Date of Award
Spring 2014
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Nursing
First Advisor
Hanson, Lisa C.
Second Advisor
VandeVusse, Leona
Third Advisor
Harrod, Kathryn S.
Abstract
Women's perspectives of their experiences are important, and worthy of study. However, there have been no qualitative comparative investigations of vaginal birth after cesarean (VBAC) experiences of American women using their birth stories as data. Furthermore, there have been no studies where women's experiences of cesarean have been compared with their own subsequent VBAC.
The purpose of this study was to gain insight into the comparative experience of VBAC and cesarean, valuing women and their experiences through the use of a feminist research perspective. By contributing new and valuable insight into an area of research that has been identified as a "critical gap in the evidence" by the National Institutes of Health, the overall purpose of this study was to improve the health care of women.
A purposive sample of 13 women was obtained. Participants shared their stories of cesarean and VBAC during audiotaped interviews. Demographic information was obtained including indications for the prior cesarean, time since cesarean and VBAC, and the type of healthcare provider that attended their VBAC.
During data analysis, four themes emerged. These themes included perspectives on cesarean, informed decision making, perspectives on VBAC, and cesarean resolution. In addition, 21 subthemes were identified.
Participants described their cesarean as being unexpected/unwanted, often accompanied by feelings of failure and memory loss. The cesarean and recovery periods were accompanied by unexpected levels of intense pain, difficulty with breastfeeding, decreased mobility, and dependence on others. Women described their VBACs as universally positive experiences that were psychologically, emotionally, and/or physically beneficial. This positive impact was not limited to the time of the delivery and postpartum recovery, but was a healing experience that brought profound change to lives of the women.
By listening and learning from women, healthcare providers can become enlightened as to the significance of birth in the lives of women. This can serve as a catalyst for changing attitudes towards birth, empowering women to have positive birth experiences, whether vaginal or cesarean.