A Qualitative Inquiry to Explore Why Women with Previous Cesarean-Section Do Not Choose Vaginal Birth after Cesarean

Background & aim: The complications of cesarean section (CS) are greater than vaginal delivery in most cases and will be increased in repeat cesarean section. Therefore, women are not keen to choose vaginal birth after cesarean section (VBAC). The present study was conducted to explore why women with previous cesarean section do not choose VBAC. Methods: This qualitative content analysis was performed on 13 women with previous cesarean section as well as 12 health care providers, who were selected from Om-Albanin hospital in Mashhad, Iran. Data was collected through semi- structured individual interviews and two focus group with women and health care providers. The interviews were recorded, transcribed and analyzed using Graneheim and Lundman’s conventional method of content analysis (2004). The trustworthiness of data was verified by Lincoln and Guba’s criteria. Results: The main category of "feeling of loneliness, inability and fear of VBAC" was emerged from three sub-categories including "non-supportive sociological perspectives", "inefficient care” and "psychological fear of childbirth". Conclusion: The mothers had conflict in choosing VBAC due to emotional, social, and care system issues. Therefore, comprehensive supports including cultural interventions for vaginal birth in order to correct women’s beliefs and enhance their knowledge as well as planning a supportive and special care system for women with previous CS will help them in decision making for VBAC. Planning for these strategies and evaluating their effectiveness are suggested.