Maternal perceptions of cesarean birth care: a qualitative study to inform ERAS guideline development
Open accessAbstract
BACKGROUND: Cesarean birth (CB) is the most common inpatient surgical procedure, and until recently, there were no internationally accepted, standardized clinical guidelines available. The Enhanced Recovery After Surgery (ERAS®) program aims to improve outcomes through the development of international guidelines (IGs). As an ERAS IG for CB was being developed, this qualitative study was conducted to explore and consolidate women's experiences with CB. METHODS: Qualitative methods were used to assess the patient experience with current evidence‐based CB protocols across operative phases. Twelve women who experienced CB at a single center in Canada were interviewed using an open‐ended, semi‐structured interview guide at six weeks postpartum. Two researchers coded the emerging themes separately and compared findings. RESULTS: Women described feeling informed, but felt they did not have a choice. Presurgery, women wanted more information about the risks of CB. Preoperatively, women expressed confusion with the procedures, but felt informed about local anesthesia and thermoregulation. Post‐CB, women felt informed about pain and nausea control; however, urinary catheter removal was delayed when compared to the ERAS recommendations. Information about postpartum infant care was not well communicated, as many women were uninformed about delayed cord clamping and infant thermoregulation. CONCLUSIONS: This qualitative study provides opportunities to improve communication, the patient‐practitioner relationship, and the overall satisfaction throughout the CB process. The findings support the implementation of patient decision aids and training with the shared decision model. The improved procedures recommended in the ERAS IG for CB have the potential to deliver significant improvements to patient care and patient satisfaction.
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- Authors
- Wollny, K., Metcalfe, A., Corrigan, C., Drobot, A., Gilmour, L., Wood, S., Wilson, R. D., Gramlich, L., & Nelson, G.
- Affiliations
- University of Calgary (CA)
- Alberta Health Services (CA)
- University of Alberta (CA)
- Corresponding author
- Wollny, Krista
- ORCID
- Venue
- Birth
- Publisher
- Wiley
- Published
- 2021-06-16
- Volume
- 48
- Issue
- 4
- Pages
- 550-557
- ISSN
- 0730-7659 (ISSN-L)
- 1523-536X
- OpenAlex
- W3168934412
- Semantic Scholar
- 5d2e9b87a204107a92710482eefae9eadcfe5471
- Cited by
- 5
- References
- 30
- Citations by year
- 2025: 2 · 2023: 2 · 2022: 1
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Birth (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- cesarean section, enhanced recovery after surgery, patient decision aids, shared decision-making, patient-provider communication, patient satisfaction, postoperative care, urinary catheter removal, delayed cord clamping, infant thermoregulation, informed consent, postpartum care
- MeSH terms
- Umbilical Cord Clamping, Cesarean Section, Female, Humans, Mothers, Postnatal Care, Pregnancy, Qualitative Research, Postpartum Period
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