2015/12/17 by Striebich, Sabine, Tegethoff, Dorothea
#610 Medical sciences #Beratung #Entscheidungsänderung #Medicine #Wunschkaiserschnitt #counseling #decision change #elective cesarean section #elektive Sectio caesarea
paper · doi:10.3205/zhwi000002
Background: Primiparous women who request an elective cesarean are counseled at the hospital where they want to give birth. As a result some pregnant women change their mind and aim for a vaginal birth. Objective: Exploration of the experiences of women, who requested a cesarean section but changed their mind and experienced a normal vaginal birth, with regard to the change in the decision making process and to relevant aspects of the professional advice received. Methods: Using Schütze’s method, narrative interviews with five women were conducted 10 to 24 months after their first labor. The evaluation was performed according to the ("documentary") method by Bohnsack/Nohl. Results: The participants of this study stated that sufficient time, a trustworthy atmosphere and acceptance were important aspects of the counseling session. Two women completely changed their subjective attitude and decided to attempt a normal birth rather than opt for a cesarean (subjective distancing). This change was brought about either by evidence-based information on the advantages and disadvantages of both modes of birth, or by becoming convinced of the value of experiencing a normal birth. Three women were strengthened in the belief that they were capable of giving birth normally by the assurance of individual support, effective pain control, or the explicit recommendation of a trusted expert (motivated distancing). Conclusion: Professionals such as midwifes, physicians and/or psychologists can give health promoting and preventive advice to pregnant primiparous women opting for an elective cesarean section by integrating the identified aspects of counseling and knowledge of various options in the decision making process.