had no effect on the women's mode of birth, or their preferences for mode of birth.…”

Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals

“…The same is true of interventions to increase the VBAC rates. A recent Cochrane review stated that there is currently no evidence of differences in VBAC rates between intervention groups with decision support and control groups [20]. The authors concluded that research is needed on shared decision support interventions for women regarding their mode of birth after a previous caesarean section.…”

“…VBAC is generally supported by the fact that the proportion of women with a low risk pregnancy who are able to have a successful vaginal birth after a previous caesarean section is around 74% [4,12,24,32,37]. More recently, there has been interest in supporting women in their decision making about mode of birth after a caesarean [19,20], and women's views on how they experienced VBAC have received more attention [27,39]. The fact that women who experience VBAC are often more satisfied as compared to those with a repeated caesarean section [39] is an additional reason to advocate VBAC.…”