Perspectives, Decision Making, and Final Mode of Delivery in Pregnant Women With a Previous C-Section in a General Hospital in Peru: Prospective Analysis (original) (raw)
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BMJ, 2007
Alan A Montgomery, senior lecturer in primary care research, 1 Clare L Emmett, trial coordinator, 1 Tom Fahey, professor of general practice, 2 Claire Jones, research assistant, 3 Ian Ricketts, professor of assistive systems and healthcare computing, 3 Roshni R Patel, specialist registrar in obstetrics and gynaecology, 4 Tim J Peters, professor of primary care health services research, 1 Deirdre J Murphy, professor of obstetrics, 5 on behalf of the DiAMOND Study Group ABSTRACT Objectives To determine the effects of two computer based decision aids on decisional conflict and mode of delivery among pregnant women with a previous caesarean section. Design Randomised trial, conducted from May 2004 to August 2006. Setting Four maternity units in south west England, and Scotland.
The Process of Women’s Decision Making for Selection of Cesarean Delivery
2009
Background and Aim: Although cesarean section has been considered as a way for reducing infant and mother mortality rate, it has been changed to a general dilemma, so that in Iran, cesarean rate is higher than World Health Organization standards. The aim of this study was to discover the process of decision making for selection of cesarean delivery by those whodid not have indication for cesarean. Material and Method: Twenty six pregnant women, experiencing the third trimester, were selected based on purposeful and theoretical sampling. For access to participants, the researcher referred to one teaching health care centers of Iran University of Medical Sciences and two private offices of gynecology in Tehran, Iran. The data were collected by semi-structured interviews. All data were audio taped and transcribed. Data collection and analysis was performed simultaneously. Constant comparative method was used to analyze data. Results: The main categories were "fear due to not having knowledge", "being painless, and physical and spiritual peace" and "unpleasant experience of others and their encouragement", "being worry of complications", "inappropriate communication of health care staff", and "the feeling of loneliness and death", "infant's health". Constant analysis of data revealed that women get through for creation balance in order to receipt the best result, process of to consider, making a lawful and to choice. Conclusion: Attentive to main theme that it is fear of labor and delivery is a physiology phenomenon. It is necessary to encourage methods for relieving pain and fear and for promoting self-esteem in order to make good decision by pregnant women. It is also important to encourage women for vaginal delivery.
Health Expectations, 2007
Objective To develop and pilot two computer-based decision aids to assist women with decision-making about mode of delivery after a previous caesarean section (CS), which could then be evaluated in a randomized-controlled trial. Background Women with a previous CS are faced with a decision between repeat elective CS and vaginal birth after caesarean. Research has shown that women may benefit from access to comprehensive information about the risks and benefits of the delivery options. Design A qualitative pilot study of two novel decision aids, an information program and a decision analysis program, which were developed by a multidisciplinary research team. Participants and setting 15 women who had recently given birth and had previously had a CS and 11 pregnant women with a previous CS, recruited from two UK hospitals. Women were interviewed and observed using the decision aids. Results Participants found both decision aids useful and informative. Most liked the computer-based format. Participants found the utility assessment of the decision analysis program acceptable although some had difficulty completing the tasks required. Following the pilot study improvements were made to expand the program content, the decision analysis program was accompanied by a training session and a website version of the information program was developed to allow repeat access. Conclusions This pilot study was an essential step in the design of the decision aids and in establishing their acceptability and feasibility. In general, participating women viewed the decision aids
BMC Pregnancy and Childbirth, 2009
The rate of caesarean sections is increasing worldwide, yet medical literature informing women with uncomplicated pregnancies about relative risks and benefits of elective caesarean section (CS) compared with vaginal delivery (VD) remains scarce. A decision board may address this gap, providing systematic evidence-based information so that patients can more fully understand their treatment options. The objective of our study was to design and pretest a decision board to guide clinical discussions and enhance informed decision-making related to delivery approach (CS or VD) in uncomplicated pregnancy.