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Title: Mode of delivery after caesarean section : an investigation of offspring risks and factors influencing women's attitudes towards delivery options
Author: Black, Mairead
ISNI:       0000 0004 6353 1845
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2016
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Over 18 million caesarean sections (CS) are performed around the world each year, with many being planned repeat CS which may lack absolute indications. Abdominal delivery on this scale demands an appreciation of the lasting impact, positive or negative, on the health of women and children. Maternal outcomes of planned CS birth have been extensively investigated, but knowledge of outcomes for offspring is largely limited to those occurring in the neonatal period. Avoiding labour and vaginal birth may protect offspring from birth injuries, but could also adversely affect their later health due to avoidance of physiological processes which aid immunity and gut function. Concern that CS may compromise offspring health has arisen from studies which demonstrate an increased risk of chronic health problems following CS compared with vaginal birth. However, the clinical implications of existing studies are unclear due to high risk of selection bias, confounding and lack of power. Studies which can overcome these issues are required. Studies focusing on offspring of women with a history of CS mean the risk of confounding by indication for CS is minimised, as the majority of repeat CS are planned due to maternal preference rather than medical indications. At present, it is not known whether perceived offspring health outcomes of mode of delivery drive women's birth choices after a previous CS, and if so, whether such beliefs reflect evidence-based information on offspring risks. The existing literature highlights a number of factors that may play a role in shaping these birth choices, but no studies have attempted to identify beliefs which independently predict birth preferences after a CS. Such a study has potential to identify key beliefs to target in future interventions designed to optimise women's birth choices. This project investigated both the health of offspring delivered by planned repeat CS and women's beliefs which predict their preferred mode of delivery after CS. Offspring health was investigated using a population-based cohort study. Pregnant women's beliefs about birth after CS were investigated using a synthesis of qualitative literature and a theory based interview and questionnaire study.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Delivery (Obstetrics) ; Cesarean-born children ; Pregnant women