There is minimal evidence regarding the role or impact of birth plans from the perspective of women experiencing scheduled caesarean birth.
Quality maternity care requires respect for women’s preferences. Evidence suggests birth plans enable communication of women’s preferences and may enhance agency when vaginal birth is intended, however there is limited evidence of how this translates in the perioperative environment where caesarean birth is the intended outcome.
Explore the experiences and perspectives of women who had utilised a scheduled caesarean birth plan at an Australian tertiary maternity hospital.
A cross-sectional design was used; 294 participants completed the survey within two weeks post-birth. Descriptive statistics were used to analyse quantitative data, qualitative responses were analysed using content analysis.
Over half of the women requested lowering of the surgical-screen at birth, most requested immediate skin-to-skin with their babies; around two-thirds of these preferences were met. Use of a birth plan for scheduled caesarean section supported women’s ability to communicate their desires and choices, enhancing agency and reinforcing the significance of the caesarean birth experience. Qualitative data revealed two main categories: Perceptions and experiences; and Recommendations for improvement, with corresponding sub-categories.
Findings provide unique opportunities to consider the provision of woman-centred care within the highly technocratic perioperative environment.
All women, regardless of birth mode, have a right to respectful maternity care that prioritises their wishes and agency. This study provides evidence for the positive utility of birth plans in caesarean birth, local adaptation is encouraged.
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- World Health Organisation. WHO recommendations: Intrapartum care for a positive childbirth experience. Geneva World Health Organisation, 2018.
- White Ribbon Alliance. Respectful maternity care: The universal rights of childbearing women: The White Ribbon Alliance, 2011.
- Department of Health. Clinical practice guidelines: Pregnancy care. Canberra, 2020.
- National Centre for Health and Care Excellence. Ceasarean birth: NICE guideline, 2021.
- 5. The Organisation for Economic Co-operation and Development. Health at a glance 2019: OECD indicators 2019.
- Western Australia’s Mother’s and Babies, 2016: 34th Annual Report of the Western Australian Midwives Notification System.Dep. Health, West. Aust. 2021;
- Neonatal safety of elective family-centered caesarean sections: A cohort study.Front. Pediatr. 2018; 6: 20
- Implementing family-centered cesarean birth.J. Midwifery Women’s. Health. 2015; 60: 682-690
- Women's experiences and satisfaction with having a cesarean birth: An integrative review.Birth. 2020; 47: 169-182
- Cesarean and vaginal birth in Canadian women: A comparison of experiences.Birth Issues Perinat. Care. 2010; 37: 44-49
- Women's self-reported experience of unplanned caesarean section: Results of a Swedish study.Midwifery. 2017; 50: 253-258
- Institutional processes and individual responses: Women’s experiences of care in relation to cesarean.Birth. Birth Issues Perinat. Care. 2010; 37: 150-159
- Women's psychosocial outcomes following an emergency caesarean section: A systematic literature review.BMC Pregnancy Childbirth. 2019; 19: 1-24
- Women's experiences of intrapartum care and recovery in relation to planned caesarean sections: An interview study.Women Birth. 2021; 34: e248-e254
- Women's experiences of decision-making and beliefs in relation to planned caesarean section: A survey study.Aust. N. Z. J. Obstet. Gynaecol. 2021; 61: 106-115
- Predictors of women's perceptions of the childbirth experience. Journal of Obstetric.Gynecol. Neonatal Nurs. 2008; 37: 24-34
- 'Off everyone's radar': Australian women's experiences of medically necessary elective caesarean section.Midwifery. 2012; 28: e900-e909
- From birth plan to birth partnership: Enhancing communication in childbirth.Am. J. Obstet. Gynecol. 2017; 216 (31): e1-e4
- World Health Organisation. WHO recommendations on health promotion interventions for maternal and newborn health 2015: World Health Organisation, 2015.
- National Centre for Health and Care Excellence. Intrapartum care for health women and babies. National Centre for Health and Care Excellence; 2014.
- Plans, preferences or going with the flow: An online exploration of women's views and experiences of birth plans.Midwifery. 2017; 54: 29-34
- Communication and decision-making in labour: Do birth plans make a difference?.Health Expect. 1998; 1: 106-116
- “I felt part of the decision-making process”: A qualitative study on techniques used to enhance maternal control during labor and delivery.Int. J. Childbirth Educ. 2011; 26: 21-25
- Birth plans: What matters for birth experience satisfaction.Birth Issues Perinat. Care. 2016; 43: 144-150
- Perspectives of expectant women and health care providers on birth plans.J. Obstet. Gynaecol. Can. 2013; 35: 979-985
- The natural caesarean: A woman-centred technique.BJOG: Int. J. Obstet. Gynaecol. 2008; 115: 1037-1042
- The society for obstetric anesthesia and perinatology consensus statement on the anesthetic management of pregnant and postpartum women receiving thromboprophylaxis or higher dose anticoagulants.Anesth. Analg. 2018; 126: 928-944
- Promotion of family-centered birth with gentle cesarean delivery.J. Am. Board Fam. Med. 2014; 27: 690-693
- Early skin-to-skin contact for mothers and their healthy newborn infants (Review).Cochrane Database Syst. Rev. 2016; 11: CD003519
- Australian women's perception of their preparation for and actual experience of a recent scheduled caesarean birth.Midwifery. 2014; 30: e131-e136
- Cross-sectional studies - what are they good for?.Acta Obstet. Et. Gynecol. Scand. 2018; 97: 388-393
- Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness.Nurse Educ. Today. 2004; 24: 105-112
- Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study.Nurs. Health Sci. 2013; 15: 398-405
World Health Organisation. Caesarean section rates continue to rise, amid growing inequalities in access 2021. 〈https://www.who.int/news/item/16–06-2021-caesarean-section-rates-continue-to-rise-amid-growing-inequalities-in-access〉.
- The influence of childbirth expectations on Western Australian women's perceptions of their birth experience.Midwifery. 2007; 23: 235-247
- The relationship between prenatal control, expectations, experienced control, and birth satisfaction among primiparous women.Midwifery. 2012; 28: 39-44
- Exploring women's experiences of participation in shared decision-making during childbirth: A qualitative study at a reference hospital in Spain.BMC Pregnancy Childbirth. 2021; 21: 1-12
- Midwives' perceptions of being 'with woman': A phenomenological study.BMC Pregnancy Childbirth. 2019; 19: 1-14
- Social perceptions and bioethical implications of birth plans: A qualitative study.Clin. Ethics. 2020; 16: 196-204
- The best laid plans? Women's choices, expectations and experiences in childbirth.Health. 2014; 18: 41-59
Published online: September 19, 2022
Accepted: September 2, 2022
Received in revised form: September 2, 2022
Received: May 31, 2022
Publication stageIn Press Corrected Proof
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