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How Does Standardized Prenatal Counseling Affect Women's Choices About Their Mode of Delivery After Cesarean?

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In Folder: Nursing Practice, Ph.D.

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How Does Standardized Prenatal Counseling Affect Women's Choices About Their Mode of Delivery After Cesarean?

Chinkam, Somphit - Dissertation

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title: How Does Standardized Prenatal Counseling Affect Women's Choices About Their Mode of Delivery After Cesarean?

creator: Chinkam, Somphit

subject: Dissertations, Academic.

description: In previous research, it has been shown that women with a prior cesarean who received prenatal counseling on modes of delivery options were more likely to plan a trial of labor after cesarean (TOLAC). This counseling, however, has not been not standardized during prenatal visits even though it enhances a shared decision making between the woman and the provider. Both the shared decision making and the midwifery model of care were used to guide this study. The purpose of this study was to create and evaluate a standardized counseling tool for women who were eligible for a TOLAC. The research question was how does standardized prenatal counseling affect the following: 1) the rate of TOLAC and vaginal birth after cesarean (VBAC); 2) women’s preferences and rationale for choosing the modes of delivery; and 3) womens’ satisfaction with care. The hypothesis was that women who received the standardized prenatal counseling would be more satisfied with their care, more likely to choose TOLAC, and would have an increased success rate with VBAC. The study was conducted using a quasi-experimental design and a satisfaction survey. The settings were the prenatal clinics affiliated with Boston Medical Center (BMC). The participants included a convenience sample of 22 women who were candidates for TOLAC, and cared for by the midwifery service prenatally. The comparison group included a retrospective chart review of 72 midwifery prenatal patients from 2011. Research findings indicated: 1) the intervention group had a slightly higher VBAC rate; 2) were more likely to have their birth attended by midwives; 3) women’s decisions were influenced most by their midwives, and secondly by their partners; 4) the counseling tool received relatively high ratings, and women were mostly satisfied with the care received; 5) faster recovery time was the most cited reason for choosing TOLAC, while fear of birth and knowing when the baby would be born were most cited reasons for scheduling elective repeat cesarean delivery (ERCD). The study concluded that standardized counseling may provide women with enough information to make a decision on mode of delivery increase satisfaction with the care received, and increase the number of VBAC’s attended by midwives. This model could be replicated on a large scale with the goal to improve the VBAC rate using the midwifery model of care for women with previous cesarean delivery.

publisher: Simmons College (Boston, Mass.)

contributor:

date: 2014

type: Text

format: 1 PDF (185 Pages)

identifier: td_np_2014_sc

source:

language: English

relation:

coverage:

rights: Material from the Simmons University Archives collections are made available for study purposes only. For more information, or to request rights to reproduce or reuse any material, contact the University Archives at archives@simmons.edu.

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