Australian women's perception of their preparation for and actual experience of a recent scheduled caesarean birth

Abstract

Objective: to add to knowledge around women's perceptions of their preparation for and actual experience of a recent scheduled caesarean birth. Design, participants and setting: a mixed method study incorporating a postal survey and one-on-one interviews was used. The survey provided feedback on resources to prepare women for their caesarean birth such as a positive birth class, DVD and birth plan. Women were also invited to participate in an interview to share perceptions of their preparation and actual birth experience. Participants attended the only public obstetric tertiary hospital in Western Australia and experienced their caesarean birth between August and December 2012 (n=256). Frequency distributions and univariate comparisons were employed for categorical data, whereas thematic analysis was undertaken with transcripts to extract common themes. Findings: data reflect 46% (117 out of 256) of women returned a postal survey. The interview option was removed after three months of data collection, when 38 women were interviewed and data saturation was reached. Of the 61% (71 of 117) who completed a birth plan, 59% (42 of 71) felt it was used to guide their care. Only 38% (44 of 117) were able to stay together with their (baby and partner) in recovery. Thematic analysis revealed a positive theme suggesting their experience ‘couldn't have been 'better' with sub-themes: ‘involved in care’; ‘informed the whole way through’; ‘magical for him to be near me’ and ‘everything was done brilliantly’. Negative reflections centred around ‘we were just a number’ and included four sub-themes: ‘no option’; ‘still had questions’; ‘separated from him and her’ and ‘none of it happened’.Conclusion: acknowledgement that a scheduled caesarean section is more than a surgical procedure, but a birth is paramount. For women to have a positive birth experience we must respect their wishes within their birth plan and embrace a family friendly model, where mothers, partners and babies can stay together.