Grant: Operating Grant

Repeat cesarean sections (c-section) are a major contributor to the high rate of c-sections in Canada. Planned repeat c-sections that are not medically indicated are associated with increased risks to maternal and newborn health, increased cost to the health care system and added strain on the already existent shortage of maternity care providers. The majority of women with a previous c-section are eligible for a trial of labour leading to a vaginal birth; yet the number of women opting for this choice has dropped by half over the last decade (CIHI, 2011). Our study examines the factors pregnant women who have had a previous c-section consider when deciding on delivery method. We will also examine issues maternity care providers consider in counseling pregnant women on method of delivery. The study will implement in-depth interviews with pregnant women who have had a previous cesarean section to explore factors they consider when deciding their preferred delivery method. Similarly, we will interview maternity care providers about issues they consider when counseling pregnant women about method of delivery. Two surveys will be developed based on the interview findings. The first survey will be distributed to a representative sample of pregnant women with previous c-sections to evaluate under what circumstances they would decide to have a trial of labour over an elective repeat c-section. The second survey will be delivered to a representative sample of maternity care providers to examine under what circumstances they would counsel women to attempt a trial of labour or an elective repeat c-section. The study findings will provide important new knowledge for policy makers, maternity care planners and providers to inform the ongoing development of safe and effective strategies to address the high rates of c-section in Canada.