Using a scheduled caesarean birth plan: A cross-sectional exploration of women's perspectives

Abstract

Problem: There is minimal evidence regarding the role or impact of birth plans from the perspective of women experiencing scheduled caesarean birth.

Background: Quality maternity care requires respect for women's preferences. Evidence suggests birth plans enable communication of women's preferences and may enhance agency when vaginal birth is intended, however there is limited evidence of how this translates in the perioperative environment where caesarean birth is the intended outcome.

Aim: Explore the experiences and perspectives of women who had utilised a scheduled caesarean birth plan at an Australian tertiary maternity hospital.

Methods: A cross-sectional design was used; 294 participants completed the survey within two weeks post-birth. Descriptive statistics were used to analyse quantitative data, qualitative responses were analysed using content analysis.

Findings: Over half of the women requested lowering of the surgical-screen at birth, most requested immediate skin-to-skin with their babies; around two-thirds of these preferences were met. Use of a birth plan for scheduled caesarean section supported women's ability to communicate their desires and choices, enhancing agency and reinforcing the significance of the caesarean birth experience. Qualitative data revealed two main categories: Perceptions and experiences; and Recommendations for improvement, with corresponding sub-categories.

Discussion: Findings provide unique opportunities to consider the provision of woman-centred care within the highly technocratic perioperative environment.

Conclusion: All women, regardless of birth mode, have a right to respectful maternity care that prioritises their wishes and agency. This study provides evidence for the positive utility of birth plans in caesarean birth, local adaptation is encouraged.

Keywords: Birth plan; Caesarean birth; Caesarean section; Maternal choice; Perioperative; Woman-centred.