The study aims to identify and explore the non-clinical and clinical factors that influence the decision to perform CS in nulliparous women and the postpartum morbidities experienced by women following birth by CS.
1) To identify the combination of pre-pregnancy, antenatal and intrapartum factors, non-clinical and clinical, and possible patterns, associated with birth by CS in 2,600 nulliparous women in Ireland.
2) To identify the postpartum morbidities experienced by nulliparous women who birth by CS and compare these to morbidities experienced by women who birth vaginally.
3) To explore, from the perspectives of women (n=20-25), midwives (n=10-12/13) and obstetricians (n=10-12/13), the factors influencing the decision to perform a CS in nulliparous women. This will be achieved using a mixed methods design in two phases. In phase 1, the quantitative phase, data will be collected using self-completed surveys antenatally and at 3, 6, 9 and 12 months postpartum and from hospital records of consenting women. Phase 1 serves as a vehicle to access women for the phase 2 interviews. In phase 2, the qualitative phase, in-depth interviews will be used to explore women’s and clinicians’ perspectives of the factors that influence the decision to perform CS. Descriptive and inferential statistics will be used to identify combination of factors, non-clinical and clinical, associated with CS and morbidities post-CS compared to those reported by women birthing vaginally. Thematic analysis will be used to explore the factors that influenced the decision to perform CS from the perspectives of women, midwives and obstetricians.
Understanding the complexities of factors that contribute to the decision to perform CS in nulliparous women, and awareness of the impact of CS on women’s postpartum health, has the potential to help reduce the rate of CS in nulliparous women and ultimately reduce the number of repeat CSs in multiparous women.
