Decision-making and involvement of women with previous C-section in choosing their mode of delivery.

Objective: To determine the attitude and factors leading to decision regarding the mode of delivery in women with previous experience of C-section.

Methods: The cross-sectional study was conducted at Maternity Unit of Jinnah Postgraduate Medical Centre, Karachi, from January to August 2008, and involved 150 women with one previous C-section without any recurrent cause. All women had a parity of two or more. Women with more than one caesarean section and women who lost contact were excluded. The women were recruited from antenatal clinic and were briefed by medical professionals before the questionnaire was filled out. SPSS version 10 and Chi square test were used for statistical analysis.

Results: Of the total 29 (19.3%) preferred a repeat caesarean section, and 121 (80.7%) opted for the trial of scar. No significant difference was seen in the mode of delivery when the decision was taken by women alone or when it was taken jointly by doctors and women. When the decision was taken by doctors, there was significant difference in the mode of deliveries. The patients expressed satisfaction towards the information received. Previous associated factors, like negative birth experience, had an influence on decision-making regarding the mode of delivery.

Conclusion: Decision by women is extremely important regarding their mode of delivery and should be respected. Psychological support during pregnancy may provide an alternative to caesarean section for women with previous negative experience.