Perspectives, Decision Making, and Final Mode of Delivery in Pregnant Women With a Previous C-Section in a General Hospital in Peru: Prospective Analysis. Issue 2 (August 2017)

• Record Type: Journal Article
• Authors: Lazo-Porras, Maria; Bayer, Angela M.; Acuña-Villaorduña, Ana; Zeballos-Palacios, Claudia; Cardenas-Montero, Deborah; Reyes-Diaz, Michael; Naranjo-Caceres, Monica; Malaga, German
• Is Part Of: MDM policy & practice. Volume 2:Issue 2(2017)
• Publication Date: 2017-08
• Subjects: decision making -- mode of delivery -- qualitative study -- Caesarean section -- VBAC; Medicine -- Decision making -- Periodicals; Medicine -- Decision making; Decision Making; Clinical Medicine; Health Policy; Periodicals; Periodicals; Electronic journals; 616.075
• DOI: 10.1177/2381468317724409
• Languages: English
• ISSNs: 2381-4683

Abstract

Objective: Explore the perspectives, decision-making process, and final mode of delivery among pregnant women with a previous C-section (Cesarean section) in a general public sector hospital in Lima, Peru.Methods: A qualitative prospective study using semistructured interviews at two time points in the outpatient obstetrics and gynecology clinic of a public sector, university-affiliated reference hospital in Lima, Peru. Seventeen adult pregnant women with a prior C-section who were deemed by their attending obstetrician to be candidates for a trial of labor were interviewed. The first interview was between 37 and 38 weeks of pregnancy, and the second interview was 24 to 48 hours after delivery. Main outcome measures: Predelivery decision-making process and final mode of delivery.Results: Among the 17 participants, about half (9) of the participants stated that the physician explained that they had two approaches for delivery, a trial of labor after C-section (TOLAC) or elective repeated C-section (ERCD). Two women stated that their respective providers explained only one option, either an ERCD or TOLAC. However, 6 women did not receive any information from their providers about their delivery options. Of the 10 participants that decided TOLAC, 8 ended up having a C-section, and of the 7 patients that had planned an ERCD, 1 ended up having a vaginal delivery.Conclusion: Many participants affirmed that they made the decision about their approach of delivery. However, most of the participants that decided a TOLAC ended up having a C-section because of complications during the final weeks of pregnancy or during labor.