Concern and worry: The experience of nulliparous women choosing an elective caesarean section

Choosing an elective caesarean section as an option for birth is a contentious issue that has attracted worldwide attention. An increasing number of New Zealand women are choosing this method for the birth of their babies. Different dimensions of the issue have been investigated and factors other than medical necessity play an important play an important role in the decision to perform an elective caesarean section. A qualitative study using van Manen's (1990) method of hermeneutic thematic analysis has been designed to answer the question: How do nulliparous women choose an elective caesarean section and what is their experience of that choice? Eight nulliparous women who had given birth in the previous 1-23 months were interviewed and the data were analysed to uncover the meaning of how the women came to the decision to choose an elective caesarean section and their experience of carrying through with that decision. The two data chapters that contain extracts from the transcripts of the interviews illustrate some of the motivation for requesting an elective caesarean section without medical justification. The notion of concern and worry about the potential jeopardy to the baby causes some women to want to take the risks upon them selves. Belief in the unpredictability of natural birth leaves some women considering they would be unable to cope with the intensity of the pain. The unknown length of the labour and the stamina required of managing such an endurance provided the impetus for nulliparous women in this study to seek a caesarean section. Thinking back, forward and around the experience gave insight to the aspects of the experience of the birth. The women related their experience of being left without adequate preparation for the birth. They were disappointed they had missed out on at some aspects of a natural birth. Their own anticipated depiction of birth left some women feeling inadequately prepared. For the Health Provider there is a dilemma between giving birth information that could be alarming to the women and encouraging women to attempt a natural birth. By listening, rather than judging them, we can share women's ways of being in the world