School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
Women Birth. 2018 Feb;31(1):69-79. doi: 10.1016/j.wombi.2017.06.008. Epub 2017 Jun 24.
Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women's experiences of vaginal birth after caesarean can improve health practitioners' understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.
This paper reports on a meta-ethnographic review of 20 research papers exploring women's experience of vaginal birth after caesarean in a variety of birth locations. Meta-ethnography utilises a seven-stage process to synthesise qualitative research.
The overarching theme was 'the journey from pain to power'. The theme 'the hurt me' describes the previous caesarean experience and resulting feelings. Women experience a journey of 'peaks and troughs' moving from their previous caesarean to their vaginal birth after caesarean. Achieving a vaginal birth after caesarean was seen in the theme 'the powerful me,' and the resultant benefits are described in the theme 'the ongoing journey'.
Women undergo a journey from their previous caesarean with different positive and negative experiences as they move towards their goal of achieving a vaginal birth after caesarean. This 'journey from pain to power' is strongly influenced by both negative and positive support provided by health care practitioners. Positive support from a health care professional is more common in confident practitioners and continuity of care with a midwife.
对于许多经历过剖宫产的女性来说，阴道分娩是一种安全且满意的选择，但在大多数国家，阴道分娩的比例仍然很低。探索女性经历剖宫产阴道分娩的经历，可以提高卫生保健工作者对促进或阻碍女性实现剖宫产阴道分娩的因素的理解。
这篇论文报告了对 20 篇研究论文的元人种学综述，这些研究论文探讨了不同分娩地点的女性经历剖宫产阴道分娩的经历。元人种学利用一个七阶段的过程来综合定性研究。
总体主题是“从痛苦到力量的旅程”。主题“伤害了我”描述了之前的剖宫产经历和由此产生的感受。女性经历了从之前的剖宫产到剖宫产阴道分娩的“峰谷”之旅。实现剖宫产阴道分娩被视为主题“强大的我”，并在主题“持续的旅程”中描述了由此产生的益处。
女性经历了从之前的剖宫产的旅程，有不同的积极和消极体验，因为她们朝着实现剖宫产阴道分娩的目标前进。这种“从痛苦到力量的旅程”受到卫生保健从业者提供的积极和消极支持的强烈影响。来自卫生保健专业人员的积极支持在自信的从业者和与助产士的连续护理中更为常见。
