Perspectives, Decision Making, and Final Mode of Delivery in Pregnant Women With a Previous C-Section in a General Hospital in Peru: Prospective Analysis

Maria Lazo-Porras, Angela M. Bayer, Ana Acuña-Villaorduña, Claudia Zeballos-Palacios, Deborah Cardenas-Montero, Michael Reyes-Diaz, Monica Naranjo-Caceres, German Malaga

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
JournalMDM Policy and Practice
Volume2
Issue number2
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Caesarean section
  • VBAC
  • decision making
  • mode of delivery
  • qualitative study

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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