Objective:

The purpose of this study was to discover a theory of how women decide to deliver their infants by cesarean section instead of experiencing a trial of labor and expected vaginal delivery when it is appropriate. The specific goals were to answer the research questions:  What is the decision-making process by which healthy, low risk women choose to deliver their babies by cesarean delivery in the absence of medical indications?  What antecedents occur to influence a pregnant woman’s decision to undergo a maternal request cesarean section?

Design:

Design: Exploratory study. Symbolic interactionism and feminism were utilized to provide a theoretical framework for the study. The grounded theory methodology by Strauss and Corbin, (1990) was used to develop the core category, context, antecedents, intervening factors and consequences.

Setting

Setting: Knox and Sevier Counties in East Tennessee

Patients/Participants:

Participants:

Seven women underwent in-depth interviews. To qualify for the study, the women had to be healthy and low-risk, had an elective cesarean section within the last two years, be 18 years or older and reside in East Tennessee.

Methods:

Methods:  Grounded Theory Methodology by Strauss and Corbin (1990)

Results:  

Results:

From the data, a substantive theory was identified, “Having an elective c-section: Doing what’s best.” Mothers voiced that they felt like having a c-section was best for them and their baby. The antecedents of the women’s decision were being scared and perceiving a cesarean section as an easier way to give birth. Women made this choice after gathering information and seeking support from health care providers, friends and family within the context of progressing through the pregnancy. Intervening facilitating factors included receiving support from others and the ability to schedule the c-section. Hindering factors were non-supportive people and inappropriate medical information. Once the decision was made and the cesarean section was performed, the women voiced happiness with their decision.

Conclusion/Implications for nursing practice: The findings of this study may assist office nurses, public health nurses, midwives and advanced practice nurses, childbirth educators and other women’s health nurses to educate  women that childbirth is a normal process and vaginal birth can be achieved in most women safely and educate women on the risks/benefits of both birthing options.  Recommendations are given for further research.

Keywords:  Elective cesarean section, cesarean section, childbirth