A Qualitative Study Exploring Women's Experiences of Unplanned Cesarean Surgery and Their Suggestions for Improving Care

Karen Robb, RN, MA

ABSTRACT
The rate of unplanned cesarean birth is increasing and there is a growing body of evidence regarding the
associated psychosocial harms. A phenomenological study exploring eight women's lived experiences of
intrapartum cesarean birth in Nova Scotia was undertaken. Two groups of women were recruited, three
receiving care from a midwife with transfer from a planned home birth and five women under the care of a
physician. Semi-structured interviews were tape-recorded and transcribed. These data, combined with
participant diaries and e-mails, were analyzed using Colazzi's method. Three major themes emerged: 1)
Immediate and lingering emotional reactions, which were wide ranging, the majority negative,
particularly fear, disappointment and self-doubt, 2) Mediating f actors, most significantly, continuous
contact with the baby and provider support, especially from midwives, and 3) Participant suggestions for
improving care which included prenatal operating room (OR) tours, family-friendly OR policies,
postnatal medical review with extended follow-up and peer support. This study adds to the already
substantial evidence of associated psychosocial harms which can be mediated by concurrently reducing
unnecessary cesarean surgery and implementing measures to improve the quality of cesarean care.

KEYWORDS
unplanned cesarean, midwifery care, childbirth experiences, fear, disappointment