Factors Associated with the Rise in Repeat Cesarean Deliveries

Abstract Background: Women choose elective repeat cesarean deliveries as opposed to vaginal birth after cesarean (VBAC’s) based on various reasons and these choices are most often made without adequate education from healthcare professionals. Objectives: The purpose of this integrative literature review is to determine why there is a continuing rise in elective repeat cesareans and whether women in the United States are being routinely informed of VBAC’s based off of their decision for the mode of delivery. Method: An integrative literature review was conducted using the databases of CINAHL, PubMed, ProQuest Nursing and Allied Health, and other studies from journals that include American Journal of Obstetrics and Gynecology, Journal of Midwifery and Women’s Health, and Midwifery Journal. Search terms included: cesarean rates, repeat cesarean rates, elective repeat cesarean delivery, United States, vaginal birth after cesarean, VBAC risks, repeat cesarean risks, reduction strategies, education, and knowledge of VBAC’s. A total of 12 articles were reviewed. Results: Five major reasons why women choose elective repeat cesarean deliveries were identified. These reasons include: a lack of knowledge on VBAC’s, comfort with previous birth mode, choosing the provider’s preference, fear of pain during childbirth and scheduling preferences. A lack of education amongst expecting mothers has been shown to contribute the most to the rise in cesarean deliveries in the U.S. Conclusion: Further research needs to be done to help identify how educating expecting mothers on the possibility of a successful VBAC versus a repeat cesarean delivery will help them make a more thorough and more informed birthing mode decision, thereby potentially decreasing the rise in repeat cesarean deliveries