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Making decisions about birth after caesarean
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Previous pregnancy and caesarean birth :
After caesarean birth
Recovery & complications after previous caesarean
Bonding, feeding and support after previous CS
Women's feelings about their previous caesarean
Experiences of previous pregnancy & caesarean
Women's expectations for their previous births
Information needs/sources in previous pregnancies
Women's experiences of their previous CS
Next pregnancy and birth after caesarean :
Decisions about how to give birth after caesarean
Reasons for wanting a planned caesarean
Reasons for wanting vaginal birth after caesarean
Women's experiences of making the decision
Roles of health professionals in decision-making
Roles of partners & others in decision-making
Experience of next birth after caesarean
Women's experiences of their next caesarean
Women's experiences of vaginal birth after CS
Preparing for next birth after caesarean
Women's expectations for their next birth
Information needs & attitudes in next pregnancy
Views on information from health professionals
Views on information from other sources
Taking stock of birthing experiences :
Comparing birth experiences and recovery
Women's views on choice about birth
Advice to other women facing decisions about birth
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Making decisions about birth after caesarean
Subject index
Clip
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Interview 23
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She didn't feel comfortable stating her preferences too resolutely but thinks she'd be more comfortable talking about them with her next birth.
Had lengthy labour with 1st child after being induced, taken for emergency CS after baby's heart beat dropped. Explored options early in 2nd pregnancy, decided on VBAC. 2nd child born after 10 hours, painful labour but great sense of achievement.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 03
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She felt that the relationship with her team of midwives was very basic and businesslike.
Very keen to have intervention-free birth with 1st child, laboured to 9cm, then had CS when baby passed meconium. Felt cheated and upset long after. Wanted VBAC with 2nd child but opted for CS when 2 weeks overdue. Planned CS was much better than expected.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 06
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With her first birth, she went along with whatever the medical team recommended. In her second pregnancy, she felt more prepared to question things.
Had planned CS with 1st child due to his expected size. Felt CS was unnecessary, but stress-free way of having baby. Difficult decision with 2nd child, felt both anxious and curious about labour. Now pleased to have had vaginal birth with ventouse.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 20
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The doctor consulted her about whether she wanted to labour for a while longer and she was able to discuss her concerns about what a caesarean might m
Went 8 days overdue with 1st child, laboured for 48 hours. Had epidural and then emergency CS when child became distressed. Easy recovery but felt wrong about having planned CS with 2nd child. Considered it during labour but persevered and had vaginal birth assisted by forceps.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 40 and over
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Interview 05
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She felt treated unsympathetically by the consultant and was annoyed to find out she had been excluded from an initial discussion about caesarean.
Had a very traumatic 1st birth, long labour, CS was offered only after baby went into distress. Felt excluded from decisions and treated unsympathetically. Felt pushed into VBAC with 2nd birth. Chose to go private instead and had planned CS.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Susan - Interview 01
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She thinks having someone explain to her why things happened the way they did might help her come to terms with the disappointment she still feels.
First child born by emergency CS. She felt disappointed with the process and keen to give birth to her 2nd child vaginally, but discovered at her 20 week scan that her placenta covered her cervix (placenta previa) so she would need another CS.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Interview 17
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She has decided to attempt VBAC even though she does not feel overly optimistic and is worried about the possibility of uterine rupture. Played by an
Waters broke but 1st baby's head was outside the pelvis. Induced, then had emergency CS. Agonised over how to deliver 2nd child, persuaded by health professionals to attempt VBAC. Laboured to 7cm, but baby's head not engaged so needed another emergency CS.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 06
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Her questions changed throughout her pregnancy. She would have liked to talk to a midwife outside of formal appointments. Having web-based information
Had planned CS with 1st child due to his expected size. Felt CS was unnecessary, but stress-free way of having baby. Difficult decision with 2nd child, felt both anxious and curious about labour. Now pleased to have had vaginal birth with ventouse.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Interview 23
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In her experience, midwives will often gloss over the risks to reassure women.
Had lengthy labour with 1st child after being induced, taken for emergency CS after baby's heart beat dropped. Explored options early in 2nd pregnancy, decided on VBAC. 2nd child born after 10 hours, painful labour but great sense of achievement.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 03
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She found it helpful that her doctor tried to find out what she wanted and offered her reassurance rather than just providing her with routine factual
Very keen to have intervention-free birth with 1st child, laboured to 9cm, then had CS when baby passed meconium. Felt cheated and upset long after. Wanted VBAC with 2nd child but opted for CS when 2 weeks overdue. Planned CS was much better than expected.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 07
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She had conflicting advice from the community midwives and from staff at the hospital about her chances of having a vaginal birth.
Went 14 days overdue with 1st child, was induced, then had CS after 2 days of labour. Advised to have planned CS with 2nd child, booked for 10 days past due date, still hoping to go into labour. Surprised by her positive experience of 2nd caesarean.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 09
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She thinks giving women balanced information about all possible risks might conflict with giving them reassurance and encouragement about their birth
Pregnant with twins, had CS when she did not dilate beyond 9cm. Felt happy with her care and recovered well but disliked need for support after the operation. Keen to have vaginal birth with 2nd child. Went two weeks overdue, then delivered very quickly after being induced.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Susan - Interview 01
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She had decided early on that she wanted to attempt vaginal delivery and looked at various websites to prepare herself for discussions with health pro
First child born by emergency CS. She felt disappointed with the process and keen to give birth to her 2nd child vaginally, but discovered at her 20 week scan that her placenta covered her cervix (placenta previa) so she would need another CS.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 09
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She initially struggled to reach a decision because she thought her doctor and midwife might be withholding information about low chances of her havin
Pregnant with twins, had CS when she did not dilate beyond 9cm. Felt happy with her care and recovered well but disliked need for support after the operation. Keen to have vaginal birth with 2nd child. Went two weeks overdue, then delivered very quickly after being induced.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Interview 14
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She was very worried about making the wrong decision.
Admitted to hospital with pre-eclampsia, 1st child was born 6 weeks premature and had to spend 10 days in SCBU. Found it very difficult to decide how to give birth to 2nd child, worried about risks either way. Had vaginal birth assisted by ventouse.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 40 and over
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Interview 02
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Talking to a consultant about why her previous caesarean had been necessary and learning that similar complications were unlikely to happen again enco
Laboured to 8cm dilation with 1st child. Cord wrapped round baby's neck, had emergency CS under general anaesthetic. Chose VBAC for next birth because of quicker recovery. 2nd child born in 2½ hours, though had to have epidural afterwards to remove placenta.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 40 and over
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Interview 08
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The consultant told her that in her position she, too, would have opted for a caesarean. This helped to reassure her that she had made the right choic
Keen on unassisted birth with 1st child. Slow to go into labour and dilate. Had epidural and then CS 2 days after waters broke. Felt cheated at first but adjusted with time. Had planned CS with 2nd child to avoid previous ordeal.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 19
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Speaking to the midwife helped her to make up her mind to have a planned caesarean. The doctor said he could understand her reasons. Played by an acto
Her waters broke 10 days past her due date, but contractions did not start. She was induced, didn't dilate, then had CS after 14 hours of labour. Chose to have a planned CS with 2nd child as felt pessimistic about her chances of having a vaginal birth.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 40 and over
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Interview 08
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She went along with her consultant's advice to have a repeat caesarean but did not feel put under pressure in any way. Played by an actor.
Keen on unassisted birth with 1st child. Slow to go into labour and dilate. Had epidural and then CS 2 days after waters broke. Felt cheated at first but adjusted with time. Had planned CS with 2nd child to avoid previous ordeal.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 29
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She was surprised that the consultant just asked about her preference rather than engage her in discussion. She had expected more of a two-way process
1st child delivered with forceps and ventouse. Had bad tear, lost lots of blood. Planned caesarean with 2nd child 16 months later on advice of doctors. Struggled to decide how to deliver 3rd child, pessimistic about her chance of having VBAC, feels planned CS is the safer option.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Interview 14
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She would have liked her doctor and midwife to tell her which way to go instead of leaving things up to her.
Admitted to hospital with pre-eclampsia, 1st child was born 6 weeks premature and had to spend 10 days in SCBU. Found it very difficult to decide how to give birth to 2nd child, worried about risks either way. Had vaginal birth assisted by ventouse.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 27
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She suspects most midwives tried to push her into a trial of labour and disapproved of her decision for a caesarean, because they are driven by an age
1st child was breech, had planned caesarean. Struggled to breastfeed and felt low for long after. Wanted planned CS with 2nd child, but felt pushed into VBAC by clinicians. Went into labour early and had emergency CS at 38 weeks, found experience worse than previous.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 07
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The medical staff talked her through the delivery moment by moment. Having a first glance at her daughter still attached by the cord was wonderful.
Went 14 days overdue with 1st child, was induced, then had CS after 2 days of labour. Advised to have planned CS with 2nd child, booked for 10 days past due date, still hoping to go into labour. Surprised by her positive experience of 2nd caesarean.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 40 and over
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Interview 05
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Her experience in private care was much better than her previous caesarean. Last time she had felt anxious and out of control, but this time the atmos
Had a very traumatic 1st birth, long labour, CS was offered only after baby went into distress. Felt excluded from decisions and treated unsympathetically. Felt pushed into VBAC with 2nd birth. Chose to go private instead and had planned CS.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 20
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She thinks women should be involved in decision-making as much as possible but at the same time the idea of patient choice can be taken too far.
Went 8 days overdue with 1st child, laboured for 48 hours. Had epidural and then emergency CS when child became distressed. Easy recovery but felt wrong about having planned CS with 2nd child. Considered it during labour but persevered and had vaginal birth assisted by forceps.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 12
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She thinks as a nurse with an insight into the medical system she was more able to assert her wishes than other women might have been in the same situ
Keen on vaginal birth with 1st child, felt she lost control at hospital, had various interventions and emergency CS. Decided to have VBAC with 2nd child against consultant's advice, but supported by doula and midwife. Very pleased with unassisted birth.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Interview 17
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She thinks women who don't have a strong preference about how to give birth might find it difficult to make up their own mind and be swayed by the vie
Waters broke but 1st baby's head was outside the pelvis. Induced, then had emergency CS. Agonised over how to deliver 2nd child, persuaded by health professionals to attempt VBAC. Laboured to 7cm, but baby's head not engaged so needed another emergency CS.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 27
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Based on her own experience, she thinks women who want a planned caesarean need to state this clearly because health professionals tend to assume that
1st child was breech, had planned caesarean. Struggled to breastfeed and felt low for long after. Wanted planned CS with 2nd child, but felt pushed into VBAC by clinicians. Went into labour early and had emergency CS at 38 weeks, found experience worse than previous.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 20
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She thinks health professionals need to allow women sufficient time to discuss their options. Hospital appointments often can feel rushed.
Went 8 days overdue with 1st child, laboured for 48 hours. Had epidural and then emergency CS when child became distressed. Easy recovery but felt wrong about having planned CS with 2nd child. Considered it during labour but persevered and had vaginal birth assisted by forceps.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 07
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She thinks women should not be put under pressure to attempt vaginal birth if their chances of success are low - it will only make them feel guilty.
Went 14 days overdue with 1st child, was induced, then had CS after 2 days of labour. Advised to have planned CS with 2nd child, booked for 10 days past due date, still hoping to go into labour. Surprised by her positive experience of 2nd caesarean.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 30 and under
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Interview 23
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She thinks it's important to be confronted with the facts, even if they can be scary.
Had lengthy labour with 1st child after being induced, taken for emergency CS after baby's heart beat dropped. Explored options early in 2nd pregnancy, decided on VBAC. 2nd child born after 10 hours, painful labour but great sense of achievement.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 36-39
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Interview 07
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She thinks midwives are best placed to give women information, because they are the professionals that women see the most. Having a midwife she knew a
Went 14 days overdue with 1st child, was induced, then had CS after 2 days of labour. Advised to have planned CS with 2nd child, booked for 10 days past due date, still hoping to go into labour. Surprised by her positive experience of 2nd caesarean.
Pregnancy & children
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Making decisions about birth after caesarean
>>
Aged 30 and under
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Interview 14
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Before her VBAC, she would have found it helpful if doctors and midwives could have advised her which way of giving birth was the best option for her.
Admitted to hospital with pre-eclampsia, 1st child was born 6 weeks premature and had to spend 10 days in SCBU. Found it very difficult to decide how to give birth to 2nd child, worried about risks either way. Had vaginal birth assisted by ventouse.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 28
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She thinks it's important that health professionals take into account women's past experiences and support them in their decision-making without tryin
Difficult pregnancy, laboured for 2 days, then found baby was double-breech and had emergency CS. Had trouble breastfeeding and felt very low for 6 months. Uncertain about how to deliver 2nd child, leaned towards planned CS but went into labour early and had VBAC as operating theatre was busy.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 27
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Health professionals should be careful not to stereotype women who ask for a caesarean as simply 'too posh to push'.
1st child was breech, had planned caesarean. Struggled to breastfeed and felt low for long after. Wanted planned CS with 2nd child, but felt pushed into VBAC by clinicians. Went into labour early and had emergency CS at 38 weeks, found experience worse than previous.
Pregnancy & children
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Making decisions about birth after caesarean
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Aged 31-35
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Interview 09
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She understands that health professionals have to inform women about all the risks but thinks they could do more to encourage women that VBAC is possi
Pregnant with twins, had CS when she did not dilate beyond 9cm. Felt happy with her care and recovered well but disliked need for support after the operation. Keen to have vaginal birth with 2nd child. Went two weeks overdue, then delivered very quickly after being induced.
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