Department of Public Health Studies, Elon University, 100 Campus Drive, Elon, NC, 27244, USA.
Matern Child Health J. 2022 Apr;26(4):806-813. doi: 10.1007/s10995-021-03277-2. Epub 2021 Nov 3.
Women who have had a cesarean section (C-section) and become pregnant again may choose to have a planned repeat cesarean delivery (RCD) or vaginal birth after a cesarean (VBAC). This study aimed to characterize the pregnancy and birth experiences of African American (AA) women who had a successful VBAC, failed VBAC, or RCD.
Eligible participants (N = 25) self-identified as AA, had a C-section and a subsequent birth(s) in the past 12 years, and were educated past high school. Each participant was individually interviewed via phone call. The Sort and Sift, Think and Shift method was used to evaluate interview transcripts to minimize researcher bias and emphasize the voices of the participants.
The resulting themes included the impact of providers on pregnancy and childbirth satisfaction, the value of autonomy in maternal health decision-making, and the role that racism plays in AA women's birth experiences. Although some participants recalled a positive experience, the presence of limited autonomy, lack of support, and negative experiences with providers indicate that birth after a prior C-section for AA women can be improved.
Providers should address their own racial biases and utilize the shared decision-making approach when their patients decide between a VBAC and RCD to improve patient satisfaction.
曾行剖宫产术（C -section）并再次怀孕的女性可选择计划性再次剖宫产（RCD）或剖宫产后阴道分娩（VBAC）。本研究旨在描述成功 VBAC、VBAC 失败和 RCD 的非裔美国（AA）女性的妊娠和分娩经历。
符合条件的参与者（N=25）自我认定为 AA，过去 12 年内有剖宫产史和随后的分娩史，且受教育程度高于高中。每位参与者均通过电话进行单独访谈。采用分类与筛选、思考与转变方法评估访谈记录，以最大程度地减少研究人员的偏见并强调参与者的声音。
得出的主题包括提供者对妊娠和分娩满意度的影响、产妇健康决策自主权的价值以及种族主义在 AA 女性分娩经历中的作用。尽管一些参与者回忆起了积极的体验，但自主权有限、缺乏支持以及与提供者的负面体验表明，对于 AA 女性而言，剖宫产后再次分娩的体验可以得到改善。
提供者在其患者决定 VBAC 和 RCD 时应解决自身的种族偏见，并采用共同决策方法，以提高患者满意度。
